M from Minnesota, a Personal Care Attendant of two brothers (18 and 24) that have autism and are non-verbal. She reached out to us to tell us her BitePRO story. We were touched by her love of the family she supports, and her unconditional compassion for those in her care.
'With the mother and father originally immigrating over from Somali many years ago, they have made a wonderful life for themselves and their seven children, with 2 having severe special needs requiring a lot of assistance. As the children's ages range from 11 to 28, there is always something going on with this family.
I try to alleviate some of the stress by providing assistance for the boys 3-5 days a week for six hours a day. My daily routine for the two brothers looks like; helping them with personal hygiene, providing daily enrichment, cooking, cleaning, taking to Speech and OT therapy as well as all the surprises a regular day may throw at me.
With myself being the primary caretaker, other than family members, injuries occur regularly. The 18 year old son has severe behaviors and does self harm (biting, pinching, and smacking his head) as well as attacking me regularly when he is in distress. I believe it has a lot to do with his inability to communicate how he feels properly and he looks to me to help fix it. Over my three years with him, I have been severely bit around 25 times with a lot of those needing visits to urgent care with broken skin and risk of infection.'
What training have you undertaken to support you in working with individuals exhibiting challenging behaviours?
My degree is in Therapeutic Recreation which is working with individuals with disabilities more recreation based. I had classes in university that prepared me for different disabilities but nothing on challenging behaviours. All my knowledge on challenging behaviours has come from real work experience. I did 2 years after university in an EBD classroom for boys that had emotional regulation problems and the past 3 years has been with individuals with autism, that are nonverbal or limitedly verbal. In the school district that I work in, they provided us with CPI training (Crisis Prevention Intervention) that is an 8-hour initial training session which is valid for two years, needing a four hour refresh every two years to maintain the certification.
This training is required when working with any individual with special needs, challenging behaviours or not. It helps you learn techniques to deescalate situations that may cause behaviours, but it also teaches you physical restraints if needed. It primarily focuses on how to prevent the behaviours before it results in a restraint. Other then that, that is the only true training I have had.
What are your thoughts on challenging behaviours as a way of communicating unmet needs?
I personally believe behaviours occur when communication is lacking in the individual. If they get frustrated and have no way to communicate, if that’s with words, sign, gestures, or vocalizations, of course behaviours are a way to communicate. I believe these individuals that present challenging behaviours don’t mean to hurt themselves or others, it is just a way of getting our attention to help in a time of need or crisis. I almost feel honoured being the person the individual comes to because let look to me as one to help them in their time of need.
Tell us more about your experiences of challenging behaviours in your role.
My first experience with working with challenging behaviours started 4 years ago when I was assigned to work with a then 15-year-old nonverbal boy with autism and severe behaviours. I was one of two staff that were to always be with him wherever he went. He was tall and very flexible so when he got upset, it took many people to keep him and others safe. In my time working with him, I have probably been bitten over 20 times ranging in severity. I learned everything with this student as I went and as situations raised. On top of this student, I have worked with many other students, ranging in different age ranges. I currently still work with this student from 4 years ago and his behaviours are improving but we still have our moments.
What is your opinion on protective clothing as a means of increasing confidence when providing care?
I believe any protective clothing will increase people’s confidence with working with challenging behaviours. Safety is someone’s top priority in a job so if that’s something they don’t have to worry about, then they can focus on other aspects of their job.
Do you think carers should be offered protective clothing by their employers/via government funding when performing necessary manual handling of those who are prone to these behaviours?
I do believe employers should provide protective equipment because I know of many people that have quit jobs because of their injuries caused from students. I have purchased my own protective equipment to keep myself safe because my job wouldn’t provide it themselves. Keeping your employees safe should be a top priority and if not, this causes a lot of workmen’s compensations.
Is there anything else that you would like to share with us?
I absolutely love what I do no matter if I get injured or not. It will not stop me from doing what I love!
M has since agreed to trial some of our bite resistant garments, and will be feeding back her review in a follow-up post. If you have a story about your experiences with behaviours that challenge, as a nurse, teacher, parent or unpaid carer, we would love to hear from you.
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