Booklet - 2003

Challenging Behaviour by Carol Jennings, PDSG

Challenging Behaviour

Personality Change
Along with the obsessions, speech problems and strict routines, the main challenging behaviours are aggression and disinhibition.

Triggers
Working on the premise that ‘prevention is better than cure’ it is useful to look for the triggers for this behaviour. Can we determine a possible cause?

• Medical: these include
  Reaction to medication and infections e.g. urinary or respiratory tract.
  The most important factor is identification of pain.
• Environmental: This includes anything that attacks the senses:
  Too much noise or too many people
  Intrusion of personal space
  Frustration due to change of routine
  Lack of communication
  Loss of impulse control
  The need to control often hiding incompetence with accusations
  Trying to get own way or attention

Making matters worse
It helps if the carer is not confrontational and does not take personal offence or raise their voice. Hurrying or crowding heightens feelings of threat and alarm. Also avoid reacting to their abuse, trying to reason with them – they can’t, or trying to make them do something they don’t want to do.

Dealing with the problem
Effective management of aggression and disinhibition is helped by the following skills:

• Staying calm, respecting personal space and reassuring.
• Keep a sense of humour.
• Refocus – perhaps with a change of subject or treat.
• Keep decision making to a minimum.
• Try to find purposeful activities, exercise.
• Allow flexibility of routines, behaviour, and desires.

Conclusion
Challenging behaviour happens. We may not be able to stop the problem but we can;
i) Try to be aware of the triggers
ii) Never argue - assure a feeling of safety by consistency and continuity
iii) Walk away, try later, and be flexible.

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