Behavior Level

Defensive: Angry, verbally abusive and lost rationality, patient is loud and threatening self and others, rapid pacing and physical demonstration of increasing agitation.

 

•         Behaviors may include:

•         Increase in cognitive arousal

•         Acceleration of activity

•         Sense of growing tension

•         Clenching of fists and hands

•         Further increase in rate of volume & speech

•         Demanding

•         Verbal assaults or threats

•         Hyper-vigilance

Staff Attitude/Approach

Directive: A directive approach in which a staff member takes control of a potentially escalating situation by setting limits.

 

•         Suggested Interventions:

•         Set limits – clear, simple, reasonable and enforceable.  

•         Verbal or written contract for improved behavior.  

•         Mediation by a third party.

•         Offer PRN medication.

•         Provide opportunities for brief “time out” in patient’s room or designated area

Stages of Behavioral Escalation