The Behavioural Supports Ontario Initiative’s target population includes older adults presenting with or at risk for responsive behaviours that may be associated with dementia, complex mental health, substance use and/or other neurological conditions and their care partners
The target population specifically states “older adults” due to the significant and rapidly growing population of older adults and the resulting impact this is having on the provincial health care system. Behavioural Supports Ontario does not define a specific age range since in some situations an “older” person could include adults with complex age related disorders who may not be over 65 years of age.
Responsive behaviours is a term that is often preferred by persons with dementia, mental health, substance use and/or other neurological disorders to describe how their actions, words and gestures are a response to something important in their personal, social or physical environment (Alzheimer Society of Ontario, 2014). These behaviours are often a result of changes in the brain affecting memory, judgement, orientation and mood. Behavioural Supports Ontario recognizes that all behaviour has meaning and that responsive behaviours are often a form of communication of an unmet need. While the term ‘challenging behaviour’ or ‘behaviour that challenges’ is a term that is often also used, the term responsive is preferred as it encourages health care providers and other care partners to focus more on what can be done to make change rather than the behaviour’s impact.
Examples of responsive behaviours include: grabbing onto people, hitting/kicking, performing repetitious mannerisms, pacing/wandering, hurting self/others, cursing, screaming, sexually expressive behaviours, etc.
Dementia, Complex Mental Health, Substance Use and/or other Neurological Conditions
BSO focuses on enhancing health care services for older adults at risk for or presenting with responsive behaviours. Many responsive behaviours are a result of changes in the brain resulting in cognitive impairment. A number of conditions can cause cognitive impairment such as: dementia (also known as major neurocognitive disorder), substance use/addictions disorders, complex mental health issues with other chronic conditions, and/or individuals with Parkinson’s disease/other neurological disorders. Although other populations are not specifically included, the vision, guiding principles and overall behavioural support service model are likely applicable to other populations with similar challenges.
Family caregivers and other care partners are also included in the population that BSO serves. If you are providing care and support a family member or friend presenting with responsive behaviours, your wellbeing is essential. Taking on such a role can be challenging and can sometimes result in compassion fatigue or “caregiver burnout”. BSO Team Members can assist in suggesting self-care strategies and possible approaches to assist with communicating with your loved one.
Central East BSO Implementation Strategy
Long-Term Care Homes (LTCH) Approach
Utilizing an Early Adopter (EA) strategy, 13 EA LTCHs are engaged to enhance care, participate in quality improvement (QI) activities, transfer knowledge and spread to other LTCHs in Central East
Integrated Care Team (ICT) consisting of external resources of Psychogeriatric Resource Consultants (PRC), Nurse Practitioner Supporting Teams Avoiding Transfers (NPSTAT), and Geriatric Mental Health Outreach Team (GMHOT) provides support and care continuum coordination
BSO community resources are integrated with the Central East Geriatric Assessment and Intervention Network (GAIN) teams where all service providers embrace a shared and managed care model for frail seniors living in the community