Dr Alice Rota-Bartelink - - PowerPoint PPT Presentation

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• Dr Alice Rota-Bartelink

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Australian Standards

2 standard drinks per day 2 alcohol-free days per week Even less for older adults

(www.betterhealth.vic.gov.au)

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• Homelessness
• Premature Ageing
• Little or no family or friends
• Limited finances
• Self Neglect & malnutrition
• Traumatic injuries and assaults
• Social Isolation
• Coexisting mental illnesses
• Guardianship and Administration Orders
• Complex/Challenging behaviours
• Imprisonment and Institutionalisation
• Acquired Brain Injury –alcohol and other
• Ongoing addictions –alcohol, other drugs, gambling
• Reluctant to seek appropriate, timely medical care & poor

compliance

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• Services – Overview
• 5 Residential Aged Care Facilities

(+ 1 currently in development)

• 226 Housing Units (+ 176 units

currently in development)

• 2 Rooming Houses
• CACPs, EACH & EACH Dementia

Packages (439 individuals)

• Outreach Services (140 individuals)
• Recreation Program
• >350 staff

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In October 2006 Wintringham was awarded a $900,000 J.O and J.R Wicking Trust Research grant administered by ANZ Trustees to develop and trial a specialised model

• f care to support older people living

with an acquired brain injury (ABI), in particular older homeless people with challenging behaviour as a result of an alcohol related brain injury (ARBI). This grant was the largest ever awarded by The Wicking Trust and regarded as a flagship project.

Older People with Acquired Brain Injury and Associated Complex Behaviours: A Psychosocial Model of Care

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15 Care providers/ Agencies Consultancy Employment Agencies Training Organisations Community Care Networks & Partnerships Dementia-specific Services A.C.A.S & Support Services Fire Consultancy Consultancy C.A.L.D Disability Support M.A.C.N.I Dental Allied Health Residential Care Detox & Rehab G.Ps Police O.P.A Social Specialised Services Education & Employment Aged Care Alcohol & Drugs Justice Emergency Services S.R.S Emergency Dept. Hospital Ambulance State Trustees Prisons Office of housing Courts Supported Crisis Services & Accommodation Outreach Contact Tracers Centrelink Grants & Funding Research & Development A.T.S.I Veterans Affairs Housing Income Support Physical Health Homelessness Case Management Case Management Disability Services Case Management Mental Health Assessment Services Acquired

Brain Injury

Assessment Services

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• 1. The PERSON with ARBI is “difficult,”

“hard to manage,” or even “aggressive”

• 2. Caregivers attempt to

change the PERSON’s behaviour

• 3. If they aren't successful,

the PERSON may be labeled: “Problem person” - “Impossible” - “Mean” - “Unappreciative” - “Manipulative” - “a Pain”

• 4. No new interventions are

tried because THE PERSON IS the "PROBLEM"

• 5. Caregivers “cope” by

ignoring or avoiding the PERSON

• 6. The PERSON is NOT

comforted or assisted and behaviours become more intense

• 7. Caregivers feel

even more distressed and frustrated by the behaviours

• 8. Caregivers avoid,

ignore, or even "fight back" 9.The PERSON’s behaviour continues, and often becomes even more intense

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2 4 6 Average Change Over Time HADS-Depression HADS-Anxiety No of Liferoles CIQ-Home Integration CIQ-Social Integration CIQ-Productivity CIQ-Overall AUDIT Life Satisfaction HONOS-Total OBS-Clusters OBS-Total NPI-Severity No of Drinks No of Cigarettes Control Wicking

23 Challenging Behaviour

5 10 15 20 25 30 35 40 45 Time 1 Time 2 Time 3 Time 4 Time 5

• No. of Incidents

subject 1 subject 2 subject 3 subject 4 subject 5 subject 6 subject 7 mean Estimated Pre-Trial Average

Frequency of Incidents of Challenging Behaviours Overall among Wicking Participants Over Time (F= 4.820, p=0.008)

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