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Trial shows how to manage extreme behaviours

A new service model has been developed and put into practice for older people living with alcohol-related brain injury (ARBI) and complex behaviours, enabling them to transition into long-term residential aged care.

Wintringham, the Victorian service that developed and trialled the model says it demonstrates that extreme behaviours arising from ARBI can be managed within the aged care system in a cost-effective and humane manner.

The specialist welfare organisation providing housing and care to elderly, frail men and women who are homeless or at risk of homelessness, which received funding from the Wicking Trust for 10 years to develop and test the model, completed its final report on the project last month.

Bryan Lipmann

“The behaviours of those with ARBI mean they cannot be accommodated within mainstream aged care,” Wintringham’s founder and CEO Bryan Lipmann told AAA.

“They exist on the fringes of aged care, sapping disproportionate resources from multiple government agencies and portfolios including aged care, mental health, drug and alcohol, justice, hospital and community services, housing and homelessness.”

Wintringham’s Wicking project addressed the issues raised by systemic failures to improve outcomes for this subgroup including humane treatment, cost and effectiveness.

“We believed that with appropriate resourcing we could provide a comprehensive, permanent solution to the otherwise intractable and expensive problems generated by this group,” Mr Lipmann said.

The key components of the two Wicking programs tested as part of the project were intensive case management, neuropsychological assessment and individualised behaviour management planning and monitoring.

Staff working with selected participants received additional training around behaviour management principles and diversional activity support to facilitate their participation in structured recreational activities.

The research estimated the economic savings to government through the Wicking model as opposed to “life on the streets” at approximately $11,000 per participant per year.

“The Wicking projects demonstrated the potential to be packaged as a transitional care model from which participants would emerge with a high likelihood of successfully transitioning into a more traditional Wintringham aged care service,” Mr Lipmann said.

“Another trial in a separate setting is needed to test whether transition results into Wintringham aged care can be replicated. This would yield vital information on the most successful and cost-effective transition model.”

To inform future policy and practice

Mr Lipmann said there were positive indicators of recognition at the national level of the need to address exactly the issues generated by the cohort studied.

“The Wicking project will contribute to a greater understanding of what is achievable when a highly supportive model of residential care is provided to people with ARBI and complex behaviours,” he said.

“For the first time in Australia, this knowledge base is poised to inform government initiatives to provide a supportive, enabling and cost-contained future for such clients.”

The Wicking Trust focuses on funding projects around Ageing and Alzheimer’s disease. Grant Hooper, The Wicking Trust’s senior grants manager said he was excited at the success of Wintringham’s Wicking Projects.

“The significant outcomes achieved for participants and staff, not to mention the cost savings achieved, indicates that Wintringham has identified a highly-effective model of care for this very challenging and often excluded members of our community,” Mr Hooper told AAA.

“We hope that the learnings from the Wicking projects will now inform change in policy and practice across the sector.”

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3 Responses to Trial shows how to manage extreme behaviours

  1. Bronwyn Baker September 13, 2017 at 11:06 am #

    I am very excited to hear this news as I saw a youtube about Wintringham and Bryan Lipmann’s work a few years ago. It was impressive to see an individual so passionate about a small but very disadvantaged group of people and the immense difference he and his team could make in a person’s life. I would recommend the youtube to everyone to watch and hope Bryan is recording more of his work for others to learn from.
    Thank you

  2. Andy Kelly September 13, 2017 at 1:03 pm #

    The question BEFORE the govt decides (if they do) to run with it is of course…can we replicate the environments, staff attitudes, specific training and enthusiasm necessary to produce the same results?
    After 40 + years in this sector I’ve learned to pick up New programmes slowly and to let them go slowly (if you must).
    The program sounds interesting however and if it looks promising, should be encouraged.
    Is there a publication that discusses WHAT they did specifically to achieve the results, what was the impact on staff and in particular what qualities in staff proved most beneficial. Reference was given to ‘additional training around behaviour management principles’. What was the training?, how much time was given to it? etc

  3. Grant September 13, 2017 at 3:34 pm #

    Andy, you ask some important questions and raise some useful cautions.

    Wintringham did publish an evaluation report in July 2016, authored by Dr. Alice Rota-Bartelink. I suggest that you contact them to get hold of a copy.

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