Understanding and Responding to Challenging Behaviour Understand the

Understanding and Responding to Challenging Behaviour ‘Understand the message and engage with the need that is not being met’

Unmet needs l l l It is widely recognised that most challenging behaviour in dementia is an attempt at communication ‘unmet needs’ What may those needs be? Stokes (2001) “We can no longer assert that when cognitive functioning fails us, all that is left is our physical self. We must attend to the psychological needs of people with dementia if we want to improve their well-being. ”

Unmet needs l Kitwood (1997) “Satisfaction and well-being will only be attained when we address meaningfully the needs of those with dementia, needs which are common to all people, yet may be heightened by the experience of dementia. ”

Physical needs l l Challenging behaviour may result from pain People with dementia DO FEEL PAIN, but may not understand it and respond with anger or fear. Privacy, dignity and respect in care Poor care often results in annoyance and frustration, which are common triggers for challenging behaviour.

The need for security l l l We all need to feel psychologically safe Fear and frustration is one of the main causes of challenging behaviour in dementia Night time can be very traumatic Lots of different staff may cause insecurity Resistance or aggression may result from a poor approach

The need for occupation l l To be engaged in occupation and have stimulation is fundamental to psychological well-being Under stimulation is a cause of challenging behaviour in dementia

Social and human contact need l l Social contact is crucial to well-being and has a protective effect against psychological distress People need to feel a sense of belonging

The need to know l l l Humans are inquisitive beings! Due to confusion and disorientation, people with dementia have an increased need to know, and seek information from those around them and from their environment People will seek meaning and comfort.

Egocentric needs l We all need to have self-respect, selfdetermination and control, and a sense of possession (mine) l Challenging behaviour in dementia is often caused by staff failing to acknowledge or to meet egocentric needs.

Sexual needs l There is no age at which sexual activity abruptly ends yet the cultural expectation is for older people to be asexual l We cannot deny a person sexual expression, but need to ensure their safety and dignity