Here is my story about Amelie. She was introduced to me as a wonderfully unique and caring woman, who loves being busy and adores having glass or 2 of coca cola.
As a young child, Amelie was diagnosed with autism and spent her childhood and early adulthood in the arms of a loving Mum and Dad. Amelie has a good relationship with her Mum and Dad. Sadly, a few years ago, Amelie’s Dad passed away and she went to live in a residential care setting living with 6 other people.
After a short period of time living there and coping with her father’s death, Amelie’s residential home was about to change. Amelie moved to her new home living with just one other person that she knows and her own support team. These changes in Amelie’s life have had a massive impact on Amelie and in the behaviours she is able to use to communicate with her new staff team.
I was Amelie’s support worker and I am now responsible for managing her support. It takes a certain kind of person to support Amelie well. She is a very complicated person, with a history of presenting with violent outbursts and aggression. Amelie also has to deal with lots of compulsive obsessions, which vary and change from time to time. Life can be quite problematic for Amelie but her support team recognised the many positive aspects to Amelie’s personality. When supported in a way that makes sense to her, Amelie shows she is very caring and is affectionate to the people she likes.
Amelie’s new home and the support she receives has been designed with Amelie at the centre. She lives with one other person and receives one-to-one support throughout her day.
Amelie’s care and the person centred approaches used to think about Amelie’s home environment, communication and behavioural support means that her new routines compliment all the things that worked well and made sense to her from her younger days.
In looking at designing the new support for Amelie, I recognised the need to move some of Amelie’s existing staff team with her and to bring new people into her life. The team have been supported to use positive behaviour management to support Amelie manage her obsessions. Indeed, it was suggested to utilise her obsessions as a tool to develop more positive elements to Amelie’s daily life. Amelie loves to drink cola; however, this obsession with cola meant that at home, Amelie’s behaviours could be extremely challenging to manage. Consequently, in trying out new and different ideas, cola is no longer kept in her home. If Amelie wants it, her support staff suggest “let’s go out and have a cola ”. Amelie loves this whole experience; she chooses which type of cola she wants and this has seen a dramatic reduction in her obsessive behaviours around her love of cola.
Amelie also developed a dangerous obsession with biting cables; whilst her team acknowledged that they felt she loved the sensation of a cable in her mouth, the imminent risk of electrocution meant the team had to approach this obsession in a different way. Quite simple techniques were used, with low cost adaptations to her TV, kettle and toaster meant that Amelie is now much more involved in her adapted environment.
It is respectfully understood that any change to Amelie’s life is a stressful and potentially traumatic undertaking for Amelie. I have worked with this understanding to develop a consistent team around Amelie. They have worked to get to know Amelie and Amelie has got to know her new staff team.
As a result of these simple and effective strategies, incidents involving Amelie’s behaviours have reduced by 70-80% and I feel that there is a significant positive redirection in her obsessive behaviours.
As I reflect, life is still not perfect for Amelie, but I feel that using a person centred approach to developing support and managing risk has “laid the foundations for her to progress further”. A key characteristic to the success of any support worker in Amelie’s team is versatility and we are looking at recruiting several new members to the team, to provide variety in her support. The team feel that Amelie prefers male support; the thinking behind this reflecting the many years supported by her Dad . Ned, a support worker, is a gentle giant, who has brought calmness and a love of books to Amelie’s life. Ned and Amelie enjoy spending time together; Ned reads and shares a book with Amelie. She seems to love the rhythm of the words as they are read to her. Ned is multi-lingual and she really enjoys being read to in any this in any language .
Prior to this, the thought of reading with Amelie was “unheard of!” Since Ned joined the team, there has been no need to support Amelie’s behaviours with medication; instead Ned deals with any incidents using the things we know work for her like reading to her. Another of Amelie’s support staff, Keira has a very strong relationship with Amelie. Keira is a very straight talking woman who has a reputation for being composed. Not with Amelie !! Very early in their relationship, based on the premise of a game, Keira found that Amelie loves tickling! Ameile just loves this to play this with Keira and is very gentle and they have lots of fun.
My final reflections are that these on-going reductions in Amelie’s obsessive behaviours were more to do with the connection the support staff are making with Amelie, rather than specific qualities of any one support team member. This connection is based on trust, respect and one simple golden rule: “keep your promises to Amelie; if you say you are going to go out somewhere, then do it. Go out when and where you have said you are going. “In showing Amelie loving support, she will give back to you. Be honest and let’s learn together”.