Elderly male in care home setting holding stress ball

Managing Challenging Behaviour in a Care Setting

James Hourihan, Author

Dealing with challenging behaviour in a care setting is often emotionally distressing for both carer and patient. In care homes, encountering behaviour that challenges is not uncommon, and if left unaddressed, it can become increasingly challenging to manage. Although situations like these are inherent to the role, inefficient processes and methods for managing challenging behaviour can have a detrimental effect on the wellbeing of all involved.

Challenging behaviour is a catch-all term that includes one or combinations of shouting, wandering, biting, throwing objects, repetitive talking, destroying personal possessions and other objects, agitation and general anger, physical attacks on others, and waking others at night. In short, this term describes any behaviour by patients that is deemed to be dangerous to themselves, their fellow patients, and staff, or is considered antisocial within environments where those patients have to coexist with others on a long term basis.

(BMJ 2006;332:741)

Understanding Challenging Behaviour and Its Underlying Causes

Challenging behaviour can arise from various factors, including communication difficulties, unmet needs, pain or discomfort, trauma or environmental triggers. A trigger does not need to be visible in order for it to play a part in a person’s discomfort.

A complete understanding of the true causes behind a person’s challenging behaviour can allow care workers the confidence to tailor their approaches individually and methodically. By being perceptive to the reasons in advance, carers can work collectively, sharing information to take the necessary precautions for reducing challenging behaviour, together promoting a more positive working environment.

Adopt a Person-Centred Approach

Adopting a person-centred approach prioritises the individual’s needs and preferences in all decisions, ultimately leading to more positive outcomes and a higher quality of life for residents. Promoting person-centred care revolves around acknowledging the distinct needs, preferences, and goals of each resident, recognising their unique backgrounds, experiences, and aspirations, and customising care accordingly.

By assessing individual needs and creating tailor care plans and interventions that are personalised to the patient, caregivers can foster a sense of understanding and respect, which often results in reduced challenging behaviour.

The Importance of Communication

It is important to remember that there is always a reason behind any form of challenging behaviour, and should be viewed as a form of communication through means outside of the spoken word. Care professionals must employ clear, empathetic communication, actively listen to individuals under their care, and provide opportunities for them to express their feelings and concerns. It is important not to match the escalation through abrupt words, increased volume or aggressive tones, but to instead communicate clearly and calmly through suggestions and explanations such as “I would like to..”.

When individuals feel heard and understood, tensions can be diffused, and challenging behaviour minimised.

Managing challenging behaviour within a care setting is a pivotal aspect of providing high-quality care. By understanding the root causes of challenging behaviour, adopting person-centred approaches, and prioritising effective communication, the care sector can create a safer and more supportive environment for those in need. Positive responses to challenging behaviour at an organisational and individual level in a care setting can lead to improved work environments for care staff, and optimal patient care and outcomes.

Our RRN Certified Courses are designed to equip carers and organisations in health and social care with the knowledge and skills needed to effectively address challenging behaviour. By incorporating these lessons, organisations can create a more supportive care environment, improving the overall well-being and outcomes for individuals in their care.

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