Managing Behaviour That Challenges in Care
What do we mean by behaviour that challenges?
According to the NHS, behaviour that challenges “is often seen in people with health problems that affect communication and the brain, such as learning disabilities or dementia.” Behaviour may be labelled as challenging if it “puts them or those around them (such as their carer) at risk, or leads to a poorer quality of life” and may include self-harm, aggression, disruptiveness, inappropriate sexual behaviour, or destructiveness.
If your own patience is wearing thin and you can feel yourself becoming frustrated or angry, stepping away from the situation may give you both a few minutes of space to calm down. While this isn’t always possible, even just moving back from the person and giving them their personal space may have a positive effect. Try not to chastise yourself for losing your temper if it happens occasionally; we’re all human and a stressful situation pushes even the most patient of carers.
While it’s difficult not to take a person’s aggressive or angry behaviour personally, it is rarely about the carer themselves. Try not to feel as if the person has developed negative feelings towards you and let this cloud your assessment of the situation. It is most likely the situation that is causing their behaviour to change, not a change of feelings towards you.
How to effectively manage behaviour that challenges
Managing behaviour that challenges isn’t always easy, yet understanding as much as you can about the person you’re supporting and their reality means that you can effectively manage it. When a person exhibits behaviour that challenges, they’re not doing it to be ‘difficult’, ‘aggravating’, or ‘annoying’, despite what the people around them might think. It’s important to remember that they’re most likely trying to communicate something in the only way they can at that moment.
Speak slowly and clearly about how you will resolve the situation
It’s vital to remember that the person is not behaving that way to deliberately upset you. They may be experiencing a very different reality due to their condition, which is why it’s essential that we try to understand what they’re trying to communicate by their behaviour. Speaking slowly and calmly while watching their body language may give clues as to what they need. Reassuring them that they’ve been understood will also help them to feel more secure in themself and that their needs are valued.
If there is an obvious stressor in the environment, remove it if possible
Are they hungry, cold, or frightened? Are they attempting to take their clothes off in a public place, suggesting they’re too hot? By explaining to the person how the situation will be resolved, or taking appropriate action, their behaviour may deescalate. For instance, if you’re in a supermarket and they appear to be hot, take them somewhere cooler, such as the chiller aisle. If the stressor is another person, then encourage them to stop doing whatever is triggering them. Distraction is often the best technique in these situations.
Treat the person with compassion and patience
We all have a right to be treated with compassion and patience when we’re upset or angry, so why should it be any different for someone we’re caring for? It’s natural to be frustrated at times when caring for other people as stressors can affect everyone; however, to resolve a situation effectively, they should be spoken to respectfully and calmly. If it’s possible to ‘rewind’ a situation so that the point of contention is eliminated, try and decide whether it’s worth it. For instance, if a task can be delayed a while without consequence, then it may help to do so.
What Can You Do If the Behaviour Persists?
You will undoubtedly work out over time what strategies are effective when managing behaviour that can be challenging, as everyone is different and their triggers and calming methods will vary. It’s important to “Try to adapt to the situation as it is” according to the Alzheimer’s Society, as “Trying to get things back to the way they were before, or expecting too much of the person, can cause more problems.”
It’s really important for us to get the bigger picture and decide if the behaviour we’re witnessing really is challenging. It may be perfectly justified, and perhaps we’re being oversensitive and expecting too much of the person or imprinting our own standards on them instead of thinking about what is in their own best interest. Just because we wouldn’t behave in a certain way doesn’t mean everyone else should be judged for doing so; for instance, talking to strangers or expressing an opinion loudly. We may consider something ‘challenging’ that is actually justified and accepted by others without embarrassment.
Looking after your own mental and physical well-being is also crucial so that you’re always in the best shape to manage someone’s behaviour in a challenging situation, which is why it’s vitally important that carers get to take regular breaks. Helping Hands have been providing exceptional respite care since we were founded in 1989, meaning that carers get to reconnect with themselves, and the person they’re caring for receives unbroken continuity in their life. Receiving respite care in their own home avoids the upheaval of getting used to a new set of surroundings with the anxiety that can bring, instead remaining in their comfortable and familiar home with a respite carer who will quickly become a friend. We offer respite care on both a visiting and live-in basis for a few days or weeks, meaning that you return to them refreshed, renewed and ready to face any challenges that may come your way.