{"id":502,"date":"2016-12-20T00:04:56","date_gmt":"2016-12-20T00:04:56","guid":{"rendered":"http:\/\/www.cddh.monashhealth.org\/?page_id=502"},"modified":"2017-01-25T03:10:29","modified_gmt":"2017-01-25T03:10:29","slug":"behaviour-change","status":"publish","type":"page","link":"https:\/\/cddh.monashhealth.org\/index.php\/medical-practitioners\/behaviour-change\/","title":{"rendered":"Behaviour Change"},"content":{"rendered":"[mk_page_section bg_image=&#8221;https:\/\/cddh.monashhealth.org\/wp-content\/uploads\/2016\/11\/medical_practitioners.jpg&#8221; attachment=&#8221;fixed&#8221; bg_position=&#8221;center center&#8221; bg_repeat=&#8221;no-repeat&#8221; bg_stretch=&#8221;true&#8221; enable_3d=&#8221;true&#8221; video_color_mask=&#8221;#2a363b&#8221; video_opacity=&#8221;0.5&#8243; min_height=&#8221;350&#8243; el_class=&#8221;banner-border-pink&#8221; sidebar=&#8221;sidebar-1&#8243;][vc_column][mk_padding_divider size=&#8221;200&#8243;][mk_fancy_title color=&#8221;#ffffff&#8221; size=&#8221;32&#8243; font_weight=&#8221;300&#8243; txt_transform=&#8221;uppercase&#8221; letter_spacing=&#8221;1&#8243; font_family=&#8221;none&#8221; align=&#8221;center&#8221;]Behaviour Change[\/mk_fancy_title][\/vc_column][\/mk_page_section][mk_page_section section_layout=&#8221;left&#8221; padding_top=&#8221;0&#8243; padding_bottom=&#8221;0&#8243; sidebar=&#8221;sidebar-1&#8243;][vc_column][vc_row_inner][vc_column_inner][vc_column_text]People with difficulty communicating with words may express their discomfort or distress through changes in their behaviour. A change in someone\u2019s behaviour may therefore reflect physical illness, disorder of mental health, sensory changes (vision or hearing loss) or a change in their social, physical or sensory environment. A thorough history and detailed physical assessment of the patient are required for accurate diagnosis.<\/p>\n<p>Assessment and Management are based on the following considerations:<\/p>\n<ul>\n<li>Consider SAFETY does the behaviour constitute a serious risk to your patient or to others?<\/li>\n<li>Is there an underlying MEDICAL diagnosis?<br \/>\nConsider pain and other symptoms: g. Gastro-oesophageal Reflux Disease(GORD), constipation, Urinary Tract Infection, musculoskeletal pain including pathologic fracture, itch, nausea\u00a0etc<\/li>\n<li>Is there a PSYCHIATRIC diagnosis?<br \/>\nConsider anxiety, depression, psychosis, bipolar disorder and other disorders of mental health<\/li>\n<li>Have ENVIRONMENTAL, changes in life circumstances or other triggers been identified and addressed? Consider changes in home, work, recreation, social activities. Consider changes in family, friends, co-residents staff \u2013 particularly experiences that may lead to loss and grief.<\/li>\n<li>Have SENSORY issues been identified and addressed? Consider sensory loss (vision, hearing) and sensory sensitivity (noise, light, touch, taste, texture)<\/li>\n<li>Is MEDICATION required?<br \/>\nThe indications for the use of medication to address underlying medical or psychiatric issues are the same as those for the general population.<\/li>\n<\/ul>\n<ul>\n<ul>\n<li>The use of medications primarily to modify \u00a0behaviour should only occur after<br \/>\nthe exclusion of underlying diagnoses and consideration of environmental and other triggers or in situations where the behaviour presents a significant danger to the person or others. Such use of medication is a chemical restraint, must only be used for a defined period of time while other strategies are put in place, and must be regularly reviewed.<\/li>\n<li>Have you reviewed all medications? Does the person\u2019s demeanour or behaviour suggest any adverse effects?<\/li>\n<li>What NON-PHARMACOLOGIC interventions might be effective in place of or as well as medications?<\/li>\n<\/ul>\n<\/ul>\n<ul>\n<li>Would the client benefit from medical, psychiatric or allied health specialist REVIEW?<\/li>\n<\/ul>\n<p>CDDH has developed a framework for the assessment and management of people with intellectual disabilities presenting with behaviours of concern.<\/p>\n<p><a href=\"https:\/\/cddh.monashhealth.org\/wp-content\/uploads\/2016\/11\/assessment-framework-.pdf\" target=\"_blank\">Assessment Framework<\/a><\/p>\n<p>We have also developed a guide for GPs on the use of psychoactive medication for adults with intellectual disabilities presenting with behaviours of concern.<\/p>\n<p><a href=\"https:\/\/cddh.monashhealth.org\/wp-content\/uploads\/2016\/11\/2015-medication-review-guide-for-gps.pdf\" target=\"_blank\">Medication Review Guide for GPs<\/a><\/p>\n<p>Note: Victorian Legislation defines CHEMICAL RESTRAINT as the use of a chemical substance (medication) to control or subdue a patient for the primary purpose of behavioural control. It does NOT include the use of a drug prescribed by a medical practitioner for the treatment of a diagnosed mental or physical illness.<\/p>\n<p><em>The Restrictive Intervention Self-Evaluation Tool (RISET) is an on-line learning tool that educates the user about restrictive practices.<\/em><\/p>\n<p><em>It is a &#8216;decision-making tool&#8217; that guides the user through important information to help them understand when a restrictive intervention has occurred.<\/em><\/p>\n<p><em>The RISET was developed to improve the disability sector&#8217;s understanding of its obligations under the Disability Act, 2006<\/em><\/p>\n<p><a href=\"http:\/\/www.surveygizmo.com\/s3\/2741253\/Has-a-Restrictive-Intervention-Occurred\">http:\/\/www.surveygizmo.com\/s3\/2741253\/Has-a-Restrictive-Intervention-Occurred<\/a><\/p>\n<p>The <a href=\"https:\/\/tgldcdp.tg.org.au\/etgAccess\" target=\"_blank\">Management Guidelines: Developmental Disability <\/a><u>on eTG <\/u>provides GPs with further advice on the assessment and management of behaviours in the context of a patient with a developmental disability.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/mk_page_section]\n","protected":false},"excerpt":{"rendered":"<p>[mk_page_section bg_image=&#8221;https:\/\/cddh.monashhealth.org\/wp-content\/uploads\/2016\/11\/medical_practitioners.jpg&#8221; attachment=&#8221;fixed&#8221; bg_position=&#8221;center center&#8221; bg_repeat=&#8221;no-repeat&#8221; bg_stretch=&#8221;true&#8221; enable_3d=&#8221;true&#8221; video_color_mask=&#8221;#2a363b&#8221; video_opacity=&#8221;0.5&#8243; min_height=&#8221;350&#8243; el_class=&#8221;banner-border-pink&#8221; sidebar=&#8221;sidebar-1&#8243;][vc_column][mk_padding_divider size=&#8221;200&#8243;][mk_fancy_title color=&#8221;#ffffff&#8221; size=&#8221;32&#8243; font_weight=&#8221;300&#8243; txt_transform=&#8221;uppercase&#8221; letter_spacing=&#8221;1&#8243; font_family=&#8221;none&#8221; align=&#8221;center&#8221;]Behaviour Change[\/mk_fancy_title][\/vc_column][\/mk_page_section][mk_page_section section_layout=&#8221;left&#8221; padding_top=&#8221;0&#8243; padding_bottom=&#8221;0&#8243; sidebar=&#8221;sidebar-1&#8243;][vc_column][vc_row_inner][vc_column_inner][vc_column_text]People with difficulty communicating with words may express their discomfort or distress through changes in their behaviour. A change in someone\u2019s behaviour may therefore reflect physical illness, disorder of mental [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":72,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/pages\/502"}],"collection":[{"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/comments?post=502"}],"version-history":[{"count":4,"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/pages\/502\/revisions"}],"predecessor-version":[{"id":563,"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/pages\/502\/revisions\/563"}],"up":[{"embeddable":true,"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/pages\/72"}],"wp:attachment":[{"href":"https:\/\/cddh.monashhealth.org\/index.php\/wp-json\/wp\/v2\/media?parent=502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}