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Caregiving for Adults with Intellectual or Behavior Issues: How to Diffuse Tension

Working with people who have intellectual disabilities or behavioral issues can be challenging, Daisy Williams takes steps to minimize stressors in the lives of those she cares for. She has been a direct care professional who provides care for individuals who live in Casmir Care’s Community Residential homes for eight years and counting.

Her work involves direct caregiving. The individuals she works with have cerebral palsy, intellectual disabilities, schizophrenia and/or bipolar disorder. She helps them with activities of daily living such as eating, bathing, dressing, continence and instrumental activities of daily living such as cooking, caring for pets, completing housework, and using the phone.

When caring for individuals in Casmir Care Services’ Community Residential Homes, she has noticed that sometimes what people watch on television can set them off. Someone who is fully bipolar, schizophrenic, or both, may think everything happening on “Jerry Springer” is about himself or herself. The individual may react to what they see by saying, “I don’t have any gun,” Daisy said.

 

(Residential Associate Daisy Williams demonstrates the “soft face” she uses to calm  residents down.)

Avoiding Triggers

“So, you have to be really careful about what you put on the television,” she said. Sometimes something said on TV triggers something in their memory. Then the individual may react to it by becoming sad or violent or having an outburst. “And you have to know them to be able to understand what just happened to them, so you can diffuse it,” she said.

When individuals in care are accidentally exposed to things that trigger them, Daisy’s standard procedure is to proceed with caution. “The most important thing I do is stay calm and do not speak until I’m sure that they’re ready to be approached,” she said.

As direct care staff, you must be sure it’s the best time to approach the individual. Sometimes, it is safer to not move and first carefully assess the situation.

Diffusing Tension

“And you try to look in their eyes softly,” she said. Make your eyes soft so that you can melt their heart, she advised. “Then they’ll open back up to you,” she said. “But you have to be able to do that.”

When pressed for more details, she said to put on a soft face with puppy dog eyes. You might say something like: “I feel your pain. Tell me what you need. I wish I could make it go away.” Watch the person’s body language. Once they relax, perhaps unballing fists and you see the tension drop away from the person’s body, it will be easier to approach the individual. Then you gently say, “That was then. We’re here for you.”

Mental Redirection

If a resident is having problems that day, Daisy tries to ease them into working toward having a better day tomorrow. The idea is to keep them focused on what’s ahead and the good things in their life as opposed to whatever they were voicing concern about. She might bring up something fun they did in the past, like going to Dave & Buster’s, and suggest doing it again. The mental redirect gives them something else to think about, she explained.

Those under care trust Daisy to understand their needs. “I’m more of a mom caretaker”, she said.

As director of operations here at Casmir Care Services, I know that Daisy has a great sense of intuition that helps her manage our individuals’ needs with ease. Her antennae are always out, trying to a get a read on how they are feeling. She has the patience, flexibility, compassion, and empathy required to deal with the individuals we support. She has demonstrated this consistently over the years and with a cross-section of the individuals we support. Our individuals are lucky to have her help them through their days.

Resources
How to support a loved one during a psychotic episode
Solving problems can enhance resilience and improve adjustment
Being an effective caregiver
Caregiver and schizophrenia: How to handle the psychosis

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