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How to deal with challenging behaviour in adults

A person's behaviour can be defined as "challenging" if it puts them or those around them (such as their carer) at risk, or leads to a poorer quality of life.

It can also impact their ability to join in everyday activities.

Challenging behaviour can include:

  • aggression
  • self-harm
  • destructiveness
  • disruptiveness

Challenging behaviour is often seen in people with health problems that affect communication and the brain, such as learning disabilitiesor dementia.

What can you do to help?

As a carer, try to understand why the person you look after is behaving in this way. For example, they might feel anxious or bored, or be in pain.

If you can recognise the early warning signs, you may be able to prevent behavioural outbursts.

For example, if being in a large group of people makes the person you care for feel anxious and they become agitated, you could arrange for them to be in a smaller group or have one-to-one support.

Some people find a distraction can focus a person's energies elsewhere and prevent them displaying challenging behaviour.

The person you care for might behave in a challenging way to get your attention.

If this is the case, consider not responding directly to their behaviour - although you shouldn't ignore them completely.

But if their behaviour puts them or someone else at risk, you'll need to intervene as calmly as possible.

Professional help

If you're finding it hard to cope with the behaviour of the person you look after, ask your GP to refer you to a specialist.

The specialist will want to know what situations or people trigger the behaviour, what the early warning signs are, and what happens afterwards.

In extreme circumstances - for example, if the person's behaviour is harmful to themselves or others and all methods of calming them have been tried - a doctor may prescribe medication.

If you're concerned about the side effects of medication, speak to the person's GP.

Tips for carers

  • seek support - many organisations for people with learning disabilities or dementia have schemes to connect carers with others in a similar situation 

  • get respite care for the person you look after so you can take a break

  • keep in touch with friends and family members - they can be an important source of practical and emotional support

  • don't be tempted to restrain the person you look after unless you believe their behaviour is putting them at risk and they don't have the mental ability or capacity to make a decision

Sexual behaviour in adults

Sexually inappropriate behaviour in adults who need care can be a result of a mental health or neurological condition, such as dementia.

It may include:

  • undressing in public
  • fondling genitals
  • touching someone inappropriately

You may not be able to stop a person engaging in inappropriate sexual behaviour, but there are ways you can address it:

  • think about or ask the person why they're acting in a certain way. For example, if they start to undress in public, are they hot or uncomfortable?
  • stay calm
  • treat the situation with humour, rather than getting angry
  • distract their attention, rather than getting confrontational
  • if other people are present, explain to them that the behaviour is because of an illness and isn't personal
  • keep a diary to see if you can find a pattern in their behaviour - for example, whether it's more likely to occur in certain situations, with the same people present, or at certain times of the day or night

If you're finding it difficult to control the behaviour of the person you look after, speak to social services or their GP.

This page is based on content that originated from the NHS (adapted).

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