Behavior Management Techniques Requiring Prior Approval

The following are techniques which may be used in certain circumstances, after you and the case manager, along with the client and other appropriate individuals, develop a plan to address client behavior:

• Use of mechanical restraints, including lap or wrist belts/straps.
• Use of manual restraint in which bodily contact is utilized to manage behavior.
• Administration of medication to address combativeness, anxiety, or night-time wandering.
• Use of “time outs” in bedroom or other common space.
• Restriction of senses in certain circumstances, such as placing headphones on resident in order to play music, or placing hands in front of eyes for a limited amount of time.
• Deprivation of food or drink temporarily if food cannot be consumed without combative or disruptive behavior.
• Inspection of room or belongings for restricted items, e.g. cigarettes.
• Whenever you are using techniques approved in a plan, and are unsure of whether a response is appropriate, please contact the case manager.

All copy on this page has been reprinted from the Anoka County Adult Provider Handbook.

Techniques for promoting positive behavior in Adult Care

Use the following techniques to encourage positive behavior:

• Examine behavior objectively to see if it needs changing. It may not be harmful to the resident and may be appropriate, given the client’s capabilities.
• Listen to the resident.
• Plan and implement activities that match the interests and abilities of the resident. These activities may be social or related to skills development, or have other purposes beneficial to the resident.
• Allow resident to wander in a supervised fashion if it is beneficial to or reduces stress for the resident. Walk with resident if assistance is needed, or monitor if resident is medically able to walk without assistance. This may include wandering outside if properly supervised.
• If resident is agitated or upset, try to redirect attention to another object or topic. Changing the subject or calming the resident in a caring and compassionate manner may help reduce agitation.
• If resident is demonstrating inappropriate behavior, make effort to redirect behavior or guide resident to more appropriate behavior or activity.
• Give positive feedback to resident and reinforce appropriate behavior. Praise resident.
• Model positive behavior to resident. Act appropriately and encourage all other household members to demonstrate positive behaviors.
• Use positive reinforcement. An incentive or reward program may help encourage positive behavior. Demonstrate through chart or other visual system.
• Talk to other providers. They may be able to give you some insight about the behavior or have some helpful ideas.
• Prohibited Behavior Management Techniques
• The following are inappropriate responses to challenging behavior. They are not to be used at any time:
• Activities defined as maltreatment under Vulnerable Adult Act. This includes corporal punishment, including hitting, pinching, slapping or biting. This also includes speaking in a manner that ridicules, demeans, threatens or is abusive. For further information about the Vulnerable Adult Act, please see information distributed by your licensing worker or contact your county’s Adult Protection Worker.
• Placement of resident in locked room as means of restraint or punishment.
• Restriction of resident’s access to nutritious diet, drinking water, hygiene facilities, normal sleeping conditions, or necessary clothing.
• Denial of access to client’s relatives, visitors or legal counsel, either in person or by telephone.
• Physical punishment involving requiring resident to stay in fixed position.
• Placement of resident in seclusion.
• Use of intense sounds, lights, or other sensory stimuli to manage behavior.
• Use of noxious smell, taste, or substance to manage behavior.
• Denial or restriction of access to equipment including wheelchairs, walkers, hearing aids or communication boards, unless emergency situation requires this. Please consult the case manager to determine which situations warrant this type of restriction.