Guide to working safely with challenging behaviours in health care

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Employee / workerEmployer

Challenging behaviour is any behaviour that causes significant distress or danger to the person of concern or others.  It can include an outburst of aggression, or resistant type behaviour by clients.

Challenging behaviours are difficult for everyone involved.  Whilst managing these behaviours may be part of the job, it is not acceptable for workers to be hurt.

Report early signs of challenging behaviours. Talk about your concerns with your supervisor or at team meetings.  Early reporting enables management to take action.

Preventing challenging behaviours

Any situation or feeling can act as a trigger for challenging behaviour.  This is frequently unpredictable. However the approach made towards the person is very important.

  • Pause – stand back, take a moment before approaching and assess the situation.
  • Speak slowly and clearly in a calm voice.
  • Explain your care actions.
  • Try not to rush the person, act calmly.
  • Show respect and treat people with dignity at all times.
  • Minimise boredom, social isolation and irritating factors in the environment such as noise, uncomfortable clothing.
  • Enhance comfort, exercise, participation in activities, decision making and dignity.

Communication is the key

Avoid harsh aggressive or abrupt statements.  Don’t say things such as “You must….”, “Don’t…..”, “Stop…….”.  Use alternatives and “I’ language like “I would like you to…” It would help me if……”, “ I feel scared when…….”.

When challenging behaviour happens

  • Back off where possible.
  • Keep calm.
  • Call for help.
  • Leave the person to calm down, if possible.
  • Remove others from the environment, if possible.
  • Be aware of body language and tone of voice used to the person.

Employers have a duty of care to do all things possible to prevent or minimise any harm that may occur as a result of challenging behaviours.  This includes providing a means of communication for emergencies, an emergency response system and procedures.

Workers must follow reasonable instructions in managing challenging behaviour and protect the safety and health of themselves and others.

Further information

Code of practice: Violence, aggression and bullying at work.

Handbook for workplaces: Prevention and management of aggression in health services. June 2017

Guide / handbook
Last updated 09 Oct 2018

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