Module 2.3: Caring for the person displaying challenging behaviours

Question 1

Challenging behaviours implies?

Answer 1

a treat, which evokes a defensive response

Question 2

the nature of challenging behaviours can include…(6)

Answer 2

• Aggression & violence and/or violent outbursts
• Assault & property damage
• Related to intoxication (Alcohol / drug withdrawal)
• Self-harming behaviours
• Behavioural / psychological symptoms
• the mental illness itself

Question 3

Outline the most common causes & triggers of challenging behaviour. - Violent (6)

Answer 3

Triggers for Violent behaviour-

• Demands on consumer
• Negative attitude by health professional
• Pressure to take medications
• Power imbalance
• Generally feeling unwell / pain
• Long waiting times

Question 4

Outline the most common causes & triggers of challenging behaviour. - General (6)

Answer 4

• The experience of the illness
• Need to seek Help (feeling of emergency)
• Vulnerability & powerlessness
• Unfamiliar environment
• Marginalised group
• Loss of self-determination

Question 5

Outline the most common causes & triggers of challenging behaviour. - Organic (3)

Answer 5

• Delirium
• Dementia
• Head injury

Question 6

List 4 forms of ‘difficult’ behaviours

Answer 6

1) Withdrawn, aggressive, & hard to reach/engage.
2) demanding & claiming
3) Attention seeking & manipulating
4) Aggressive 7 dangerous

Question 7

Identify skills & techniques to minimise escalating behaviours & aggression (8)

Answer 7

• Clear management plan
• Regular review of goals
• Maintain an attitude of hope
• Set limits / boundaries
• Be honest & open
• Respond to the person / not the diagnosis
• Set realistic goals with the patient
• Written care plan in times of crisis

Question 8

Outline key steps / strategies to de-escalate a person who is displaying challenging behaviours (11)

Answer 8

• Remain calm, unhurried; warm & friendly approach
• Be supportive, respectful, courteous & avoid defensiveness.
• Maintain safety of self & others
• Focus only on essential tasks
• Do not touch the aggressor
• Provide adequate personal space
• Actively listen - acknowledge their anger.
• Diminish environment stimuli
• Be aware of own feelings (avoid counter-transference)
• Place limits on behaviour & provide consequences
• Observe for further escalation of aggression