Peter Bewert, managing director at Meaningful Care Matters, considers why and how the word ‘behaviour’ is associated with negative connotations in health and social care settings. Is this a new dirty word?

For me, the term behaviour can have an array of different connotations, though, it can be considered derogatory for a person living with dementia or mental illness, as it is not a word associated with person-centredness due to its polarising nature.

Unfortunately, the term behaviour has been coined by health care workers from the days of highly task-focused institutionalised care. Sadly, this remains a current narrative all too often experienced.

Behaviour as a term can be defined as an adverse behavioural expression, which remains shocking at best whilst being demoralising and stigmatising, particularly for people living with mental health problems or dementia at best.

I am disappointed to say as a senior executive, I too could rationalise these to be ill-informed and not fully reflective of the truth. I know better and am ashamed this was once my attitude. Once I truly understood what person centredness looks, sounds, and feels like, I always faced the reality we could do better and simply saying sorry when getting it wrong was no longer enough.

We can’t blame our teams or staff for this, as it is a sign of culture. personcentred cultures need to be real, authentic and genuine with the attitude of what can we do better.

Put simply, behaviours do not define people; feelings and emotions do. An expression of ill-being which is commonly considered to be a ‘challenging behaviour’ is simply an expression of need being communicated, which we as health professionals are yet to figure out.

So, what is ‘Behaviour’?

1 . How one acts or conducts oneself, especially towards others

2. How an animal or person behaves in response to a particular situation or stimulus

3. How a machine or natural phenomenon works or functions.

In my opinion, behaviour is an outward expression of the world in which we live, based on our internal feelings and emotions. People living with dementia cannot regulate their response in the language construct, which people who can communicate and comprehend can. The outward response is an expression of an internal feeling and emotion.

That said, we need to learn to speak in the language of feelings to recognise our responses and actions to support the person to feel safe, comfortable and secure while restoring their internal equilibrium through sensing and feelings-based responses.

Behaviour is not a dirty word, it is a natural human phenomenon, and we need to change the narrative that our behavioural expressions are unique, individualised and completely normal. Lanzer (1950), states that all human behaviour is both a product and a response to the situation, in an effort for the human being to adjust to that situation. Furthermore, the concept of normality in behaviour is based on feelings and emotions (individual internal psyche) and is not a matter of scientific objectivity.

In short, expressions are real, feelings/ emotion-based and individualised, so we need to accept reality and interpret them through the lens of emotions and feelings, after all, we all have them. Individual perception and personal reactions to behaviour are normal and are either expressed in an emotional or feelings response. This elicits ill-being or well-being and no circumstance is ever the same or related to pathological disease morbidity. (Strack, 2016)

Psychology has taken the notion of exploring behaviour as a learned interaction with the environment over time (conditioning) and our response to the environment stimuli (2017, McLeod). This would indicate that behaviour is in fact neither good nor bad, but instead an interplay of three components – actions, cognition and emotions (Farnsworth, 2019).

Overall, there is a stigma which is associated with the word behaviour when in fact, behaviour is a healthy part of humanity and we need behaviours to be happy, healthy, and responsive in our society. Feelings matter most. We cannot forget the person behind the expression. After all, they are communicating something to us we desperately need to know. That is the behaviour that needs to be our new norm.

Meaningful Care Matters is a leading care and organisational development group that specialises in helping health and social care providers to access a variety of support services. The group helps to facilitate the creation, reinvigoration and sustainable implementation of person-centred care cultures where people matter, feelings matter and we are ‘Free to be Me’.