Positive Behaviour Support (PBS) is about understanding why someone may be distressed or showing behaviour that concerns us, rather than simply trying to stop the behaviour.
The behaviour may be a way of communicating pain, anxiety, frustration, sensory overload or another unmet need. Follow the person's care plan and positive behaviour plan. Know their:
Triggers and early signs of distress
Communication needs
Sensory needs
Usual routines and preferences
What helps them feel calm and safe
Consistency and predictable routines can help prevent distress. If behaviour changes, try to understand what may be causing it before reacting.
Consider whether the person could be:
In pain or unwell
Anxious or upset
Overwhelmed by noise, light or their surroundings
Struggling to communicate something
Finding a change in routine difficult
Stay calm and do not take the behaviour personally.
Use the preventative and de-escalation strategies in their PBS plan and give the person appropriate space and time.
A simple example:
A care recipient normally enjoys going out for a walk but suddenly starts shouting and refuses to leave the house.
Instead of assuming they are simply being difficult, consider what may have changed. Perhaps the usual route is noisy, they are feeling unwell, or they were not given enough notice about the change in routine.
Check their care plan, talk to them in the way they prefer and give them time to respond. If they are becoming overwhelmed, reduce the pressure and use the strategies that are known to help them calm down.
If this is unusual or happens repeatedly, record and report it so the care team can look at what may be triggering the behaviour.
Record and report
Any significant incident or change in behaviour should be recorded accurately.
Where required, include what happened before, during and after the behaviour. This helps the care team understand triggers and identify what may work better in the future.
Report any concerns or repeated changes to the care management team.
Restrictive practices
Restrictive interventions should only ever be used as a last resort, where necessary to keep someone or others safe, and must be in line with the person's care plan and relevant guidance.
Never use restraint as a punishment or because a behaviour is inconvenient.
Remember: Behaviour is often communication.
Instead of asking “How do I stop this behaviour?”, think about “What is the person trying to tell me, and what do they need?”
Your role is to support the person safely, with dignity, while helping them have as much choice, independence and control as possible.