Keeping your loved one and others safe
We have already covered the potential causes of behaviour that challenges, including the use of strategies such as Positive Behaviour Support (PBS) and developing a behaviour support plan. A good behaviour support plan sets out possible triggers and provides alternative ways of meeting needs to avoid the person resorting to challenging behaviour. All strategies should be based upon the least restrictive principles in relation to managing risk. It is also important to remember that a sudden change in behaviour could be due to a health issue and to therefore contact the GP straightaway.
A PBS plan can help those working with your loved one to cope with any known behaviour and adapt accordingly in order to best meet the person’s needs. However, given the unique needs and sensitivities of each individual, there is always the possibility of a sudden and unexpected escalation of behaviour.
Staying safe at home
Although you know your loved one better than anyone else, the potential for unexpected behaviour is still something to be wary of. The smallest of things can trigger a sudden escalation in behaviour, which might risk harm to the person themselves or those around them. It is important to manage the potential risks, the dangers to/from the environment and, as far as possible, defuse any escalation of behaviour. Using a calm and understanding approach, and offering your loved one reassurance, one or two incentives and choices, is usually helpful.
Before outlining our suggested approach, it is important to recognise something else that can prove difficult to manage – our own expectations! We are mum or dad and they are our son or daughter. We have our own perceptions and values as to what constitutes good, bad or acceptable behaviour that have developed as we have grown up. Making allowances when your child has a learning disability or autism can therefore sometimes not be the first thing you think of when experiencing sudden and unexpected challenging behaviour. Your immediate reaction, if defensive or perceived to be aggressive, could make the situation even worse. It is therefore important to try to stay calm and remember that the behaviour is a cry for help.
Please note: Physical interventions should always be a last resort. It should only be done if you really know what you’re doing. Unless you have proper training and/or if the person is in immediate and significant danger, you should stick to non-restrictive methods as much as you can.
De-escalation strategies – you can do this!
Please note: None of the following information regarding de-escalation and staying safe constitutes official or professional advice. It is general information offered by parents who are providing suggestions based upon their own lived experience. If you require specialist intervention advice, please contact your loved one’s care manager or a behaviour specialist. We also recommend seeking professional guidance for any behaviour that carries a risk of actual or potential self-harm. Do not be afraid to ask for help from professionals – there are lots of advantages to being able to work together to find out the causes for behaviour.
Every person and every situation is unique. It is important for any strategy you use to be in accordance with any current behaviour management plan. However, we have suggested some generic interventions below to help you calm the person and assist recovery.
It is also important to recognise that you know your loved one best. Trust your instincts as to what works best for them. You are the expert in your own child. Share your knowledge with carers working with your loved one in a non-confrontational way.
Please note: Always keep a list of emergency contacts close at hand just in case and store all the numbers in your phone too for instant access.
Top de-escalation tips suggested by families
- Send others away from the immediate area and ask them to keep out of sight.
- Remove dangerous objects and keep the person as safe as you can.
- Try to remain in control and stay calm. Say as little as possible. Use a calm voice and avoid disciplining.
- Disengage emotionally, and try not to take the behaviour personally.
- Avoid standing face-to-face. Instead, turn to one side to remain non-threatening.
- Present yourself as a helper rather than an enforcer.
- Try redirection (e.g. offer two acceptable choices to give them a sense of control).
- Offer incentives to try and help them think past the immediate situation.
- Back away if danger or if you are being targeted. Turn your back or temporarily go into the next room. Stay out of range but still within reach but only do this if safe to do so.
Helpful suggestions to minimise distress
- Always be risk alert. History is the best predictor of the future. If, for example, you know that your loved one can pull your hair when they are stood behind you, be alert to this risk and their movements.
- Be aware of where your exits are, and if you are feeling in danger, consider if leaving the room is the safest option.
- Remain calm. Emotions can run high in difficult situations, so try not to let your emotions control your actions. Although the behaviour is directed at you, it is likely that your son/daughter feels safest expressing themselves with you and it is therefore unlikely to be personal or your fault.
- Try active listening. Get on their level, mirror their body language and match their mood. They will see you are then ‘on their side’ rather than someone to challenge. Once you have engaged and matched their mood, you can try slowing down your communication and the volume of your voice. It is likely your son/daughter will mirror you.
- Humour is great at diffusing situations. Try doing something silly to make them laugh. Laughing is often incompatible with anger.
- Can you make some drastic change that will make them pause and wonder what is going on? This might be putting on their favourite song on full blast, bursting into song, changing the colour of the lightbulbs in a room, coming in with a silly wig or mask on.
- Try a change of scenery, together or alone. Sometimes being in a different place can relieve the tension.
- Think about how you can make the room feel more spacious. Ask other people to move out of the area, remove things that could cause harm, open doors and windows.
- Reduce verbal communication. Many people with learning disabilities, autism or both struggle to understand verbal communication. The ability to do this is further reduced when they are distressed or agitated.
- Can you give them what they want? Sometimes it is easy to get caught in a battle of trying to win, but sometimes ‘letting them win’ is ok.
- Try to make highly preferred items available as a competing option. They could carry on with the risk of being physically challenging towards you, or they could go into the kitchen where there is lovely apple pie and ice cream!
- Use interests and fixations. For example, if they are obsessed with watching their favourite TV programme, put it on or try to introduce a favourite toy, item or activity. If they become absorbed in that they will be less likely to show physical challenge to you.
- Consider physical contact. Sometimes a hug, or a reassuring touch can be what is needed, and they may not understand their actions are making you move away.
- Try to avoid demanding an apology. We all find it difficult to say sorry, so why should your son/daughter find it easy? They may not understand the apology or know how to repair relationships when things go wrong. But if they want to say sorry, by all means welcome it with open arms.
- Try to forgive and forget quickly, and avoid bearing grudges. They say every day is a new day, well sometimes it has to be every minute is a new minute!
- Remember to take care of your own emotional wellbeing. See here for some helpful information https://www.cerebra.org.uk/help-and-information/guides-for-parents/factsheet-emotional-well/.
Requesting help in an emergency
If you are worried about the immediate safety of your loved one, or they are at risk of hurting themselves or others around them, take one of the following actions depending upon your circumstances:
- If you have already been given a Crisis Line number from a health professional, ring them straightaway.
- If your loved one has a care plan that states who to contact when you need urgent care, follow this plan.
- If it is an emergency, call 999 and ask for a police and ambulance response if the person’s behaviour presents a serious risk to themselves and / or others.
For further information about when to call 999 go to: https://www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergency-care/when-to-call-999/
This site uses Akismet to reduce spam. Learn how your comment data is processed.