Challenging behaviour can be explored in every client group however the client group explored here is older adults within informal care. Due to the Data Protection Act 1998 the name of the older adult involved in the care has been changed to Client X. Why challenging behaviour occurs can be explored and explained through many different avenues such as through the use of psychological theories and situational factors that can effect behaviour. A class discussion found a definition of challenging behaviour to be ‘Difficulty breaking though to or working with an individual/group with behaviour that is challenging for you personally to deal with regardless of circumstances’. However according to Emerson, (1995, cited in Emerson, E 2001) challenging behaviour can be defined as “Culturally abnormal behaviour(s) of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities.”.
Such varied definitions of challenging behaviour can be confusing which is why it is important to have one definition of challenging behaviour in the work place so when dealt with it is always consistent and can be tailored to the individual organisations need for example a prisons outlook on challenging behaviour may vary considerably from that of a care home. The definition used with Client X was ‘Any behaviour that became difficult to handle when anyone carer was present and if behaviour continued to remain difficult to handle two carers would then be present at all times.’ This then helped with recognising when help would be need and everyone was then able to deal with challenging behaviour of Client X in the same manner.
There are many different forms challenging behaviour can take and during a session with Client X she showed several different forms of challenging behaviour that escalated from on to the other. In the morning Client X was normally a bit confused and disorientated however on this particular morning she was more confused than normal due to an infection and new medication. She became hard to communicate with because of her confusion and it became very hard to understand what she wanted. This then made her frustrated so she became verbally aggressive and started to shout and swear at the carers to try and get their attention but this just made it even harder to understand her and find out what she wanted. Due to still not being able to understand the needs of Client X she became physically aggressive and tried to lash out and hit anyone that came near her.
This situation was then dealt with by calming the client down by bringing her, her morning cup of tea as she began to calm down she became easier to understand it was at this stage she was able to be understood which meant she was able to get what she wanted and was no longer displaying challenging behaviour. During another incident of challenging behaviour with Client X she became non – participative when she was first put under the care of others, she had just come out of hospital after a long spell of illness. She had always been extremely independent and when she came out of hospital she then needed to be cared for because she was unable to do things for herself such as get dressed and make her own food. Having lost her independence and having to rely on others Client X became withdrawn and unresponsive to the carers and refused to participate in activities she used to participate in, such as going to the hairdressers on a Friday.
She also refused to speak to her carers to tell them what she wanted and she refused to eat the meals that were prepared for her which may be seen as a form of self – injurious behaviour. She told carers that she would only eat if they were to leave her alone. This became increasingly hard to deal with until Client X became accustom to the notion that she was unable to do everything she was able to do before. As a way of helping Client X she was given as much independence as possible to try and make the transition easier. As she became used to the carers coming into the house she soon became glad of the company due to being unable to get out of the house on her own. This then grew an element of trust between the client and the carer which meant that she was then more willing to participate with the carers and would communicate with them on a regular basis.
Challenging behaviour can be explained through the use of psychological theories, Maslow’s theory, and his hierarchy of needs is based on motivation and that every person is driven to grow into a self-actualised person (Bingham et.al. 2009:86). Maslow’s hierarchy of needs has six stages; Physiological Needs, Safety Needs, Love and Belonging Needs, Self-Esteem Needs, Fulfilment Needs and Self-actualisation. This theory relates to Client X because all her physiological needs are being met through the attention of her carers. Some of her safety needs are being met through safety of family and she has a home, however due to having to take medication every day and being unable to walk without the use of a walking aid is affecting her sufficiently meeting all of her safety needs. This would then cause Client X to display challenging behaviour because she wanted to be more independent and be able to walk without an aid.
Again some of her love and belonging needs are met because she has a family but due to busy schedules does not get to see them as often as she may like. Since she came out of hospital her confidence and self-esteem dramatically diminished due to no longer being able to do things for herself and she was not given the same respect by others since she was no longer able to get around herself and she was no longer able to work. She then began to internalise this and start to act on it which continued to decrease her confidence and self-esteem. This would also cause Client X to act in a challenging way because she would be frustrated with having to be looked after and being reliant on others to her meet her basic physiological needs. Although not all of Client X’s needs have been met there is still opportunity to self-actualise as self-actualisation is meeting ones own potential and Maslow believes we are not static and can move up and down the hierarchy of needs due to a change in circumstances. (McLeod, S. A. 2007).
The behaviourist theory of Classical Conditioning made famous by Ivan Pavlov is a theory based on learning a new behaviour by association, this is when a stimulus triggers a response (McLeod, S. A. 2008). Which can be explained from a quote by John B. Watson the famous psychologist who states “Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I’ll guarantee to take any one at random and train him to become any type of specialist I might select — doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors.” (Watson 1930, cited Cherry no date). Client X learned through association such as she would associate Fridays with going to the hairdressers and if she was unable to go due to being too ill at that particular time then she would become withdrawn and not want to talk to anyone or participate in anything.
Also during periods when she was having a confusing spell she would associate older gentlemen with her late husband and become hysterical and it would become difficult to calm her down, however she would calm down if she was removed and the gentlemen was no longer in site. Life experiences and situational factors can also contribute to challenging behaviour, as stated earlier Client X is unable to walk without the use of a walking aid. Due to this it makes it hard for her to gain access to her own home as a result of having front and back steps, leading to the front and back doors. This external factor causes Client X to be unable to leave the house much which causes her to become frustrated and display challenging behaviour, this can take the form of verbal and sometimes physical aggression towards her carers if they are unable to take her out the house on a particular day.
Due to not being able to leave the house she is unable to make social connections she also has to take daily medication and has low self-esteem due to being unable to walk without an aid. These internal factors cause challenging behaviour in the form of segregating herself from others and becoming withdrawn from social situations. Challenging behaviour can be explained through psychological theories and can be understood through the knowledge of life experiences. Having the knowledge of a client’s psychological background and knowing what internal and external events in that clients life are contributing to their behaviour can help to reduce the frequency for challenging behaviour and can be dealt with in an appropriate and effective way when it does occur.
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