understanding the gpep model
DESCRIPTION
Understanding The GPEP Model. Geropsychiatric Education Program (GPEP) Vancouver Coastal Health. Learning Objectives. Identify four types of influences on behaviours: Psychiatric Physiological Psychosocial Environmental: social, physical environment - PowerPoint PPT PresentationTRANSCRIPT
Understanding Understanding The GPEP Model The GPEP Model
Geropsychiatric Education Program Geropsychiatric Education Program (GPEP)(GPEP)
Vancouver Coastal HealthVancouver Coastal Health
Learning ObjectivesLearning Objectives
Identify four types of influences on Identify four types of influences on behaviours:behaviours: PsychiatricPsychiatric PhysiologicalPhysiological PsychosocialPsychosocial Environmental: social, physical environmentEnvironmental: social, physical environment
Discuss the GPEP Model as a tool for Discuss the GPEP Model as a tool for understanding behaviour and planning understanding behaviour and planning individualized careindividualized care
Psychiatric Psychiatric Influences on Influences on
BehaviourBehaviour
Psychiatric InfluencesPsychiatric Influences
DementiaDementia DepressionDepression DeliriumDelirium Other:Other:
SchizophreniaSchizophrenia Bipolar DisorderBipolar Disorder Personality disorderPersonality disorder Obsessive Compulsive DisorderObsessive Compulsive Disorder
Physical Physical Influences on Influences on
BehaviourBehaviour
1. Aging: A Universal 1. Aging: A Universal ProcessProcess
Affects everyone Affects everyone Occurs in every Occurs in every
system of our bodysystem of our body Individual – no fixed Individual – no fixed
patternpattern
2. Physical Illnesses 2. Physical Illnesses and Behaviourand Behaviour
Arthritis Diabetes Parkinson’s Disease Chronic Obstructive
Pulmonary Disease Emphysema High Blood Pressure Visual disturbance….
Normal
Cataracts
Normal
DiabeticRetinopathy
Normal
Glaucoma
Normal
MacularDegeneration
3. Medications and Side 3. Medications and Side EffectsEffects
All medications have All medications have
possible side-effectspossible side-effects Your role: Your role:
to notice if there is a sudden change to notice if there is a sudden change in behaviourin behaviour
REMEMBER: role of medications in REMEMBER: role of medications in deliriumdelirium
4. Pain 4. Pain
What percentage What percentage of elders in the of elders in the community have community have significant pain?significant pain?a. 10 – 25 %a. 10 – 25 %
b. 45 – 60 %b. 45 – 60 %
c. 70 – 85%c. 70 – 85%
Why Elders May Not Why Elders May Not Report PainReport Pain
Fear of being called a complainer Think no one would listen Think pain is a normal part of aging Cannot tell you because of dementia Fear of consequences May express pain differently
Psycho-Social Psycho-Social Influences on Influences on
BehaviourBehaviour
Who is this Person?Who is this Person?
Psychosocial InfluencesPsychosocial Influences
Personal routinesPersonal routines Early life eventsEarly life events Life roles/work historyLife roles/work history Important relationshipsImportant relationships Coping strategiesCoping strategies CultureCulture Spiritual values/beliefsSpiritual values/beliefs Personality style…Personality style…
The Physical The Physical Environment’s Environment’s Influence on Influence on BehaviourBehaviour
How does the Physical How does the Physical Environment affect Environment affect
behaviour?behaviour? Level of
stimulation Private space Lighting / Glare Room temperature Signs & labels Poor colour
contrast Safety concerns
The Social The Social Environment’s Environment’s Influence on Influence on BehaviourBehaviour
How OUR communication and approach How OUR communication and approach affects the client/residentaffects the client/resident
Parts of OUR Parts of OUR CommunicationCommunication
Only 7-10% of Only 7-10% of our message is our message is found in our found in our WORDSWORDS
Verbal Verbal communication – communication – the actual words the actual words we say…we say…
Parts of OUR Parts of OUR CommunicationCommunication
But…90% of our But…90% of our message is found in message is found in our NON-VERBALSour NON-VERBALS
Non-verbal Non-verbal communication – communication – how we say what we how we say what we say:say: ToneTone VolumeVolume Body language…Body language…
Do WE have Good Do WE have Good Listening Skills:Listening Skills:
Not interruptingNot interrupting Being non-judgmentalBeing non-judgmental ValidatingValidating Allowing for silenceAllowing for silence Using supportive body Using supportive body
languagelanguage Are we paying attention…Are we paying attention…
Understanding Understanding Responsive Responsive BehavioursBehaviours
What is a Behaviour?What is a Behaviour? Something someone is doing that Something someone is doing that
you can see or hearyou can see or hear DescriptiveDescriptive SpecificSpecific Non-judgmental / not labelingNon-judgmental / not labeling
Understanding Understanding BehavioursBehaviours
Refusal, agitation, and aggression Refusal, agitation, and aggression always has a cause/trigger:always has a cause/trigger: Protecting oneselfProtecting oneself Unmet needsUnmet needs Broken brainBroken brain
When cognition and communication are When cognition and communication are impaired it is the way in which people with impaired it is the way in which people with dementia tell us that something is wrongdementia tell us that something is wrong
Very often starts with anxietyVery often starts with anxiety Has a patternHas a pattern
Tools to Describe Tools to Describe Behaviours:Behaviours:
1.1. Identify the behaviour: Identify the behaviour: • Identification of Behaviours and Identification of Behaviours and
Guidelines for Intervention*Guidelines for Intervention*
2.2. Document the Behaviour: Document the Behaviour: • Behaviour Pattern Record*Behaviour Pattern Record*
3.3. Care Planning: Care Planning: • Behaviour Assessment Tool (BAT)Behaviour Assessment Tool (BAT)
* Cohen-Mansfield, 2004
Tool to help with describing behaviour and
classify types of behaviour
IDENTIFICATIONOF BEHAVIOURS & GUIDELINES
FOR INTERVENTIONSCohen-Mansfield
Behaviour Pattern Behaviour Pattern RecordRecord
Care StrategiesCare Strategies
Goals of Care StrategiesGoals of Care Strategies The resident will:The resident will:
feel safefeel safe feel physically feel physically
comfortablecomfortable experience a sense experience a sense
of controlof control experience optimal experience optimal
stressstress experience meaning experience meaning
and pleasureand pleasure