2/8/2011

1

The Mood Ring Theory

Understanding how mood can

influence behavior for folks

living with memory loss and

other special needs

Survey Says… Statistics suggest that

1. # of persons experiencing cognitive loss entering

our service over the next X years is around _____.

2. A high degree of persons with cognitive loss will

present with challenging behavior.

3. This will require a substantial increase in staff

trained and prepared to support persons with

challenging behavior.

4. Of the # move-out notices in RALF licensed

communities in the last year, about ____% are

related to challenging or unsafe behavior.

Setting the Stage

Synonymous with “Mood”

• Frame of Mind

• Disposition

• Status

Status can be reasonably predicted by

the set of behavioral symptoms

exhibited by the person at that time.

2/8/2011

2

Things that make you go

?HMMM?

For people who have compromised ability to

communicate, their behavior may be

1. The only way THEY have of telling us how they are

doing or what they need

and

1. The only indicator WE have of knowing how they

are or what they need

During our time together…

We will gain understanding of how:

• To identify behaviors associated with fluctuations in

a person’s mood or status.

• Adjusting our approach based on what we are

observing can prevent and/or decrease escalation.

• Individualized Person Centered Care can impact a

person’s well being on a daily basis (perhaps even

moment by moment basis) and the behavior that

comes out the other side.

Coming soon to a

classroom near you

“Toto, I don’t think we are in Woodstock

anymore”

Mantra for Functional Analysis of Behavior

• What do I not know?

• Get yourself informed.

• See it clearly.

2/8/2011

3

Quality of Life

Behavior

Quality of

Life

That by…

• Recognition of mood

fluctuations for a specific

person

AND

• Understanding what

might be influencing

them

AND

• Adjusting our support

and approach

accordingly

We will…

• Enhance quality of life.

• Reduce the # of incidents

of challenging behavior.

• Reduce the severity and

intensity of challenging

behavior.

• Improve our staff’s ability

to adjust their approach

based on their

observations.

I would like to suggest

Our Journey through History

How 70’s technology

has influenced

our 21st century thinking.

2/8/2011

4

From Then to Now

Behavior Modification/Management

• Techniques that influence behavior in a decided

direction.

Positive Behavior Support

• All behavior has meaning – It occurs for a reason.

Behavior is communication.

• Through careful analysis, we identify the meaning

and contributing factors .

• Make adjustments in service and support to address

factors identified in our analysis.

Behavioral Approach at a Glance

A B C

Antecedent Behavior Consequence

All behavior occurs in a sequence.

Antecedents

• Any noticeable event that happens

immediately before the behavior

occurs.

• Could also be called a cue or a trigger.

• Could also be called “the last straw.”

2/8/2011

5

Behavior (by definition)

• A response that happens after an

antecedent or cue.

• An observable and measurable action

that a person does to achieve what they

want or need in a particular situation.

A More Useful Definition

Behaviors are actions performed by a

person in an effort to meet their needs

or wants needs in a particular

circumstance.

Behavior is “what we do.”

Consequences (by definition)

• The result.

• What happens immediately after the

behavior occurs.

• What the person gets (or expects to

get) as a result of the behavior.

• What the person avoids (or hopes to

avoid) as a result of the behavior.

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6

Behavioral Voodoo in the 70’s.

A B C

Antecedent Behavior Consequence

• We addressed the consequences.

Pitfalls

• Didn’t address the cause of the behavior.

• Didn’t teach a new way to get needs met.

• Deals with the behavior “after” it occurs.

• All effort and time is spent in the reactive “portion of

the program.”

And… if we are going to spend the time addressing it

anyway, it makes sense to spend most of it on the

front end.

The next step in our journey

A B C

Antecedent Behavior Consequence

• We started evaluating antecedents.

• We started teaching new skills/new

ways for people to get their needs met.

• We continue to reinforce the positives.

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Our next step in time…

SE A B C

Setting Events

• Identification of stressors and pre-sets.

• Taking measures to eliminate barriers.

• Adjustment of our supports and

approaches.

Status Status 1 – What does the person look like or

behave when they are “in a good mood” or

when things are going well.

Status 2 – What does the person look like or

behave when something is up, things aren’t

bad but not great.

Status 3 – What does it look like when the

person is not doing well at all or “in crisis.”

So… What’s next?

We now know how to IDENTIFY the

fluctuations in “status.”

What are we going to do about it?

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Status 1

Our Goal: To support them to maintain it.

1. Honor routines

2. Favorite activities

3. Favorite conversations

4. Must haves (non-negotiables)

Status 2

Our Goal: To address the need and

return to Status 1.

1. Evaluate possible reason(s)

2. Work to address those reason(s)

3. Adjust expectations/requests

Status 3

Our Goal(s): Assure safety, address

need and return to Status 1

1. Evaluate risk and respond accordingly

2. Avoid power struggles/reduce

requests

3. Evaluate possible reasons and

address

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9

Package it up!

• Service Planning

• Behavior Support Strategies

• Data Collection

Quality of Life

Behavior

Quality of

Life

Tips and Take-Aways

• Increase attention

• Proper introductions

• Train for understanding

– We are more alike than we are different

– 1 person rule

– ALL behavior has meaning

2/8/2011

10

Changing Minds PBS

www.changingmindspbs.com

www.atcbs.org

Laura Larson