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Difficult, physical and verbally aggressive behaviours have combined to become one of the three most common Occupational Health and Safety issues occurring within many facilities. However, these behaviours do not belong as an OHS issue.

When we care for people with dementia we are not working with machinery, we are caring for human beings! When they react with difficult behaviour, it is not because the ‘machines’ are faulty – although we might sometimes like to think so; it is because the way we are treating them is flawed.

These people are incredibly vulnerable individuals with very special and finely-tuned needs. We cannot expect them to adjust their needs to our ways; rather we must tune our ways to meet their needs. The frightening reality is that if we don’t, we will go on producing more and more difficult behaviour responses from those in our care.

Difficult behaviour is a reaction to something that is not right for the individual person and generally occurs when the person has a need that is not being met. The need doesn’t have to be a physical one, but may be emotional or spiritual, such as the need for respect, love or happiness.

To prevent difficult behaviour, we need to change our focus from only looking for what’s wrong with the person physically to compassionately searching beyond for what the person’s unfulfilled needs might be.

In his book Non-Violent Communication American psychologist and peace mediator, Dr. Marshall Rosenberg, teaches that the language of compassion is a powerful tool when communication is difficult.

We are taught to “engage a professional distance”, to observe, evaluate, judge and label the other person’s behaviour and, in so doing, we often lose touch with our innate human quality of compassion.

Let’s change our perspective for a moment and step into the ‘difficult’ person’s shoes and compassionately discover why this person is reacting with “difficult” behaviour. Now we need to ask: What deep, underlying need has not been fulfilled for the person calling out, ‘Help, help, help’?

There could be many reasons, such as the need for attention, security or companionship. However, behind these needs lies an even deeper, underlying need. That is… the need for love.

If we cannot understand the nature of compassion, we may not recognise that when a person is calling out to us, the underlying need is for love. We only see what the person is doing as an irritation and brand it accordingly as difficult behaviour. Consequently, the more the person calls out, the more we withdraw.

This type of situation often escalates until, in desperation, the person ends up banging on the armrest or table – maybe even throwing him or herself onto the floor. This has nothing to do with the machinery being faulty, nothing to do with any neurological changes; it has everything to do with the quality of the interaction.

The solution is simple. We need to acknowledge the person’s need for love and then find ways to provide it.

Instead of thinking of difficult behaviour as something we need to manage – remember that difficult, angry and aggressive behaviour is all about cause and effect and our failure to meet a person’s needs.

As His Highness, the Dalai Lama, so simply explains:

Our actions create either suffering or happiness.

Further reading – Click topic

• A Positive Approach to Difficult Behaviour – Article – Jane Verity (Read the full version of this article including understanding cause & effect, learn how to work with the need rather than against it and discover successful strategies for preventing difficult behaviour)
• The Bus Stop Band-aid – Précis/Article – Jane Verity (Discover the emotions and reasons behind the words, I want to go home; learn positive ways to fulfil unmet needs and proven strategies to remove the necessity for the bus stop and other band-aid solutions. Also, learn why “Best” is the Enemy of Greatness.)
• 10 Successful Solutions to the Shower Challenge – Précis/Article – Jane Verity (Learn 10 reasons why people with dementia might refuse to shower and their 10 successful solutions; including: Living in the Past, The loss of Abstract Thinking, and Misinterpretation plus learn 3 helpful hints towards successful bath and shower times.)
• Reducing Anxiety and Agitation with Aromatherapy – Article – E. Joy Bowles BSc. (Read how aromatherapy appears to be providing an alternative to the use of anti-psychotic and sedative drugs that often are prescribed for so-called difficult behaviours.)
• How can Aromatherapy Help People with Dementia? – Article – E. Joy Bowles BSc. (Joy’s article reveals how the ‘sense of smell is non-verbal and can get through” to emotions when words fail’; the use of smells can help orient people with dementia to time and space; tips for choosing and using the right oils to lessen anxiety, agitation and depression.)
• Turning Hassles into Highs – Article – Jane Verity (Learn simple strategies to turn negative experiences in every day tasks into real highs, ensuring successful outcomes for all; plus the two keys to how these techniques work.)
• Hugs not Drugs – Short article – Jane Verity (Discover 3 factors behind attention-seeking behaviour, the 5 secrets to “great” hugs and 5 hints to check if a hug is creating discomfort in another person; plus a wonderful non-threatening excuse for exchanging a big hug.)
• A Doorway to the Present – Article – by E. Joy Bowles BSc. (Learn how brain cells respond to incoming messages about odours and how we can use them to redirect or distract agitation; plus learn how odours can be used to encourage people with dementia back to the present.)
• Sure-Fire Trust Building – Tip – (Discover how to establish trust with a person with dementia in a split-second, and how to avoid unconsciously triggering difficult behaviour.)
• Creative Thinking Solves Toilet Challenge – Tip – (A professional carer’s tip to solving the challenge of a resident going to the toilet everywhere, but in the toilet, plus a fantastic question to ask when seeking constructive solutions to challenging behaviours.)
• Ribbons Turn Shower Challenge into Bliss – Tip – (Read how one professional carer discovered successful showering through the magic of colour.)