If not, how can you raise the importance of this within your workplace? So far, we have explored person-centred care and how our values and beliefs can affect how we work with people. In keeping with the focus of this educational resource, we have used activities and case studies that relate to supporting people with behaviours perceived as challenging. The next section begins to explore what we mean by “behaviour” and “behaviours perceived as challenging”. 1.3 What is “behaviour”? “Behaviour” is often used in everyday language to refer to “good” or “bad” behaviour, as if our behaviour is only part of what we do. In behavioural terms, “behaviour” refers to everything we say or do. This means: a person is perceived as “behaving” all of the time activity is often thought of as being the same as behaviour a person is behaving even when he or she is doing nothing. “Challenging behaviour” has become part of everyday language in the of learning disability. Behaviour can be perceived or described as “challenging” for a variety of reasons. We’ve already considered how behaviour may be appropriate in one setting but not in another, and how a person’s ability to give a plausible account affects perceptions of his or her behaviour. We’ve also considered how different workers perceive behaviour differently and can consider it “challenging” when it presents a risk to them and others or if they find it difficult to manage or understand. This is reflected in the following definition from the Royal College of Psychiatrists: “Behaviour can be described as challenging when it is of such frequency, intensity or duration as to threaten the quality of life and/or the physical safety of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion.” We use the term “behaviours perceived as challenging” in this resource to place an emphasis on services’ ability to meet people’s needs and move away from the view that the difficulties are an intrinsic part of the person. Activity 1.3.1. Factors that impact on behaviour
Relationships and meaningful activities are important in everyone’s life and helping people connect in their communities can enable them to find real friendships. Support to undertake a task or activity should be matched to a person’s need. Skills teaching can help people learn new skills and improve their quality of life. Learning outcomes What you will know You will understand: the importance of recognising, enhancing and supporting the strengths and abilities of people with learning disabilities the benefits of continued engagement in roles and relationships, and that people with learning disabilities have a right to be supported to achieve this the importance of participation in meaningful activities what Active Support how to match support levels to need, consequently helping people develop new skills and make the most of new opportunities the nature of community mapping. What you will be able to do You will be able to: interact with people with learning disabilities in a person-centred way that recognises and utilises their unique strengths and abilities encourage people with learning disabilities to retain, regain or gain social networks, work, education and community connections support people with learning disabilities to complete tasks successfully, regardless of how little input or how much support they need build an Active Support plan support skills development facilitate the active participation of people with learning disabilities, their family and carers as partners in care use community mapping to increase networks and opportunities for people with learning disabilities.
It was really hard initially to think about how you could involve people in activities, but we had a mentor who would work with us on shift to guide us and provide feedback. The first few times I tried to involve Nadia in vacuum cleaning the floor she would just push me away. Then we changed how we asked her. We put some powder on the carpet so Nadia could see what needed to be cleaned. I know it seems like such a small thing, but for me it was great to be able to do something with Nadia and have a good time together while we were doing it. One key thought that has stayed with me since our training is how I set things up so they are a success, rather than thinking, “how do we get that task done right?” 3.5 Levels of support The level of support given to each person should be matched to their individual need. A model described in the handbook from Wales – the model – outlines how people can be supported to engage in a wide range of activities. ASK – INSTRUCT – PROMPT – SHOW – Matching support to need What this means Examples Comments ASK Verbal prompt letting someone know what is to be done It’s time to set the table Let’s set the table now If someone is competent at the task, this may be all that is needed INSTRUCT A series of verbal prompts guiding the person through the task one step at a time Fill the kettle with water Push the button down Put the tea bag in the mug Simple clear instructions; works well if person can physically complete the task but needs reminded of sequence PROMPT Clear gesture or sign or picture telling the person what to do next Pointing to the toothbrush and miming putting toothpaste on the well when a person can interpret gesture or sign; can be used with instruction SHOW Demonstrating what needs to be done Putting a towel in the washing machine and handing the next Works well when a person does not know what to do but can imitate;