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Challenging, 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 caring for people with dementia, we are not working with machinery but are caring for human beings. When they react with challenging behaviour, it is not because the ‘machines' are faulty, it is because the way they are being treated is flawed.

 People with dementia are incredibly vulnerable individuals with special and finely-tuned needs. They should not be expected to adjust their needs to routines and requirements; rather their care routines should be adjusted to meet their needs.

Understanding challenging behaviour

Challenging behaviour is a reaction to something that is not right for an 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. Or the need might be something said or unsaid; something done or not done. Always remember to ask:

• What is this person attempting to communicate?
• What is the need that is not being fulfilled?

Knowing that challenging behaviour is a reaction to something that isn't right or in other words, an unmet need the ‘challenging' person may be indirectly attempting to say, ‘Please acknowledge me as a whole person and not only for my deficiencies and changed behaviour; for I am not in control of them. I cannot bear to constantly be reminded that I need help... that I am told when to go to the toilet; when to go to bed; when to eat and especially that I can't go home.Being treated like has become my entire existence now, and it is absolutely soul destroying. I want to smile once more, laugh again and make light of it all. Please acknowledge me for all my beautiful human qualities, of which I still have plenty. The more you do this, the more these qualities will shine through and show the real me.'

Shifting focus

To prevent challenging behaviour,  change focus from only looking at what's wrong with the person physically, to compassionately searching beyond for what the person's unfulfilled needs might be.

When challenging behaviour is experienced in our own families, colleagues, residents, or their relatives, we are the ones who define the behaviour as challenging. This is due to focusing solely on the problem, and seeign the situation only from one point of view. It is easy to see the block of marble and not the angel inside.

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.)