2.6. Explain how staff should respond to behaviour considered ‘inappropriate’

This guide will help you answer 2.6. Explain how staff should respond to behaviour considered ‘inappropriate’.

People living with dementia may behave in ways others see as ‘inappropriate’. This does not always mean they are intending to shock or upset those around them. Their actions often result from the symptoms of dementia, such as memory loss, confusion, or frustration.

The word ‘inappropriate’ means behaviour that is not accepted in a certain setting or culture. For example, undressing in public, shouting, swearing, spitting, or touching other people without consent. What might be ‘inappropriate’ depends on place and context.

Dementia changes how a person thinks, feels, and acts. It often affects judgement and self-control. Someone living with dementia might not remember social rules. They may misinterpret situations or struggle to express feelings in ways they used to.

Understanding why the behaviour happens is the first step. People with dementia do not usually mean to cause harm or discomfort.

This guide contains examples of how you might respond. Always follow your own organisation’s policies and procedures.

Common Types of ‘Inappropriate’ Behaviour

Staff may see these examples in care settings:

• Physical aggression: hitting, kicking, or pushing
• Verbal aggression: shouting, swearing, making offensive comments
• Sexually disinhibited behaviour: undressing in public, inappropriate touching, sexual comments
• Repetitive actions: pacing, tapping, repeating words
• Wandering into private spaces
• Refusal to cooperate with care or instruction
• Taking items that do not belong to them
• Spitting or making noises

Each behaviour has a cause. It may be confusion, pain, misunderstanding what is happening, or frustration at not being able to communicate.

Responding with Empathy and Respect

Responding to ‘inappropriate’ behaviour is a key responsibility for staff in care settings. The main aim is to meet the person’s needs, reduce distress, and protect their dignity.

Treat the person with dementia as an individual. Consider their history, likes, dislikes, and usual behaviour. Focus on the person, not the behaviour.

Avoid punishment or making the person feel ashamed. Instead, aim to keep them safe and comfortable, along with others around them.

Steps Staff Should Take When Responding

It helps to have a clear and kind process. Some actions staff can take include:

• Stay calm and patient: Use a steady voice. Show you are not scared or threatened. Avoid raised voices, sudden movements, or angry expressions.
• Use distraction or redirection: Gently move the person to another topic or activity. Draw attention elsewhere. For example, offer a drink, suggest a walk, or talk about something they enjoy.
• Acknowledge emotions: Notice if the person is upset or anxious. Address feelings first rather than telling the person off. Say things like, “You seem worried, can I help you?”
• Offer reassurance and comfort: Physical comfort such as holding a hand or a friendly gesture may help if appropriate and welcome.
• Avoid confrontation and power struggles: Do not argue or try to force the person to stop unless safety is at risk. Arguing can increase agitation.
• Give simple and clear explanations: If possible, calmly explain why behaviour is not suitable, but use short sentences and plain language. Do not overwhelm the person with information.
• Check for underlying causes: Behaviour can signal pain, discomfort, hunger, boredom, loneliness, or a need to use the toilet. Investigate the possible triggers.
• Preserve dignity and privacy: For example, if the person undresses in public, gently guide them to a private area and help them dress. Avoid drawing attention or expressing shock.

Using Personalised Approaches

Knowing the individual makes a difference. Staff should use life history information and care plans, taking account of the person’s routines and previous lifestyle. This knowledge helps predict triggers and familiar comforting activities.

For example:

• If a person always gets up early, letting them continue this routine avoids frustration.
• If someone likes to walk after lunch, supporting this can prevent restlessness.

Staff should involve family or friends in planning whenever possible.

Teamwork and Consistency

Consistency reduces confusion for people living with dementia. All staff should use agreed responses and follow the care plan closely.

Effective teamwork involves:

• Sharing information about triggers, patterns, and successful approaches
• Recording incidents and responses in care notes
• Attending training and briefings on dementia care
• Supporting each other after incidents that cause distress

Staff meetings are good places to plan and review helpful strategies.

Minimising Risk and Maintaining Safety

Safety comes first for everyone involved. Some behaviours may pose a risk to the person, staff, or others.

Actions for maintaining safety include:

• Removing objects that could cause harm if used in anger (e.g., sharp items)
• Guiding other residents away if aggression occurs
• Seeking urgent help if there is immediate danger
• Using agreed non-restrictive interventions as outlined in policies

Physical interventions should only be used when absolutely necessary to prevent harm and must comply with the Mental Capacity Act, Deprivation of Liberty Safeguards (DoLS), and organisation policy.

Record Keeping and Reporting

Recording incidents is important. Document what happened, how staff responded, what worked, and any patterns noticed.

Reports help:

• Identify triggers and responses that work
• Keep everyone informed
• Show openness and compliance with the law

Incidents involving sexualised behaviour or aggression towards others should be reported to managers and, where appropriate, safeguarding teams.

Understanding Triggers and Patterns

‘Inappropriate’ behaviour rarely happens for no reason. Staff should look for what came before and after each incident.

Triggers might include:

• Noise or crowded environments
• Sudden changes in routine
• Being rushed or feeling helpless
• Pain, hunger, or tiredness
• Unfamiliar people or settings

Recognising patterns helps predict and prevent events in future.

Preventing ‘Inappropriate’ Behaviour

Prevention is as important as the response. This includes:

• Creating calm, familiar surroundings
• Allowing simple choices and independence wherever possible
• Keeping routines predictable
• Using memory aids, signs, and pictures
• Involving people in meaningful activity
• Meeting needs for comfort, company, and stimulation

When needs are met, distressing behaviours are reduced.

Respecting Human Rights and Legal Duties

People living with dementia have the same rights as anyone else. Respect, dignity, privacy, and freedom from abuse are protected in law, including the Human Rights Act and Care Act.

Using force or restriction without reason can break the law. Always balance safety with the person’s rights and wishes.

Communication Strategies

Communication can help to prevent and de-escalate many behaviours. Useful tactics include:

• Getting to the person’s level and maintaining eye contact
• Speaking clearly, slowly, and using simple words
• Using positive body language and gentle touch if suitable
• Listening and observing for clues about feelings
• Repeating information if needed without showing frustration

Non-verbal communication (tone, gestures, facial expression) often matters more than words.

Using Behaviour Support Plans

Support plans are personalised documents setting out:

• Triggers or warning signs
• Preferred routines and activities
• Strategies for staff to use
• Step-by-step guidance for situations that may happen

All staff should be familiar with these plans and follow them closely.

Managing Sexual Disinhibition

Sexual disinhibition is a type of behaviour where a person may act in a sexual way that is not considered appropriate. This could be exposing themselves, making sexual comments, or touching others.

Staff should handle this discreetly:

• Stay calm, never laugh, show shock, or shame the person
• Protect the dignity of the person and anyone else involved
• Move to a private place
• Redirect focus to another subject or activity
• Record what happened and inform a manager
• Offer advice and support to other people affected, such as residents or visitors

Never use restraint unless someone is at risk of harm. Sexual disinhibition is a symptom, not a personal failing.

Responding to Aggression

Some people with dementia may lash out if they are afraid or do not understand what is happening.

Respond by:

• Keeping a safe distance if needed
• Lowering your voice and showing open hands
• Avoiding sudden movements
• Offering choices if possible
• Checking for pain, frustration, or confusion
• Calling for help if safety is at risk
• Remaining with the person if it is safe to do so

Do not argue, threaten, or become aggressive in return.

Self-Awareness and Supervision

Caring for people with dementia is demanding. How staff feel and behave can affect outcomes.

Support includes:

• Taking regular breaks and speaking up about stress
• Attending supervision or reflective sessions
• Sharing difficult incidents so staff do not feel alone
• Taking part in training about communication and care

No one should be expected to manage challenging behaviour alone.

Professional Boundaries

Staff must keep clear boundaries at all times. This protects everyone. For example, do not accept or offer gifts if it might affect professional judgement.

Physical intervention should only ever be used as a last resort to prevent harm, not as punishment.

Multi-Disciplinary Working

Working with nurses, social workers, doctors, and psychologists offers a full picture of the person’s needs.

Referral for specialist support may be needed for repeated, distressing, or dangerous behaviour.

Learning from Incidents

Debriefing after incidents helps teams provide better care next time.

Reflect on:

• What worked
• What could change
• How to prevent a repeat
• How staff feel

Feedback informs care plans and staff development.

Training and Development

Ongoing training means staff use current, safe methods for responding. Areas might include:

• Dementia awareness
• De-escalation techniques
• Safeguarding and legal duties
• Personal safety
• Communication skills

Managers should arrange learning opportunities and update training regularly.

Involving Family and Advocates

Including family and advocates in behaviour support plans can provide extra understanding.

Families may share what calms the person or which triggers to watch for.

Final Thoughts

Responding to behaviour others see as ‘inappropriate’ in dementia care needs empathy, skill, and planning.

With kind, person-centred care, behaviours can often be understood and managed kindly, creating comfort for the person and those around them.