As you know, patients and their relatives can behave in a range of unpredictable and challenging ways – some can shout abuse at you, some may try to physically attack you, others may harm themselves. So, one of the key aspects of working in healthcare is the ability to deal with whatever behaviour comes your way. And this isn’t always easy.
This article gives a brief overview of recognising and managing some types of challenging behaviour. It’s a complex subject, so if your role involves caring for patients with challenging behaviours on a regular basis it is advisable to attend specialist training.
Let’s begin with a definition of what ‘challenging behaviour’ is. NHS Choices says:
‘A person’s behaviour can be defined as “challenging” if it puts them or those around them (such as their carer) at risk or leads to a poorer quality of life.’
Working in the NHS, you may see patients with various elements of challenging behaviours such as:
It is the impact
that these behaviours have that make them a challenge – both for the patient and those around them.
In order to deal with challenging behaviour effectively, it’s helpful to know some of the reasons why it occurs. Often there are a combination of reasons. These can include:
Challenging behaviour could also be a response to the environment. This could include over or under stimulation, inconsistencies in staff (including awareness, approach, training or staffing levels), or poor physical environments (such as extremes in noise levels or temperature).
You may find yourself dealing with challenging behaviour in a variety of situations.
It’s important to try to understand why the person you are caring for is behaving in this way and work out the most appropriate strategies to minimise distress and keep everyone safe. Different approaches will work for individual patients.
If you are able to catch the early warning signs, then it’s possible you could prevent any challenging behavioural outbursts from occurring now or in the future. This approach involves getting to know your patients and gaining an in-depth understanding of their needs.
For example, if you have a patient who suffers from anxiety, then you will find that being in a large group may make that person feel more anxious, in turn this can cause them to become agitated. So, to prevent this from happening, you could arrange for that person to receive one-to-one support or ensure they’re placed in smaller group situations.
In some cases, people find that if there is a distraction in place, they can focus their energy elsewhere which in turn avoids the challenging behaviour from presenting itself. However, it’s always important to remember that the person you are caring for may be behaving in a challenging way in an attempt to get your attention. In this situation, you could consider not responding directly to their behaviour. This can be a tricky balance as you don’t want to ignore them altogether. If, at any point, their behaviour puts you, the individual or another individual at risk, then it’s important to intervene calmly. If you need to seek further assistance, then don’t hesitate to do so.
Unless in an emergency or unsafe situation, a helpful place to start, when confronted by some form of challenging behaviour is to ask yourself: ‘Why does this person feel like they need to go to these extremes of showing this behaviour? What is happening from their point of view that is making them do this?’
Overall, it’s important to remember that if you feel out of your depth, in harm’s way, or the individual who is presenting challenging behaviour is a harm to themselves, that you seek additional guidance and help.
Dealing with challenging behaviour takes every day practice and there are a variety of skills and techniques that can be taught.
If you would like to be trained to deal with all aspects of challenging behaviour across a variety of fields, then have a look at our training courses today.
This post was last modified on 17 May 2021
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