Responding to Aggressive and Agitated Behaviours

Agitated or aggressive behaviour rarely comes out of nowhere. In this lesson you will learn to see these behaviours as a sign of distress or an attempt to communicate a need, rather than as a person being difficult or bad. Key points: behaviour has a purpose for the person, many of the people we support have limited ways to express pain, fear or frustration, and our job is to stay curious about what the behaviour is telling us. Seeing behaviour this way helps us respond with respect and keeps the focus on the person, not the problem.

A trigger is anything that pushes a person towards distress. This lesson covers the triggers we see most often in disability and aged care support: pain and physical illness, sensory overload from noise, crowds or light, changes to routine, staff or environment, and unmet needs such as hunger, tiredness or boredom. In aged care, delirium and dementia can cause sudden confusion and fear. Key points: a sudden change in behaviour can be a sign of a health problem, so report it, and knowing a person's triggers helps you prevent incidents before they start.

Most people show signs of rising distress well before a situation becomes aggressive. This lesson explains how agitation tends to build in stages and what to look and listen for, including changes in body language, voice, breathing, pacing, repeated questions and withdrawing. Key points: each person has their own signs, and their behaviour support plan or support plan often describes them; the earlier you notice the signs, the more options you have; and small changes made early, like offering a break, can stop a situation from escalating at all.

De escalation means helping a distressed person return to calm without force. This lesson covers practical techniques: keep your own voice low and calm, give the person physical space, use short and simple sentences, offer choices, reduce demands and pause non urgent tasks, remove the audience by moving others away, and listen to what the person is saying. Key points: your own calm is the most powerful tool you have, arguing or threatening consequences makes things worse, and you should always follow the strategies in the person's behaviour support plan first.

Some participants have a behaviour support plan written by a behaviour support practitioner. It explains the person's triggers, early warning signs and the strategies that work for them. This lesson explains why you must read and follow the plan, and why restrictive practices, such as physical restraint, locking doors or using medication to control behaviour, must never be used unless they are authorised and included in the person's plan. Key points: using an unauthorised restrictive practice is a reportable incident, and if the plan is not working, tell your team leader so it can be reviewed.

Even with good de escalation, a situation can become unsafe. This lesson covers how to protect yourself, the person and anyone nearby. Key points: know your exits whenever you enter a room, keep a clear path out, stand at an angle and out of arm's reach, remove or avoid objects that could be thrown, and guide other people to a safe place. Stepping away is a safe and professional choice when you are at risk. Our aim is always to keep everyone safe, not to control the person.

Knowing when to call for help is a key safety skill. This lesson explains how to call for support from colleagues and your team leader, and when to call 000. Key points: call for help early rather than late, follow our on call and escalation procedures, and call 000 straight away if anyone is in serious danger, is seriously injured, or if there is a weapon involved. When you call 000, stay calm, give the address and explain what is happening. Emergency services can help keep everyone safe, including the person who is distressed.

What you do after an incident matters as much as how you responded during it. This lesson covers checking that everyone is safe and uninjured, giving first aid within your training, supporting the person as they return to calm, notifying your team leader, and completing an incident report on the same shift with clear, factual details. Key points: some incidents are reportable incidents that the provider must notify to the NDIS Quality and Safeguards Commission, or to the Aged Care Quality and Safety Commission under the Serious Incident Response Scheme. Tell your team leader straight away so these deadlines can be met.

Incidents involving aggression can be upsetting, even when nobody is hurt. This lesson covers the debrief, where the team talks through what happened, what helped and what could change, so the person's support can improve. It also covers common reactions after an incident, such as shakiness, poor sleep or replaying events, and practical ways to look after yourself. Key points: take part in debriefs, tell your team leader how you are going, use our Employee Assistance Program or other support if you need it, and never feel you have to cope alone.

This case study is set in residential aged care. Giuseppe, who lives with dementia and is usually cheerful, becomes agitated over one afternoon and hits out when staff help him get changed. The lesson shows how his personal care worker recognises that a sudden change may be delirium or another health problem, keeps him and others safe, and reports promptly to the registered nurse. It also covers why medication or restraint must not be used as a quick fix. Key points: sudden change means check health first, stop the task, report quickly and follow the care plan.

This case study follows Jarrah, a young autistic man who is learning to travel by bus with support. When his bus is cancelled at a crowded interchange, he becomes very distressed and starts hitting his own head. The lesson shows how his support worker follows the proactive and calming strategies in his behaviour support plan, reduces sensory overload, keeps bystanders at a distance and uses few words. Key points: follow the plan, lower the demands and noise, never improvise a restrictive response, and record and report afterwards so the plan can be reviewed.