One Approach Does Not Fit All | A Carer's Guide to 'Challenging Behaviour'

One Approach Does Not Fit All

How to support someone who does not have a diagnosis of dementia, but may have other mental health issues, who may suffer from extreme anxiety or may just be rude, or angry no matter what you do or say.

To many the notion of being a live-in Carer evokes cosy scenes of chatting with a nice ‘old lady’, while drinking copious cups of tea, swanning off to the theatre with our clients, or even going on a cruise or two. This can happen, in a few instances, but is not generally the case. Many well-meaning Carers can come in for a rude awakening when suddenly finding themselves facing behaviour challenges they had not dreamed of.

At The Good Care Group, we are all trained in the SPECAL method of communicating with people living with dementia. However, I am not talking about this. I am wanting to address the issue of being a stranger, living in the home of someone who does not have a diagnosis of dementia, but may have other mental health issues, who may suffer from extreme anxiety or may just be rude, angry or mercurial no matter what you do or say.

Firstly, it is important to read your client. Every person responds differently, and sometimes surprisingly so, to a perfectly nice, well-meaning stranger whom they suddenly find living in their home. That most precious place of safety and sanctity can suddenly feel endangered. In my experience, the one-size-fits-all approach of unrelenting cheerfulness is not the way to win over anyone who is intent on being miserable, ill-tempered, or rude. This sunny, cheerfulness is irritating to someone who is on the other end of the emotion scale, which could be more likely to pour oil on the flames rather than penetrating their pain. For this is what it is, people who habitually exhibit rudeness and anger are in pain. They may have been in pain for years, perhaps a lifetime, and this is what they feel comfortable with, this is what they know. We cannot force someone out of pain by simply being cheerful.

This is where mirroring can be a useful tool. I do not mean we are to meet anger with anger and rudeness with rudeness. We should never be rude or angry with those in our care. What I mean is being observant and being willing to change course if your cheerfulness is not working. Be friendly, be polite, be helpful, smile, but tone it down, like a radio dial, subtly adjust your energy, your voice, your movements, your facial expressions. Talk to the person like one sensible, compassionate adult to another.

When I go into a placement with a client who has a history of “being difficult’ I spend the first twenty-four hours quietly observing that person. I do everything I am asked to, with grace and kindness, I ignore any cross words directed at me, and I never force my cheerfulness on her or him. By doing this you are doing is showing, by your actions and your manner, that you are not a threat, that you have not come into their home to tell them what to do and how to be. You are building​ up trust, a solid foundation to develop a mutually pleasing relationship with a frightened stranger whom it is your task to support.

This approach isn’t going to win people over instantly. You will be tested to see what reaction can be got from you. Persevere with kindness and willingness, give the person space to be themselves. They will test you, but once they see that you are not rising to any confrontation or telling them their behaviour is unacceptable, most people will start to relax a little. There is no fun in trying to pick a fight with someone who isn’t playing.

Once you and your client get to this point, the relationship starts to become more pleasurable for both parties and then more headway can be made with the job of providing the support required. However, always remember that you are in someone else’s home and life, so it does not do to become too casual and fall into the trap of thinking that this is a friend or relative. It is a fine line to walk sometimes, yet an observant and intuitive Carer will quickly read a situation and a person and make the required adjustments.

Laetitia Hannan is one of our very own Professional Carers who has worked with The Good Care Group as a Relief Carer on the Senior Care Team for over 3 years. Laetitia strongly believes in providing an outstanding service to the clients she cares for and provides a fascinating insight into the role of a carer. We hope that you enjoyed this blog as much as we did and find it both interesting and useful. If you have any comments or questions please feel free to leave below!

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