Medications
What is John's PRN Medication for his BSP?
Quetiapine 50mg
John may become upset if there are significant changes to routine or staffing. What is another big factor that may increase agitation for John?
If he feels his roommates are getting more attention then him. If he feels he is not receiving the attention he desires.
Not being given choice
Feeling misunderstood or unheard
List at least 1 of the behaviors to decrease on Adam's BSP
Assaults of injuries to others
PICA - ingestion of inedible substances (feces)
Emotional Outbursts
Prevention of property destruction
Kristen does well with 1:1 staffing who he has built a trusting rapport with. What other proactive strategies can staff use to support Kristen that are mentioned in his BSP?
Staff Modelling - calm, safe respectful behavior.
Choices - Foster independence and empowerment
Consistent approach - Schedule, staffing & routine
Monitor Health & Wellbeing - Managing physical health (headache, joint pain, constipation, rash etc)
Log notes
Incident reports - reviewed at staff meetings
Quarterly reports - goal updates
Pre/Post Assessments
Communication book
What is Kristen's PRN for his BSP?
Quetiapine 100mg
Kristen becomes upset when he feels misunderstood or ignored. What are at least 2 other factors that may influence an increase in behavior?
Overstimulation - noisy and chaotic environments
Emotional Dysregulation - Inability to manage feelings can increase anxiety
Communication barriers - not able to verbally express his feelings or needs
Constipation or other physical discomfort/pain
List at least 2 behaviors to decrease on John's BSP
Obsessive/Rude Behavior
Aggression
Destruction
Self Abuse
Unsafe Community access
Invasion of personal space
Adam does well with positive verbal reinforcement. But what is another unique positive procedure that works well for Adam that is in his BSP?
Managing his favorite food preparation - Adam can be particular about what he eats and seems to do well when he is able to prepare food himself.
Although staff are noticing he is becoming more flexible in this area
What are Charlie's current ISP goals? There are 2.
Arts at Nina Haggerty (Needle point, beading, painting specifically mentioned)
Eat healthy meals following the Canada Food Guide
Who do staff need to contact before they can administer a 2nd PRN?
Team Leader
Manager
On-Call
Adam does not do well with unanticipated change in routine as this can cause him anxiety. List at least 2 other factors in his BSP that can increase behavior
Not receiving an answer - May become repetitive and go into staff's face.
Personal items being touched
Being told what to do - does not always respond well to being asked to change dirty clothes
Being redirected - specifically when agitated and engaging in inappropriate washroom behavior
Infringement on Independence
One of Kristen's behaviors to decrease is physical & verbal aggression. Describe what physical and/or verbal aggression may look like for Kristen
Verbal - Yelling, swearing, screaming at others
Physical - Attempting to grab at or hit staff when unsettled. May also attempt to throw items that are in his vicinity.
John's ISP goal is being able to calmly communicate his wants and needs. Please list at least 2 positive support strategies on the ISP that staff could use to assist with meeting this goal
Meaningful conversations
Reinforce calm, safe and gentle behavior
Plan activities that John will enjoy, especially community outings
List at least 2 mandatory staff trainings that are mentioned in the Individuals BSPs
First Aid
Positive Behavior Supports
Med Admin
NVCI - Physical Holds
Bonus Question (When should NVCI be used?)
If staff administered a PRN to an Individual as per their BSP, what must be done to follow this?
Monitor Individual
Inform TL, Guardian, On-call etc, as needed
Complete Incident report and put in log notes
Document in Communication book in RED INK
Inform staff during shift exchanges and of the time the PRN was given
True or False - Charlie celebrated his birthday on July 24th. Was this event an influencing factor towards John's possible increased agitation/behavior?
True. John often becomes jealous or obsessive over events like this.
If John is showing visible signs of agitation, what is the first strategy staff should use as per his BSP
Calmly ask him if he would like to spend some time in his room. Check on him in 5 minutes to see if he is ready to talk. If he is not calm, staff will give him another 5 minutes.
Note: Staff will never lock his bedroom door as per policy.
Kristen also has an ISP goal around communicating his wants and needs. Providing choices is 1 of the positive support strategies. List at least 2 other positive strategies on the ISP
Encourage expression of wants and needs
Spending quality 1 on 1 time
Give praise when being calm, respectful and gentle when communicating wants and needs.
What is Adam's current ISP goal? There is 1.
Community access - Swimming, walking, library
6 hours - also max twice daily
What 2 big life events took place in 2025 at Gabriel Place that may have contributed to increased agitation/behavior for John and Kristen?
August 2025 - Roommate passing
October 2025 - Adam moved in
One of Adams behaviors to decrease is assaults and injuries to others. Describe what this form of behavior looks like for Adam.
Grabbing at staff
May grab some ones face and squeeze
Pinching
Why is debriefing a requirement and when should it take place?
Debriefing is important to maintain trust and understanding. Maintain rapport.
Should be done so after an incident, when it is appropriate. Individual should be calm and it is safe to do so. Can follow Therapeutic rapport process of NVCI.
Side note: Debriefing should be documented on the incident report under follow-up
What is the termination criteria for John's BSP?
Does not require PRN or use of physical holds for a minimum of 1 year.