Introduction

All of us communicate for a reason. In this lesson, we will consider that behavior has meaning and is trying to communicate something, often a signal to have an unmet need fulfilled.

The above picture illustrates the framework used in Texas OASIS HCBS to understand behavior. This framework was developed after years of experience and solid research on looking at behavior as communication with multiple perspectives.

A few of the basic points include the following:

• Behaviors are a way of getting needs met, directly or indirectly.
• Multiple factors are at play which makes it necessary to look at behaviors carefully in order to choose the best intervention in the short term and prevention in the longer term.
• Figuring out the unmet need from the behavior in the moment also allows us to make a service, support and care plan that addresses that need.
• The better we are at meeting the need, the less likely the behavior is going to happen again.

All Behavior Has Meaning

Three tested assumptions underlie this framework

• All behavior has meaning. It may not be obvious, even to the person who is behaving in a challenging way. The behavior of the person is not random or just a symptom of dementia.
• All behavior attempts to communicate. Many people, including ourselves, do not always ask directly for what we want or need. Often, what is described as 'difficult behavior' is an indirect attempt to communicate a need or a feeling. When people are resisting care, they’re trying to tell us something. Quite simply, they could be telling us to stop. It could be they are in pain. It could be they are frightened. It could be they are just having a bad day and it’s too early in the morning to get dressed. The first question in Texas OASIS HCBS when we come up against a distressing behavior is: “What is this person trying to tell me?”
• All behavior seeks to effect change. It’s not enough to explain or even understand people’s behaviors. We have to use that understanding to better meet their needs. In other words, people communicate for a reason. In the OASIS model, your job is to figure out both what the person wants you to do, and why. The more time you have taken getting to know the person and the more of a relationship you have, the better you will be able to do this.

Remember, all of us communicate for a reason.

It may simply be to have someone know and care about how we’re feeling.

Or it may be to effect some change in our situation. We want something to happen that isn’t happening or we want to stop something we don’t like!

So, the next question might be, "If the person is signaling the need for a change, what might need to be changed?" You'll take a look at that in the next lesson.