Challenging+behaviour

__**Challenging Behaviour – Andy Gibb**__ Challenging Behaviour is a term first used in North America in the 1980’s used to describe “abnormal” or “socially unacceptable” behaviour shown by an individual. (Xeniditis, 2001) The most commonly used definition in literature is as follows: ‘Challenging behaviour refers to 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 that is likely to seriously limit use of, or result in the person being denied access to ordinary community facilities.’ (Emerson 1995) Behaviours classed as challenging include: Verbal Aggression Shouting Stripping Stealing Anal Poking Self-Injury Withdrawal from others Physical Aggression Persistent Screaming Inappropriate sexual behaviour Property Damage Smearing of faeces Disturbed sleep Non- compliance (Twist and Montgomery, 2005) These behaviours can be caused by individual factors or a combination of factors and are usually due to the fact that an individual can not remove themselves from a situation, or make themselves understood. (British Institute for Learning Disabilities 2011) //Communicative// //Psychological// //Physical// //Biological// It is widely accepted that depending on the challenges, both cognitive and person centred approaches should be used as appropriate to reduce the challenges. Cognitive therapy would be directive, task orientated with the focus on behaviours. Person centred would be client led, with no goals set and a focus on emotions. (Thomas and Woods, 2006) __**References-**__ British Institute of Learning Disabilities – What Do We Mean By Challenging Behaviour, http://www.bild.org.uk/05faqs_3.htm Accessed 21st September 2011 Emerson E (1995) Challenging Behaviour: analysis and interventions in people with learning difficulties //Cambridge University Press// Cambridge. Thomas,D. Woods, H (2006) Working with people with Learning Disabilities, Jessica Kingsley Publications, London Twist S, Montgomery A (2005 ) Promoting healthy lifestyles- challenging behaviour. In: Grant G //et al// (eds) (2005) //Learning Di//sabil//i//ty- A Li//fe Cycle Approach to Valuing People ,// Maidenhead, Open University Press Xeniditis K, Russell A, Murphy D (2001) Management of People with Challenging Behaviour //Advances in Psychiatric treatment// **17** 109-116.
 * Definition**
 * Types**
 * Causes**
 * Inability to understand a nurse/ carer’s communication.
 * Inability of nurse/ carer’s understanding the patient’s communication.
 * Changes in staff (some staff can communicate effectively, some may be less able)
 * Inability of patient to communicate fears, anxieties, concerns, pain, distress
 * Staff not advising changes in patient’s daily life directly to patient.
 * Looking for attention due to requiring personal care (food, drink, change of clothes, illness).
 * Previous abuse – staff may remind patient of previous abuser.
 * Other patients.
 * Bereavement.
 * Loss of personal items.
 * Change of location ( particularly from hospital setting to home or vice versa).
 * Frustration of immobility.
 * No transport available
 * Restriction of freedom of movement
 * Changes of location, for example moved to a house where no access to garden or part of the house.
 * Recent changes in medication.
 * Required changes in medication.
 * Puberty
 * Menopause
 * Allergy
 * Infection (for example urine infection)
 * Approaches to challenging behaviour**