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Jul 9

Written by: Editor
09/07/2010  RssIcon

As the number of women held in inappropriate placements increases, St Andrew's has developed a low secure service that meets the specific needs of older women with offending and/ or challenging behaviour. Read on to learn how this service has transformed one service user's life:


Rosie - Older Women's serviceAged 61, Rosie was admitted to St Andrew’s, home of the UK’s first dedicated secure service for older women. With a history of challenging and offending behaviour, previous placements had proved unable to meet her specific needs.

From an early age, Rosie was exposed to a number of traumatic life experiences. Her home life was extremely unstable and following expulsion from school, she found it difficult to hold down a job. In her early twenties, Rosie became depressed and developed treatment-resistive psychotic symptoms. She began to hear voices, becoming paranoid of others and under the influence of her delusions became increasingly challenging and violent. Before taking residency at St Andrew’s, Rosie moved between care homes, often living with service users half her own age. Life in these environments worsened Rosie’s behaviour and staff worried for her future.

With the opening of St Andrew’s new older women’s unit, Rosie’s social worker and current care team recognised the benefits this gender and age appropriate service could offer.

RAID approach challenges and reverses learnt behaviours

Following assessment at St Andrew’s, Rosie’s lead psychologist devised a management strategy for her challenging behaviour. This was centred around the RAID approach (Reinforcing Appropriate and Imploding Disruptive behaviour) which downplayed inappropriate actions and rewarded positive conduct. This saw distraction used more often than the intrusive interventions that Rosie had experienced in previous placements.

A Risk Status System was also introduced which enabled Rosie and her clinicians to monitor the progress she was making and encouraged her to take responsibility for her actions. Her medication was reviewed and altered and as her confidence developed, Rosie attended additional activities such as music and beauty sessions. These increased her interaction with staff and peers and promoted an interest in personal hygiene. 

Older Women's service

Rosie’s physical fitness and mobility was also addressed with walks around the charity’s extensive grounds. Gym and swimming sessions also became part of her daily routine.

Promising future in sight for Rosie

During her stay at St Andrew’s, Rosie’s risk and observation levels have been significantly reduced and she now willingly participates in therapies and group activities. After years of institutionalisation, Rosie’s daily living skills are growing and she now engages with staff, sharing a joke and discussing her hobbies. Since admission, Rosie is more relaxed and there have been no incidents of self-harm.
In future, Rosie will progress to a lower security facility where she will build on her skills and embark on a community work placement.

St Andrew’s has recently opened the UK’s first Older Women’s service. This new 16 bed, low secure facility has been created in response to an increased need for this provision and offers an age appropriate environment for females aged over 55 who present with an offending history and/or challenging behaviour.

This is a hypothetical case study created from a number of service users. All names and identifiable information have been changed or removed and where relevant, consent has been obtained.

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