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Working in the care industry can be challenging enough at the best of times, even before you’ve factored in that many service users can behave in a way that’s difficult to manage.
To do the role well, those working care home jobs need to have compassion, a lot of patience and even more understanding. Many patients, clients or service users will present complex and often demanding circumstances that need to be approached with tact as well as practicality. So when difficult behaviour presents itself at work, this can add to the stress of an already stressful role.
The NHS defines “challenging” behaviour as behaviour that puts a person or those around them at risk, or leads to a poorer quality of life. Examples of challenging behaviour can include aggression, self-harm, destructiveness or disruptiveness and is often seen in those who have an illness, injury or disorder that affects communication and the brain – dementia or learning difficulties for example.
Whilst most care home jobs involve an element of managing this kind of behaviour, dealing with it can be challenging for both you and the person displaying the behaviour, and it is not acceptable for workers to be put at risk of harm or injury.
When you’re faced with difficult behaviour at work, firstly remind yourself that this probably isn’t about you, or directed at you personally. Before you respond, ask yourself why the person is behaving in this way. Is this out of character? Are they reacting to a situation, or struggling to deal with a change in circumstance? For most of us, behaviour is a way of communicating our feelings. Many service users can find it that little bit more difficult than the rest of us to explain how they’re feeling, so it could be that the person is uncomfortable or distressed by something and their behaviour is them trying to explain this. Try and see things from their perspective.
Understanding the root cause of certain behaviour will then help you to respond. A dementia patient, for example, might be confused, agitated or aggressive. Looking at things from the point of view of the person with dementia will help, because many sufferers can feel disorientated or confused. They might not understand the situation, or will feel as though they have no control – which in turn can be quite frightening. Once seen in that light, it is more understandable that a person will react in a certain way.
Sexual behaviour can be some of the most difficult to deal with and unfortunately is quite common in care home jobs – especially since the person probably won’t understand that it’s inappropriate. If this is in public and there are other people around, you can explain that the behaviour is because of an illness. Although it can make you feel uncomfortable, try not to get angry, as this might make the behaviour worse. It’s important to acknowledge that he behaviour is wrong, but distraction techniques can help lighten the mood, as can treating the situation with humour! If there are early signs of this particular type of behaviour and you aren’t sure how to respond, talk to your supervisor or colleagues about how best to handle this before it becomes more frequent or serious.
Whatever the challenge, it’s important to stay composed and professional at all times. Always remember that it’s important to treat the person with as much dignity as possible (see our post on Personal Care). Many people who are acting in a challenging way are simply afraid and they need to be reassured, so raising your voice or getting angry won’t help. Is the behaviour a response to a particular activity or something you are doing rather than saying? If you can, stop that activity and try a different approach. Work out what exactly has caused the difficult response, as this can help you adapt a personal care plan that works for that particular person going forward.
If an incident happens at work despite your best efforts to manage difficult behaviour, the most important thing is to keep a record of this and make your superior aware. This is important for the safety of both care users and care workers and to ensure that proper protocols are followed. What was the behaviour and who was involved? What caused that particular incident and how was it resolved? Learn from this so that you know how to handle it better next time. Better yet, identifying the triggers for certain behaviour can help prevent another outburst down the line – which is the best outcome for everyone involved. So many people in care home jobs put up with this kind of behaviour on a daily basis because they believe it’s a part of the job – but it’s so important to talk about it.