Getting to know Joe

When Joe arrived at St Andrew's he refused to take part in most activities.

The diagnosis

This image shows an elderly man in conversation.Joe was 50 when he was diagnosed with frontotemporal dementia and was then admitted to St Andrew’s.

When he arrived he refused to engage in most activities and had little contact with family or friends. Over time his challenging behaviour had become entrenched and he would repeatedly shout loud demands every day, making him vulnerable to assault from others.

What happened next...

Rather than focusing on ‘how can we stop Joe from shouting?’ we used the RAID® model to prompt a ‘green’ question: ‘How can we help Joe to relax and engage in meaningful activities?’ This prompted the staff to develop a more creative approach to his therapy. RAID stands for Reinforce Appropriate, Implode Disruptive, and aims to nurture and develop positive ('green') behaviour so that it displaces challenging behaviour. St Andrew's is a centre of excellence for this model.

We first settled Joe in a quiet bedroom on the ward and spent time documenting his life story and likes and dislikes, and building trust with him. We gently offered activities he had expressed an interest in, such as swimming, horse riding and music, and over time he built a natural rapport with staff and we began to understand him more.

A key element was helping Joe to understand how to express his wishes appropriately and then reinforcing positive behaviour. Over a matter of weeks the frequency of shouting dropped from 40-45 times per day to less than five, with fewer instances of challenging behaviour.

Enjoying contact with family and friends

Joe's mood has improved. He recognises and talks with others more easily and willingly engages in activities. His ‘life story’ book continues to be a reminder to himself and to staff of the person within and he has increased contact again with family and friends.