Problem solving scenario 1

Fela has been scratching his face a lot and looking uncomfortable. Because of his continuous disturbed nights over the last 4 days, staff have not been able to give him a facial trim. What should staff do?


  • It is important to read Fela’s mood and body language the entire time.
  • The focus is to get Fela in a relaxed enough state that you can give him a facial trim as he has not had one in 4 days. This is probably what’s causing the constant itching.
  • You will need to exercise caution in entering Fela’s personal space to clean his keloids so it might be wiser to dab the witch hazel on a cotton pad and prompt Fela to clean his keloids himself, then apply creams himself from small tubs.
  • It would be helpful to put the facial trim on the TEACCH board to see how Fela reacts. As him whether he is happy with it using “thumbs up, thumbs down” card/signs.
  • If he seems happy enough, then remember to put a rewarding activity on the board for afterwards e.g. snack. Proceed with caution and be very gentle, keep it to a mini trim of about 10 minutes max so as not to overwhelm him.
  • If he is not happy to have a trim, focus on relaxing him enough to get him to have a nap e.g. put on relaxing music on Plex/ youtube on a low volume, prepare room by closing curtains, offer footspa, disconnect white phone and remove other phones. After foot spa you can  prompt him to lie down on the sofa with his big blanket.
  • You can distract him from scratching his keloids by prompting him to occupy his hands with stress balls, sensory balls, fidgit spinner, slinky.
  • Hopefully after his nap/rest, he will be in a more receptive mood for a facial trim. Once again, you can ask him using the TEACCH board, “thumbs up, thumbs down” card/signs.


N.B. Fela needs to have his facial hair trimmed every other day, and facial scrub on the days in-between. All men suffer from itching if they do not shave/trim their facial hair on a regular basis. Added to this, there is hair growing in his keloid which is trapped and which he cannot get to to scratch. Fela’s keloid cream has anti-itch properties.