Hi, I am Taylor Shantz. I am a Direct Support Professional at the South Dakota Developmental Center. I have worked for them for about a year. Working at the Developmental Center I have dealt with some very abnormal things and dealt with people whose cognitive thinking ability is very low. Trying to reason with these residents is pretty difficult sometimes, it is not always possible to reason with them when they are in an aggressive state of mind or mode. In situations like these the thing we always try to do is de-escalate the scenario verbally and if we are unable to make progress or reason the last thing we do is intervene with physical holds. Sometimes you don't have time to verbally reason because it's so sudden so this is a method of self-defense as well as a method of containing the issue and making sure the resident doesn't hurt themselves or others. I am now going to show you how to perform a standing team hold and transfer into a floor hold in the safest method for you and the resident.
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Step 1: Step 1- Slowly Angle Yourself and Approach the Resident
The first step in this process is making sure there is nothing else verbally you can do to de-escalate or prevent the situation you are in. Once you realize there is nothing else you can do then you and another person (staff member) give each other some signal either verbal or if you have been doing this for a while you will know when it is time to initiate the hold or you and another staff member will give each-other a head nod or some non-verbal signal. You initiate the hold by preferably standing behind the resident angle towards there shoulder. It varies frequently because it all depends on the scenario and where it happened. You must approach slowly from whatever angle is the safest to in the situation you are in. You and the other staff must approach the resident at the same time on both sides. While walking up you should be checking the person to see if they have anything in their hands that could hurt you when you try to grab it.
Step 2: Step 2- Start the Hold
The second step is to start the hold. If you are on the right side in one fast motion you are going to want to grab the resident's right wrist with your right hand. Make sure you have tight enough grip to not let go but you also don't want to bruise whoever you re holding. While grabbing their wrist you are going to want to slide your left arm between their rib cage and their forearm. When you grab their right forearm, once you have good grip you are going to want to move your right hand from their wrist to their hand and grab it from the outside. You are going to want to get a good grip on their hand, it should look like you are almost trying to cover their hand with your hand. Then you are going to want to stand close to the person while keeping both of those grips. The closer you can be to them while performing this hold the safer you will be because you will be more secure therefore having a better grip. You are going to want to put their elbow between your left rib cage nd your left forearm. This secures their arm so they can't swing across and hit you.
Step 3: Step 3- Laying Them on Ground
The next step is if they try to lift their legs or fall to the ground. The State mandates that you are not able to take the residents to the ground they must do it themselves. If they lift their legs, you can either lower them to the ground as safe as possible or you can let go if you need to for your own safety or if you are unable to bare the weight of the person you are holding. If you lower them down, you have to step back for a second and not have hands on the person because the states restrictions on team holds.
Step 4: Step 4- Initiate the Floor Hold
The next step is to communicate with your other staff members to initiate the floor hold. For this hold it would be beneficial if you had three staff members, you can use two but not for very long. You start by having two staff approach from a tactical angle just like the standing team hold. Once you two are standing on either side approaching you will grab a hand. If you are on the left side of the person laying on the ground facing up, you will use your left hand to grab their right wrist. If you need to you can use your right hand to gain control, then transfer the wrist to your left hand. Once you have secured their hand to the floor you should take a second to look around and check other staff to make sure they are doing okay.
Step 5: Step 5- Hand Placement on Floor Hold
Next you will take your outside hand and hold their wrist to the ground, and use your inside hand to secure their shoulder to the ground. It is important during this hold to make sure you are never holding with a closed hand. You want the hand that is on their shoulder to be flat to prevent bruising and injury. You also should make sure that the outside hand holding the wrist is "U" shaped to prevent damage you could cause with your finger tips.
Step 6: Step 6- Securing Legs
While performing the floor hold you will have a staff member lay across legs of the person on the ground to prevent kicking and movement. This step is pretty simple because you lay across the legs of the resident but be sure to be above the knees so you don't cut off circulation. Once you've laid down on their legs you will be laying on your side facing which ever way gives you the tactical advantage.
Step 7: Step 7- Finished Hold
Once everyone is done performing their hold you should have the person secured to where they won't be able to aggress at anyone or hurt themselves. You can now try to talk to the person and reason with them and see if you can prevent doing anymore holds on them.