What is challenging behaviour?

Challenging behaviour in the care setting can be very upsetting for all involved. Of-ten challenging behaviour is a sign that something is wrong, a need is not being met and the person cannot communicate what they need clearly. It can be a sign of worry, fear or frustration.

However, whatever the reason for the behaviour, it is never ok for carers to face abuse at work. Employers, such as ourselves, have systems in place to protect our staff, carers and clients from this and we provide rigorous training so that carers know what to do in any situation. We provide support so that we are always availa-ble if you need us.

Below we have created a guide for how to manage challenging behaviour in the care setting to help care managers and carers alike.

What can challenging behaviour look like?

• Shouting
• Swearing
• Physically violent behaviour to you or themselves
• Refusing to help in the care process
• Refusing food or drink
• Aggression
• Becoming a danger to themselves

What causes this behaviour?

As we mentioned above, challenging behaviour can be the result of a number of different factors or stressors. Just because you may not see the stressor, doesn’t mean it isn’t a real factor in someone’s discomfort. Stressors can include sensory issues (like lights being too bright, the environment being too loud, too hot or too cold, uncomfortable tags on clothes) feeling thirsty or hungry, physical factors like injuries, illness or reactions to new medication, or emotional issues (including men-tal health conditions, dementia or emotional trauma.)

What to do if you experience challenging behaviour as a carer?

• The most important thing to do is to try and keep calm. Certain behaviours can be very distressing or upsetting to witness, and equally these behaviours will be upset-ting to the person you are caring for.
• Take a moment and a deep breath.
• Assess the situation – Remember do not put yourself into harm’s way.
• Speak slowly and clearly and explain what you intend to do to help.
• Treat the person with respect and dignity at all times – they may be unable in that moment to stop what they are doing – for example if they are overwhelmed.
• Move and act calmly – do not rush the person. Give them the time and space they need. For example, if they are overwhelmed and being aggressive, do not approach them, just stay in the room or within a safe distance and try to calmly speak to them.
• If there is an obvious stressor in the environment – for example a loud noise, then try to turn it down, if possible, as this may help make the person more comfortable.

Communication is key

Remember that challenging behaviours are in themselves communication. They are someone saying, ‘I am not happy, comfortable, well or safe.’ So, to communicate ef-fectively in what can be a highly charged emotional environment, it is important to avoid any harsh statements like ‘Don’t’ or ‘Stop!’ because the person may physically and emotionally be unable to stop their behaviour, and this could exacerbate the situation. Instead, communicate clearly how you are feeling, for example “I under-stand you are upset, however I feel worried when you do X.” Other options could be ‘I would like to help you; how can I best do this?’ ‘How can I help you right now?’ ‘It would really help me if you could do X please.’

• Keep your distance – make sure that you are safe.
• Keep a calm voice and move calmly and slowly – you may have to give the person time and space to calm down for a while.
• Call for help – remember you are not alone. Don’t be worried to ask for help, chal-lenging behaviour has a number of causes and triggers, so don’t feel worried to get help and support – you and your care team want the best for the person involved after all.

Challenging behaviour is any behaviour that causes significant distress or danger to the person of concern or others. It can include an outburst of aggression, or re-sistant type behaviour by clients. Challenging behaviours are difficult for everyone involved.