Community Magazine

Dealing with Challenging Behaviour for Care Workers

By Steve Bradley

The life of care workers is not easy. You always have to be on your toes to ensure that the right level of care is provided for your patients. Working in a care home it is quite common to come across someone that exhibits signs of a challenging nature. Left untreated this can be very difficult to manage. Before we move into the detail of how you can deal with this sort of condition, it is important to understand exactly what challenging behavior is. In short a person’s behavior can be described as challenging if it puts them or the people near them in danger.

Challenging behavior includes:

  • Aggression to their carers
  • Aggression towards other patients or family members
  • Attempts to self-harm
  • Intense feelings of fear and paranoia

These are some attitudes that can be observed in people that exhibit signs of challenging behavior. It is also worth mentioning that challenging behavior can impact upon the patient’s ability to perform and join routine activities. In this situation, it is important to work with them on how they interact with those around them, making them feel safe in their current environment.

Communication allows us to express our emotions and it empowers us to interact with each other. In most cases, a lack of communication is a recurring problem with this types of patient. They don’t find anyone with whom they can express their feelings and discuss their issues. If the problem is down to communication, it can frustrate the patient and lead to challenging behavior. If the patient sees that their behavior results in a desired outcome, this behavior will ultimately be repeated again and again.

How You Can Help

As any qualified experienced care worker will tell you, you have to understand things from the patients’ point of view and identify what the reason for such exaggerated behavior is. There could be different causes behind it, for example, they might be feeling frustrated or threatened and unable to explain why. It is very important to identify the early warning signs of challenging behavior so that you can come up with a suitable solution. If the initial signs are not taken care of, it can result in exaggerated behavioural outbursts.

It is believed by a large number of care workers as well as psychologists that a distraction can make the patient utilise their energies in some activities that they like doing and prevent any challenging behavior. A focus on hobbies or recreational activities can help. Try diverting their attention elsewhere in the preliminary stages of an attack and see if they respond positively.  If it works, remember this and use again the next time the patient exhibits signs and you may find that you quickly create a rapport with them that allows you to rapidly defuse tense situations.  Humour can quite often help if done properly.

Of course sometimes an outburst may be caused by something as simple as the patient wanting to gain the carers attention. Patients with a tendency to be aggressive often require or strive for constant care.  Any slight decline in support offered to them may result in an outburst.  It is important to be mindful of this especially when altering care plans.

One thing to be careful of, especially if you have multiple patients in your care, is not to focus all attention on the challenging patient when they lose their temper if it is done for little or no reason.  Don’t ignore them but be mindful that sometimes their requirements for attention may be down to the fact that you are working with another patient.  Giving in to every outburst can make things worse – the patient needs to learn that challenging behavior is not rewarded.  If it escalates, intervene in the calmest possible way making sure they know that you will help them when they are being responsible.

Challenging Behaviour – Guide for Care Workers

As a care worker you will inevitably have to deal with challenging behavior. The job involves balancing the needs of multiple patients and their medical care in a wide range of situations.  Care workers need to ensure that they are not preventing the patients from doing what they like by imposing limitations based on time or other factors – but also need to ensure that limited time is split fairly amongst patients.

In any difficult situation, remember that if you act aggressively in the reaction to any challenging behaviour, you are going to make things worse for the patient and other staff members. It is important to always keep your posture friendly and ensure gestures aren’t taken as being aggressive. Try to keep your facial expressions neutral and that the pitch and volume of your voice low.  Do not shout.
9 out of 10 times, if you treat aggression with a passive response the aggressor will gradually back down. Patients are more likely to respond to you if you treat them with compassion than by screaming back at them in response.

Causes of Challenging Behaviour

There can be several root causes behind challenging behavior.  If a patient is known to be of a challenging disposition prior to moving in to care, it is useful to identify the reasons behind this in advance.  By understanding potential problem areas or flair points as a carer you can implement the right level of treatment or take necessary precautions to minimise disruptions on site.

Some causes of challenging behavior are:

  • Abuse, maltreatment, neglect, frustration, pain, or some medical issues.
  • Depression & anxiety.
  • Lack of communication.
  • Not sharing the feelings with others.
  • It can be a response to the environment such as the poor physical environment.

It is also worth mentioning that challenging behavior is not the same as a psychiatric illness. A mental problem is something else that a psychiatric can identify and treat. Challenging behavior is generally due to past environmental issues that cause patients to re-act abnormally in anticipation of a negative outcome. Because of these causes, whenever the same or similar situation is repeated in any way, the outburst occurs in the form of challenging behavior. As a care worker you should look to support the patient by understanding the trigger points and be prepared for anything to happen particularly at a time when the patient begins showing signs of challenging behavior.

Challenging behavior can only realistically be tackled with positive responses and a full understanding of the real cause behind the behavior. If you are not able to identify the reason for such an outburst, listen to the patient when they are calm and work with them on how to avoid future overreactions.

As a care worker it is your responsibility to not only protect the patient from any potential risks but also themselves and others around them. By treating them with respect, using a measured response and working with them to understand that such behavior is not acceptable, you can ultimately help reduce flair ups by helping them understand why they feel the need to act this way in the first place.

Challenging behavior courses are available from Online Care Courses as part of a subscription based service.  For more information on all of our courses for care workers go here –  Care Training Courses.

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