Poor support
How to read the stories

Poor support

We all experience situations that make us feel cross and stressed. Sometimes this can lead to an angry outburst or other sorts of behaviour that challenges. Sometimes, when we lose our temper, we do things we wouldn’t normally do. Some people get so cross that they end up hitting or pushing their supporter. When the support is given in the right way, they feel relaxed and in control instead of cross and under pressure. But even when new ways are found to give that support, there are times when people still get cross. They need to learn how to cope better with situations that make them angry.

People may need help to think about the support they need to avoid them getting cross or upset or stressed. They may want to work with their supporters or family carers to develop ‘behaviour support strategies’, and find better ways of dealing with difficult situations. Behaviour support strategies should always be part of an overall plan of support aimed at helping people to live their life to the full.

What does good behaviour support look like?

The first step often involves family carers and supporters learning new and better ways of supporting the person. This can include learning the best way to communicate with them, how to help them make choices and take control of their life, and how to support them to spend time doing the things that matter to them. In addition, it is often necessary to find specific ways of helping them to avoid or cope with difficult situations.

No matter how hard we try to avoid difficult situations, there will be times in our lives when things happen that make us angry or upset or frightened. We might then respond in a way that makes the situation worse – for ourselves and the people around us. We may need to learn how to cope with difficult situations. For example, people may want to learn to deal with disappointments or having to wait for something, or they may want to learn how to tell someone that they want to be left alone, without losing their temper.

There are different ways of sorting out problems and learning new skills. People will talk very seriously about what has happened, but often humour can help them and their supporters to sort out a problem well, too. Sometimes reading or looking at pictures can help; sometimes they need to practise our coping and communication skills by ‘role-playing’ difficult situations.

Getting the right support

People can make a lot of things better by getting together with their family carers and supporters and working out the best way they can support you. However, people may also need help from a specialist, someone with the right training and experience who can help them to develop a set of behaviour support strategies. Social workers and GPs can help each person to get the support they need.

What to expect from a specialist

A behaviour support specialist usually starts by finding out more about the difficult situations people have experienced and why they respond in the way they do. This will involve talking and spending time with each person and the people close to them. They will then think about ways of making things better. This could mean improving the support people get from family carers and supporters, and helping them find new ways of expressing themselves and coping with difficult situations. The specialist will help each person and their supporters learn and practise these new ways of doing things. Finally, over the weeks and months that follow, the specialist will check that things are working better.

Making choices

Parents and staff supporting people with learning disabilities are often reminded of the importance of encouraging them to make individual choices and decisions on all aspects of their everyday lives. Services may put ‘the right to choose how you live your life’ as their key objective for all service users. But the problem in promoting a blanket policy towards individual choice is that it can be very difficult to be clear about which choices you are referring to.

We all have individual preferences about how we wish to live our lives. Choosing between coffee or tea, the colour of the clothes we wear, our hair style and our friends are not controversial decisions. But other choices may have longer term consequences. It is important to understand when advice and support may be necessary to avoid the wrong choices being made. The individual concerned may not understand the consequences of his or her choice. Sometime the ‘right to choose’ may actually put a vulnerable person at risk and mean that families and other supporters are (with good intentions) failing to exercise a duty of care.

For example, the promotion of ‘choice’ around health and personal hygiene sometimes appears to set no limits on what is safe, reasonable and socially acceptable. If people do not understand the importance of brushing teeth to avoid unnecessary dental treatment, or of proper washing to avoid possible skin infection or food poisoning, they may neglect their personal care. Poor personal hygiene may have serious consequences, not only for general health, but also for the individual’s acceptance in local community activities and possibly for access to employment.

It should never be assumed that neglect of personal care, wearing dirty or inappropriate clothes or poor diet are automatically informed ‘choices’. We all have a responsibility to encourage healthy lifestyles and greater awareness about the importance of personal care.

How to read the stories

There is no right or wrong way to read the stories.

Some people are not used to reading stories. Start at the beginning and read the story in each picture. Encourage the reader to move through the pages at their own pace.
Encourage the person to tell the story in their own words. You will discover what they think is happening, what they already know, and how they feel. If you are using the pictures to help explain a procedure to someone, you may need to describe or clarify the actions being shown in each picture to help them understand. Try not to challenge the reader(s) or suggest their ideas are wrong.
Some pictures may be more difficult to understand. It can help to prompt the people you are supporting, for example:
• Who do you think that is?
• What is happening?
• How is he or she feeling?
• Do you feel like that? Has it happened to you/ your friend/ your family?
Allow people enough time to follow the pictures at their own pace. Allow time for discussion of each picture.
Some people may benefit from reading the larger story from which the extract has been taken. This will allow them to explore their feelings and experiences in more depth. To buy the complete book, follow the link to the bookshop that appears at the end of the story.