MDS Alert
Tool Aids Care Planning
Identifying behavior triggers tells you the 'rest of the story.'
Prevention is the best medicine - and figuring out what triggers a resident's behaviors can help you implement simple environmental and interpersonal strategies to help residents with dementia or psychiatric issues feel more comfortable and in control.
Good Shepherd Nursing Home caregivers use the assessment tool on the right to gather information for psychosocial careplanning.
Resident ______________ Resident #________________ Room #________
Environment Report (RN, LPN, CNA)
(Please answer the questions below explaining any "yes" answer)
1. Does noise seem to trigger resident's behaviors?
No____ Yes____
_____Music ____Intercom ___Other Residents
_____Alarm ____Phones ___Shift Change
_____TV ____Other___________________________________________
2. If the resident's area is too congested or if he/she is in a crowded area, does this trigger behaviors?
No_____Yes____
____Hallway ____Intruder
____Lounges ____Dining Room
____Other_________________________________________________
3. Does lighting seem to trigger resident's behaviors?
No____Yes_____
____Windows at end of hall ____Too little lighting
____Too much light ____Other________________________
4. Do cares seem to upset the resident?
No____ Yes_____
____Bathing (___Shower___Tub)
____ADL Cares __________Toileting
____Other__________________________________________________
5. Other Factors:
______Time of day ______Better or worse with certain staff
______Shift change ______Roommate problems
______Sensory
____Poor vision
____Poor hearing
____Dislikes being touched
____Likes being touched
______Other_________________________________
6. Please rate overall behaviors:
_______Improved _______No change ________Deteriorated
7. Are there approaches on the care plan that no longer work?
No___ Yes___
Explain: ______________________________________________________
Suggestions:___________________________________________________
Staff Signature ____________________________________ Date________
Source: Good Shepherd Services.
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