Wilson SJ & Barrett CM. International Journal of Nursing Practice 1998; 4: 51–57
Restoring homeostasis in a residential care facility through behaviour modification
A verbally aggressive, 32-year-old male with a traumatic brain injury was admitted to a unit in an aged care facility for residential care. The homeostasis of the unit was disrupted by the resident's verbal aggression and other inappropriate behaviours. With the guidance of a neuropsychologist, nursing staff were able to use behaviour modification to successfully replace the disruptive behaviours with more socially appropriate ones. A series of positive rewards was implemented in response to socially appropriate behaviour, whilst inappropriate behaviours received a negative reward. Several disruptive behaviours were affected by the single treatment implemented. This interdependence of targeted behaviours was viewed as a clinical advantage, as it served to provide a more rapid restoration of homeostasis to the unit. The use of a single-subject, multiple baseline design in this case study demonstrates that disruptive behaviours may be reversible.