10 Commandments of De-escalation
January 14, 2021

NeurAbilities

I Personal Space
– Two arms-length from patient
– Unobstructed path from room

II Minimize Triggers
– Stay calm
– “Open” body language
– Body positioning

III Verbal Contact
– Identify lead communicator
– Introduce yourself
– Provide reassuring statements

IV Be Concise
– Use simple language
– Repeat message
– Set limits, offer choices and alternatives
– Allow time to process

V Identify Goals
– Wants/feelings

VI Active Listening
– “What I’m hearing you say is…”

VII Agree
– Build empathy
– Don’t argue

VIII Set Limits
– Be reasonable and respectful
– Clear expectation, choices and consequences

IX Offer Choices
– Offer acts of kindness (food or drink)
– Identify choices/alternatives to escalation for patient

X Debrief
– Discuss events with staff or others
– Allow the patient to describe what happened in their own words

What if the patient is non-verbal?
– Proactively identify lead and mode of communication
– Use visuals, communication device (i.e. iPad) etc.

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