Short Guide for Caregivers Dealing with Challenging Client Behavior


Caregiving is one of the most rewarding jobs, but it can also be incredibly challenging. It takes a lot of practical knowledge and skill, but it also takes a lot of patience and soft skills.


In order to be able to work with a client, professional caregivers have to be able to keep their patience, remain calm in any situation, and establish trust not only with the client, but also with their family and their healthcare providers.




Why Are Some Clients More Challenging Than Others?


When you are a caregiver starting work with a new client, and especially if you are relatively new to the job, it can be easy to forget that you are not the only one who is stressed out by this challenging life situation.


The truth of the matter is, a home care situation is also infinitely stressful for the clients, whether this is their first time having a caregiver or whether they are going through the challenge of changing caregivers and adjusting to someone new. You should always be understanding of that.


Everyone deals with change in different ways and for some people, depending on their personality or other factors, it can take some time to build trust with a caregiver.




How Should You Approach a New Client?


All clients are different and so are their expectations, but there are some strategies that work with most clients. A caregiver should be professional and patient when approaching new clients.


Elderly people appreciate having someone to talk to; sometimes they just need someone to listen to their stories or their concerns. The best care involves not only physical work but also a relationship built on understanding and support.





Always remember that clients rely on you not only to provide them with the best care but also to treat them with empathy and kindness. That can make a big difference in your relationship.




The Importance of Positive Language and Attitude


A sunny disposition and the use of positive language is always a good idea, so long as you remain honest with the clients about anything that you intend to do. Most people respond positively to optimism as long as it is not over the top.


Try to maintain eye contact as much as possible - it is an important sign that you are listening and that you are someone your client can rely on. Eye contact can also help you recognize manipulation, which can be a common occurrence when dealing with difficult clients.


Always be respectful of clients, their personality and their culture. Although it is, in general, a good idea to talk slower, bear in mind that not all elderly people are the same. Some of them are sharp and possess a great deal of mental agility and might find it offensive if you treat them differently.




Types of Difficult Clients' Behavior


Not all difficult clients act the same way. The underlying causes of their behavior as well as the behavior itself differ from one person to the next. Here are some of the most common reactions and behaviors you might come across in a difficult client.


Anger


Anger can have many causes, such as disease, fear, pain, and loneliness. Sometimes it's a part of someone's personality, but most often residents feel angry because of loss of independence due to illness. Sometimes even the simplest things can trigger someone into a rage.


If a client gets angry, the caregiver should try to stay calm. Do not respond to any verbal attacks. Instead, try to empathize with them and find out what caused the anger. It's not intuitive, but sometimes if you stay silent, that may help the client explain why they are feeling that way.


Treat the client with dignity, and do not raise your voice or react to their rage with more rage. Answer call lights promptly from all clients, especially those with a history of anger. Caregivers should always report anger to the nurse or other healthcare provider.



Combative Behavior


Combative behavior includes hitting, pushing, kicking, and verbal attacks directed toward caregivers or other people.


In situations like this, you should always remember that you are not the cause and you should not take it personally.


Violent and hostile reactions can be caused by the frustration of being in a home care situation which, can feel like loss of control. Sometimes violent reactions are a consequence of a disability or an illness that affects the brain.


When dealing with a difficult client who is being combative, block physical blows or step out of the way, but never hit back. No matter how much a resident or client hurts you, or how angry or afraid you are, never hit or threaten a client.


Do not argue or accuse them of wrongdoing. Do not use gestures that could frighten or startle them and stay aware of your environment. Try to stay neutral and reassure the client.


Caregivers should always report violent outbursts.



Mental Health Issues


Mental illness can disrupt a person's ability to function at a normal level in the family, home, or community. Although it involves emotions and mental functions, mental illness is a disease, like any physical disease. Additionally, loneliness can cause depression with the elderly.





Mental illness produces identifiable signs and symptoms and responds to proper treatment and care. Different types of mental illness will also affect how well people communicate.


Remember these tips for effective communication when your clients struggle with their mental health:

  • Do not address adults as if they were children.

  • Sit or stand at a normal distance from the resident.

  • Be aware of your body language.

  • Use simple, clear statements and a normal tone of voice.

  • Be honest and direct, as with any resident.

  • Avoid arguments and always try to speak and act with respect and concern for their wellbeing.


Inappropriate Behavior


Some residents/clients will demonstrate inappropriate behavior. Inappropriate behavior includes trying to establish a personal, rather than a professional, relationship.


Some examples include asking personal questions, requesting visits on personal time, asking for or doing favors and giving tips or gifts, and loaning or borrowing money.


Inappropriate behavior also includes making sexual advances and comments. It also includes clients removing their clothes or touching themselves in public. Illness, dementia, confusion, and medication may cause this behavior.


If as a caregiver you encounter a resident who is behaving in an inappropriate manner, do not overreact. This may actually reinforce the behavior. Instead, try to distract them.

If that does not work, gently direct the resident to a private area, and notify the nurse.

When residents act inappropriately, report it, even if you think it was harmless.




Dealing with Difficult Family Members


Sometimes the difficult behavior comes from the family instead of the client. This is usually because they are not equipped to deal with the difficulty of trusting someone else to care for their loved one, which can bring up worries and fears they don’t know how to handle.




The situation can feel like a loss of control for their family too, and they might not know what to expect.


When dealing with difficult family members, don't let your emotions get the best of you even when you feel frustrated. Hear what they have to say, and respond to their questions.


Your response should be calm, with a focus on solutions. Don't raise your voice or show that you are upset. If you reach a point at which you can’t remain calm, just remove yourself from the situation and approach it again after you have cooled down.


If the family member becomes verbally or physically aggressive or raises their voice and make unreasonable demands, remove yourself from the difficult situation. Contact your supervisor and advise the family member to do the same.




Don't Forget to Take Care of Yourself, Too


The challenges of the job can take a toll even on the most seasoned caregivers. Don't ignore your own feelings of stress! Stress can and will easily lead to burnout if you don’t take care of your own needs.


Use your free time to relax. Instead of turning over situations from work in your head, dedicate some time to your own interests, or spend time with your loved ones.


If you feel like the challenges of dealing with difficult clients are becoming too much, ask someone you trust for advice. Sometimes it helps to just tell someone about your problems and concerns and know that they are listening.


In situations when you are not able to handle the client's behavior alone, go to your supervisor to try to assess the situation and work out some strategies together.


Always document any incidents and keep your supervisor informed when things change.


Sometimes behavior can escalate over time as a symptom of an illness, so keeping detailed records of behavior changes can be helpful when addressing treatment options and might prevent future problems.