This session is suitable for all levels of staff, from all departments.

This session can be credited to the 5-Day Mental Health Recovery Care Certificate Program.

Presented by Steve Mathew (Behaviour Therapist, Mental Health Clinical Manager)

“When staff feel helpless or demeaned, when nothing they do for a resident is ever enough, or if they find themselves consistently doing things the resident could do independently then the question of a personality disorder should be raised.” Robinson & Schogt

Personality disorders in long term care homes are a relatively misunderstood and under-researched topic. Unlike the resident with dementia whose behavior is driven by a neurodegenerative process, or the resident with schizophrenia, who has an underlying organic cause for their psychosis, the resident with a personality disorder often displays cleverly calculated yet maladaptive behaviors that are driven more by past life experiences and conditioning.   Manipulation, splitting of staff, help-seeking/help rejecting behaviors and emotional dysregulation are the hallmarks of personality disorders. Some of the available research shows that institutionalizing these individuals is often problematic as they will frequently respond by attempting to control their environment. However, for older adults with medical co-morbidities and disability, they are not appropriate for independent living in the community due to the high level of risk. Once admitted to long term care, their negative coping behaviors emerge and can be highly disruptive for staff, families and co-residents.

This interactive and insightful workshop explores the problem behaviors of residents with personality disorders in long term care. The psychodynamic model forms the foundation for better understanding how unconscious defense mechanisms form in early development, which then produce maladaptive coping skills and pathological behaviors. Behavioral planning based on the principles of operant conditioning will be presented in depth to give participants a solid understanding of how to properly modify their approach, prevent countertransference and empower the resident to set goals.