“Challenging behaviour” is a descriptive term, with the meaning changing depending on context, service delivery, and even geography. Challenging behaviours can include: agitation, restlessness, sexual disinhibition, cursing, hallucination/delusion, depression and/or mania. Challenging behaviours are particularly common among those with dementia, with studies indicating that anywhere from 60 to 90% of people with dementia develop behavior problems at some point in their disease. However, these types of behaviours can also be common among a range of care recipients, for various reasons, including those with developmental disabilities. Nearly 80% of long-term care residents have some degree of moderate to severe behavior problems, stemming from mental illness, dementia, difficult personalities, longstanding behavior patterns, or personal distress. The number one cause of challenging behaviours towards caregivers is intimate care (e.g. bathing, dressing, feeding, toileting).
Studies indicate that caregivers exposed to challenging behaviours leads to increased negative emotional responses. This then means that caregivers under stress are more likely to engage in avoidant behaviours that maintain challenging behaviours (Mossman et al., 2002). The lack of caregiving knowledge about how to deal with challenging behaviours often results in caregiver stress and anxiety that is projected on the person needing care, thereby increasing negative behavioral reactions. If a caregiver is stressed and/or depressed this means that this contributes to challenging behaviors in the care recipient and challenging behaviors contribute back into increased stress and/or depression in the caregiver. More depressed caregivers report more behavioral issues in the persons for whom they provide care than those who manage the situation well (Sink et al., 2006). Therefore, appropriate information and education for caregivers is crucial in order for them to develop the necessary skills to care both for the care recipient, as well as themselves.