Stress Management in Learning Disabilities…

What is stress?

At the most basic level, stress is our body’s response to pressures from a situation or life event. Some common features of things that can make us feel stress include experiencing something new or unexpected, something that threatens your feeling of self, or feeling you have little control over a situation. [Mental Health Foundation]

In the following article, Jayne Jackson, registered manager at Apple House care home, writes an open and very insightful reflection on how stress plans can and do have a profoundly positive impact for a gentleman she supports:

Our care plans are person centred and very individual to each of the people we support.
I was looking at environmental risk assessments & policies for stress. This centred around how we could look after staff’s health and what they/we could do to help in their day-to-day working environment, which we know at times can be stressful.This prompted me to look at the people we support [in relation to stresss]. We looked at easy read documents and set up a meeting.

The easy read document comprised general things to help lower stress/anxieties. We wanted our support plans to be personalised to suit the needs of the individual.

We worked with each person individually and discussed what we could do to help them stay settled and reduce their stress levels.

For one individual this was a massive achievement as in the past just discussing and writing information could cause him to experience high levels of stress.

We worked very closely over many years with the gentleman to help him learn to trust us. We use the phrase ‘it’s good to talk’ and this person now quotes this phrase.

This plan would not have worked for this person if they did not sign up to it.

He spent time with us, we listened to him, we built ‘his’ support plan. It is important that the person has ownership over ‘their’ plan. When he is feeling stressed we refer to the plan and this keeps it fresh in his mind. We all stick to the plan; this is key in keeping his well-being stable.

This plan cannot work without the individual being involved, it is not a paper exercise, it is a live tool.

The stress support plan runs alongside others that all interlink. He is now beginning to recognise when he is feeling troubled, or finding things difficult and, with our support, he is starting to work them out.
The individual works with us. We ensure he has time to reflect, to identify what is worrying him.

Breathing exercises, conversation and space are used; usually after 10 minutes he feels able to talk about what is happening. We must ensure that the person and staff have clarification that they have settled as this prevents further stress. A physical change can be seen within him – his body language and speech will return to pre-stressed levels, and he appears calmer. This is not just a one-off thing as this may happen a few times a day, or weeks may pass without presentation of stress.

Because of the trust we have built, continuity of the team and knowing and respecting the individual it could be said that he has a better quality of life. Sure, there are stressful days for him, we all have those, but learning to cope with them is what we support him to do.

I cannot tell you how proud I feel of him and the team; it is lovely to see the person more involved in day to day things, and by doing this it also helps him to have a renewed sense of purpose and to feel valued, staying focused forming part of his routine.

This individual wrote an additional support plan with staff which was linked to additional stress; he took it to a meeting with his psychiatric team and asked them to sign up to it which they did.

He then wrote to his link mental health team and asked to be discharged. We supported him in writing a letter and discussed the benefits, including self-esteem, that he would feel. His mental health team told us they never thought they would see they day this gentleman would be signed off [from their care].

This is a massive achievement for him!

Due to the hard work and commitment of my staff, their link team and the individual himself, he has stayed settled for over a year following years of mental health decline.

In our compliment folder, the person’s mental health team praised Apple House. They commented how well we had supported the person when they had deteriorated in their mental health and suffered episodes of depression and mania, they had never see this person doing so well. This was signed by the person’s community nurse. This person was told if they remained stable for the next year they would be signed off.

Jumping forwards a year, well its happened, he has been discharged!

We look forward to maintaining his wellbeing and will continue to encourage him to further develop and reach his personal goals.

— Jayne Jackson, registered manager, Apple House care home, Bournemouth.

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