It is common to talk in eldercare communities about difficult residents. Those are residents who do not fit in with the expectations of peace and quiet in an eldercare community. They seem to have more energy than others, seem disruptive and even appear aggressive and loud. The problem is seen as one that belongs to those disruptive residents. The approach is thus to engage in behavior management or, as is more common, to look for medication to extinguish the behavior. This attitude of simply blaming the disruption on the person who seems to cause the problem is convenient for the staff as it is the residents who are being asked to change. This approach, however, ignores that there might be reasons for residents’ behavior, that we have something to learn from them.
A major shift in the conceptual understanding of looking at so-called difficult residents is to believe that their behavior is expressing an unmet need thus far overlooked. This attitude does not make residents wrong for being who they are but rather understands their behaviors as important signals to be explored and understood.
The concept of “unmet needs” is not at all a new way of thinking about behavior. As a matter of fact, our own bodies are designed to express pain if something is wrong and most parents would not ignore a child’s cry or otherwise unusual behaviors. Rather, they feel naturally drawn to want to understand such expressions further. Similarly, elders living in an elder community are not any different, especially if their language capabilities have changed over time. They often express their needs through subtle and not so subtle changes in their behaviors. We need to learn to understand such behaviors, and primarily, we need to believe that any and all behaviors have meaning.
The concept of ‘unmet needs’ moves us away from a pathologizing attitude to one of wonder, curiosity and further exploration. Not the elder or client is “wrong” or needs “fixing;” but we care-partners need to deepen our awareness and understanding about human beings and life.