Page 120 - Demo

Chapter 4118(CP) within the expert-team helped experts to feel more confident to keep moving forward implementing MDET. Phase 4. Once MDET started in care homes, professional implementation interventions were used to pursue behavioural change of care professionals. The step-by-step process of phasing out restrictive measures involved considering and trying out alternative forms of support or resources which are less restrictive. This meant that care professionals needed to learn new behaviour in the support of their client and make these new ways of working a daily habit. In changing this collective and individual behaviour Local Opinion Leaders (LOL) played an important role. In most cases, they were Personal Caregivers and Behavioural Consultants who already had a leading and responsible position, due to the tasks associated with their job. The Local Opinion Leaders played an important part in changing behaviour in three ways. First, they raised awareness among support staff of the application of restrictive measures in daily care, and motivated them to support residents in an less restrictive way (Consensus Process, CP). Second, they kept an eye on the psychological, physical and mental needs of the care team during the implementation of MDET by asking for Educational Meetings (EM) such as a %u201ctraining in dealing with challenging behaviour, or attachment theory%u201d (group home 14) to support their process of behavioural change and meet the teams%u2019 doubts concerning restrictive measures. Third, they expressed the team%u2019s collective opinion about the meaning of residents behaviour and restrictive measures deployed. They actively and critically thought along with the steps taken to reduce restrictive measures and assessed the support needed for the team to take these steps. Of decisive importance for support staff to change their behaviour and start phasing-out restrictive measures was behaviour of residents and their (verbal or non-verbal) communication in response to application of these measures (Client-Related Interventions, CRI). Discussing causes, reasons and maintenance of restrictive measures and the residents%u2019 visible and/or extinguished resistance motivated support staff to change their opinion towards these measures and their behaviour towards residents. CRI were particularly important when alternatives or less intrusive forms of restrictive