We all perceive behaviour differently and respond differently.   Some people may not feel threatened whereas others might by the same behaviour or during the same incident. Our tolerance levels also vary. Positive communication, honesty and openness helps to prevent confrontational situations from arising.

When we engage with people our perception of them and their perception of us may be influenced by each others’ previous experience of similar situations. Although some people appear to be unreasonable, there is always a reason for peoples behaviour.

It is based on:

• Prior and current experience
• Perception of what is taking place
• Opinions
• Personal attitudes and values
• Learned ways of responding
• How role models behave
• Level of social skills and social awareness

It can sometimes be influenced by matters outside the persons control, such as factors relating to their physical/ or mental health; pain levels or by having been misinformed about things (lied to).

Examples of situations that you could come across in Active that could cause confrontation.

The client / informal carer/ family may:

• be unhappy with some aspect of the service.
• have unreasonable expectations of what the service can deliver.
• be frustrated with their situation, health condition or disability.
• have impairment of the brain such as learning disability, dementia or a mental health condition etc. Some of our clients have an impairment of the brain and presenting behaviour that challenges is their way of communication that something is wrong. E.g. pain, side effect of medication, boredom, frustration, uncomfortable with temperature, uncomfortable environment (too noisy, too crowded), feeling left out etc. (see topic 3.10 for how to manage behaviour that challenges)
• feel their views are being misunderstood, not heard, ignored or when needs are not being met.
• be in doubt of honesty, trust and openness and feel disempowered and frustrated with bureaucracy, or unable to speak directly to the person who can resolve the matter.
• feel defensive, aggrieved or if they have had a bad experience of a person or service previously.
• feel that the organisation is being defensive, secretive or judgemental rather than being assisted and enabled positively. This can lead to people becoming defensive themselves, causing the situation to escalate and result in confrontation.

Typical responses to confrontation

Typical reactions to confrontational situations include flight and fight responses and learned behaviours, e.g. people may :

• Start shouting or lose their temper
• Find it difficult to think straight
• Walk away
• Disguise or hide the effect it is having and not discuss it with anyone
• Start shaking
• Cry
• Behave assertively and remain cool and calm
• Say things they regret or take revenge at a later date

Use to answer question 3.5a of the Care Certificate