When things are already escalated:
- Pause – quietly observe
- Stay calm – use few words, simple and supportive: ‘We can figure this out’.
- Wait – allow time for the person to settle down; don’t touch if not needed.
- Empathize – try to nearly but not fully match the person’s level of concern
- Offer food, water, rest, movement.
Before things have escalated or once things are settling down:
(adapted from Rady Childrens Hospital ‘Code Grey’)
- Use simple language
- Give one-step directions when possible
- Allow time for processing questions or instructions
- Use visual schedules, either pictures or written
- Provide a ‘2 minute’ warning prior to changes or transitions
- Provide ongoing calm reassurance: ‘It’s ok. We can figure this out.’
- Incorporate preferred or familiar items or activities
- Use visually interesting distractions during procedures (e.g. bubbles)
- Allow opportunities for movement (walks, jumping, etc.)
Author
Joshua Feder, M.D.
Dr. Feder's Blog
