0:00:26.159,0:00:29.129 So many people who live here do things that are repetitive 0:00:29.129,0:00:32.240 like pacing and asking the same questions over and over again, 0:00:32.759,0:00:35.479 or repetitive movements like hand slapping, 0:00:35.689,0:00:36.959 and I'm not sure what to do. 0:00:37.290,0:00:38.810 Sometimes it's annoying to me, and sometimes it's 0:00:38.810,0:00:40.400 annoying to other people that live here. 0:00:40.819,0:00:44.209 Should I just try and ignore them or make them stop? 0:00:45.570,0:00:47.319 [TAPPING NOISE] 0:00:47.569,0:00:48.490 Mr. Jones, 0:00:48.599,0:00:50.159 you've been doing that for 30 minutes. 0:00:50.290,0:00:51.159 I told you to stop. 0:00:51.250,0:00:52.130 It's very annoying. 0:00:54.000,0:00:55.490 I'm just gonna take you to your room now. 0:00:56.930,0:00:57.250 No, 0:00:57.450,0:00:57.700 stop. 0:00:57.810,0:00:58.740 We're going. 0:00:59.529,0:01:02.240 You're not coming out of your room until you stop tapping. 0:01:02.930,0:01:04.290 Stop pushing against me. 0:01:05.358,0:01:05.838 Come on. 0:01:09.360,0:01:12.070 [TAPPING NOISE] 0:01:12.170,0:01:14.459 OK. Here you are. 0:01:25.419,0:01:29.680 Repetitiveness can be exhibited in a variety of ways. 0:01:30.099,0:01:34.019 A person could do the same movement over and over, 0:01:34.500,0:01:37.970 say the same word or phrase again and again, 0:01:38.180,0:01:40.690 or ask the same question repeatedly. 0:01:40.940,0:01:44.569 When you're assessing a person who's experiencing repetitiveness, 0:01:44.900,0:01:48.819 the first thing you should do is make sure the person is not in harm's way, 0:01:49.400,0:01:53.949 or that the repetitiveness is not going to cause harm to another person. 0:01:54.040,0:01:58.989 If the repetitiveness is not causing harm to the person or someone around them, 0:01:59.199,0:02:00.269 you may decide 0:02:00.559,0:02:02.110 just to ignore it, 0:02:02.680,0:02:06.830 but ignoring the repetitiveness does not mean ignoring the person. 0:02:06.959,0:02:12.000 The repetitiveness could be a way to express a physical need. 0:02:12.479,0:02:14.110 The person could be hungry. 0:02:14.199,0:02:14.399 Hi, 0:02:14.440,0:02:15.339 Mr. Jones, 0:02:15.479,0:02:16.720 I brought you a snack. 0:02:16.880,0:02:17.710 Are you hungry? 0:02:19.979,0:02:21.149 I don't know. 0:02:21.220,0:02:21.449 Here. 0:02:28.250,0:02:29.509 Or thirsty… 0:02:29.190,0:02:30.499 [TAPPING] 0:02:30.640,0:02:31.369 Hi, Mr. 0:02:31.380,0:02:32.169 Jones. 0:02:32.399,0:02:32.850 I saw you were 0:02:33.039,0:02:33.769 tapping your arm 0:02:33.801,0:02:33.980 there. 0:02:34.120,0:02:34.519 Are you 0:02:34.539,0:02:34.680 thirsty? 0:02:36.200,0:02:36.489 No, 0:02:38.460,0:02:39.089 I don't know. 0:02:39.139,0:02:40.809 I brought you some water, here. 0:02:42.490,0:02:43.119 There you go. 0:02:43.889,0:02:47.440 They could have a need to stretch or walk around. 0:02:48.770,0:02:49.279 OK. 0:02:50.970,0:02:52.440 They could be uncomfortable. 0:02:52.869,0:02:54.679 The person could be too hot 0:02:54.949,0:02:56.139 or too cold. 0:02:56.350,0:03:01.059 They could need to be repositioned or have assistants repositioning themselves. 0:03:01.630,0:03:03.910 The person could need to use the restroom. 0:03:04.019,0:03:05.210 [BACKGROUND MUSIC] [TAPPING] 0:03:04.919,0:03:05.580 Hi, Mr. 0:03:05.589,0:03:06.070 Jones, 0:03:06.149,0:03:07.110 that music's kind of loud. 0:03:07.119,0:03:08.270 I'll turn that down for you. 0:03:10.889,0:03:12.800 You've been in this room for a while. 0:03:13.009,0:03:14.250 You need to use the restroom? 0:03:18.600,0:03:19.619 I don't know. 0:03:19.860,0:03:20.649 You don't know? 0:03:20.940,0:03:22.600 Let's go take a walk to the restroom. 0:03:23.059,0:03:23.220 Here, 0:03:23.300,0:03:23.940 I'll help you up. 0:03:26.949,0:03:26.960 Mhm, 0:03:29.320,0:03:30.020 there you go. 0:03:30.199,0:03:30.860 You could take my arm. 0:03:31.889,0:03:32.279 Right. 0:03:33.500,0:03:34.059 Here we go. 0:03:45.039,0:03:46.619 Repetitiveness 0:03:47.119,0:03:50.229 could be the result of the person being bored 0:03:50.559,0:03:53.190 or having a need to engage with others. 0:03:53.600,0:03:56.080 Once you've assessed the situation and determined 0:03:56.080,0:03:58.259 that the person is not in harm's way 0:03:58.559,0:04:00.440 and that their physical needs are met, 0:04:00.919,0:04:03.669 try engaging them in some other activities. 0:04:04.440,0:04:08.679 You might consider helping the person move to another room or another part 0:04:08.679,0:04:12.479 of the home, where they can interact and visit with other folks. 0:04:13.350,0:04:14.369 Activities 0:04:14.630,0:04:16.010 should be meaningful. 0:04:16.670,0:04:18.988 You can help them get a project started with 0:04:18.988,0:04:23.260 the activities coordinator or engagement specialist at the home. 0:04:23.510,0:04:27.070 Perhaps they could help prepare the silverware for mealtime. 0:04:28.290,0:04:28.440 Hey, 0:04:28.489,0:04:28.799 Mr. 0:04:28.809,0:04:29.130 Jones, 0:04:29.290,0:04:30.869 thanks so much for doing the silverware. 0:04:30.890,0:04:31.959 We really appreciate it. 0:04:34.910,0:04:37.980 Other activities could include working in the yard, 0:04:38.399,0:04:39.579 planting flowers, 0:04:39.750,0:04:40.470 weeding, 0:04:40.750,0:04:42.399 painting the picnic tables. 0:04:42.589,0:04:45.149 Maybe the person that you're working with would like to 0:04:45.149,0:04:47.940 write a letter to a family member or friend. 0:04:50.329,0:04:50.880 Here we go. 0:04:51.010,0:04:52.660 We got you situated with a drink, 0:04:52.730,0:04:53.440 a snack. 0:04:53.690,0:04:55.660 You're writing a letter to your grandson? 0:04:55.809,0:04:57.519 I heard it's his birthday next week. 0:04:58.029,0:04:59.500 A walk in the fresh air 0:04:59.809,0:05:02.359 is always good for the person that you're assisting 0:05:02.609,0:05:03.559 and for you. 0:05:04.769,0:05:06.559 Isn't it nice to be outside? 0:05:09.739,0:05:12.940 Initiation is a term which describes 0:05:13.250,0:05:14.959 moving from one activity 0:05:15.209,0:05:16.640 to another activity. 0:05:16.929,0:05:17.839 For example, 0:05:18.170,0:05:22.200 maybe watching television and initiate a new activity 0:05:22.459,0:05:25.570 by getting up and going to their room to read a book. 0:05:25.899,0:05:30.450 The process of initiation is a mental process. 0:05:30.700,0:05:35.339 Diseases such as Alzheimer's disease and other related dementias, 0:05:35.500,0:05:38.250 traumatic brain injury, or autism 0:05:38.570,0:05:41.579 can cause problems with initiation. 0:05:42.140,0:05:43.790 This is where you come in. 0:05:44.100,0:05:48.260 You could help the person initiate a new activity with some 0:05:48.260,0:05:51.450 of the suggestions and recommendations we offer in this film. 0:05:54.489,0:05:56.320 Tips to help with repetitiveness: 0:05:58.380,0:06:00.130 One: Assess Safety. 0:06:00.420,0:06:01.459 What is the person doing? 0:06:01.570,0:06:02.529 Is it safe? 0:06:02.779,0:06:04.820 If they continue doing their repetitive action, 0:06:04.940,0:06:07.450 are they going to hurt themselves or someone else? 0:06:07.660,0:06:08.260 If so, 0:06:08.339,0:06:10.410 calmly stop them as soon as you can. 0:06:10.980,0:06:12.049 Get help if needed, 0:06:12.260,0:06:16.290 but try to stop the unsafe action in the least aggravating way possible. 0:06:16.679,0:06:17.200 Two: 0:06:17.579,0:06:18.899 Assess Human Needs. 0:06:18.989,0:06:22.929 Repetitiveness that is not causing harm may not need to be interrupted, 0:06:22.940,0:06:26.420 but could be a sign of a human need that the person cannot express verbally. 0:06:27.480,0:06:29.070 If there is an unmet need or want, 0:06:29.239,0:06:29.750 for example, 0:06:30.000,0:06:30.399 hunger, 0:06:30.519,0:06:30.920 thirst, 0:06:31.079,0:06:31.640 boredom, 0:06:31.679,0:06:32.429 or pain, 0:06:32.839,0:06:34.269 meet that person's needs. 0:06:34.559,0:06:36.269 Maybe they just need to use the restroom. 0:06:37.329,0:06:39.100 Physical needs might include 0:06:39.570,0:06:40.399 thirst, 0:06:40.489,0:06:41.279 hunger, 0:06:41.519,0:06:43.119 the person may be uncomfortable 0:06:43.410,0:06:44.410 they may be too hot, 0:06:44.570,0:06:45.200 too cold, 0:06:45.450,0:06:46.730 or need to be repositioned. 0:06:47.559,0:06:52.459 The person might have psychological or social needs, such as, one—boredom. 0:06:52.760,0:06:53.660 In this case, 0:06:53.989,0:06:57.420 help the individual find something meaningful to do to them, 0:06:57.630,0:06:59.019 such as walking outside, 0:06:59.230,0:07:00.579 helping prepare the silverware, 0:07:00.790,0:07:01.579 writing a letter, 0:07:01.750,0:07:03.140 or creating a work of art. 0:07:03.750,0:07:05.470 Two—loneliness. 0:07:05.510,0:07:09.019 Help the person find ways to talk and do something with other people, 0:07:09.220,0:07:10.299 such as play a game, 0:07:10.510,0:07:11.160 do a craft, 0:07:11.230,0:07:12.779 or hang out with someone who works there, 0:07:12.790,0:07:14.549 such as a nurse or a CNA. 0:07:15.140,0:07:15.640 Three— 0:07:15.670,0:07:16.799 overstimulation. 0:07:17.339,0:07:20.170 Create a peaceful environment in which the person can regroup, 0:07:20.380,0:07:22.929 such as near an aviary or looking out a window, 0:07:23.140,0:07:24.970 their room or another quiet area. 0:07:25.700,0:07:28.000 Adjust the environment by reducing noise, 0:07:28.209,0:07:29.290 adjusting lighting, 0:07:29.329,0:07:31.920 or turning on peaceful or their favorite music.