Geraldine was upset. Her regular caregiver was off today, and the staff member who was helping her wasn't as familiar with her routines. She didn't wash her the same way, and didn't talk about what she was doing. She was friendly and efficient, but it wasn't the same. By the time she was ready for breakfast, Geraldine was anxious and agitated. She refused to go to the dining room.
Her caregiver left her alone for a few minutes, and went to get trays for those who were having breakfast in their rooms. She also got a tray for Geraldine. This took about 10 minutes, and by the time she came back, Geraldine was crying on the phone to her daughter. "They aren't feeding me because I complained."
What went wrong? The caregiver was trying hard to please Geraldine, who was normally sweet and appreciative. How did this situation get out of control?
The dictionary defines "intervention" as "to involve oneself in a situation so as to alter or hinder an action or development."1 In caregiving, interventions are the actions (often by the caregiver) which reduce anxiety, anger or other behaviours.
The difficulty with interventions is the same ones don't work in each situation, for each person, or all the time. Interventions often seem more error than trial.
The great thing about interventions is when they work, they are brilliant.
In Geraldine's situation, the caregiver was using a common intervention. When a person is in the midst of escalating agitation, it's often helpful to give them some space. Leave them for a few minutes. The person may have forgotten the problem and often the agitation passes.
But with Geraldine, leaving her alone for a few minutes escalates her agitation. Even if she told the caregiver to "leave her alone" it would be better not to. With Geraldine, using a quiet voice and asking her what she wants ("would you like this blanket on your legs? Which slippers would you like to wear?") works much better. That and a cup of coffee with 2 creams as soon as she gets in the dining room!
Interventions work best when you know the person well.