When faced with an older adult's irritable or agitated behaviour, caregivers can first think "why".
UK NHS advice: When an older adult exhibits behaviours such as hitting or shouting, don't rush to stop them; try to find the reason behind it — it may be anxiety, boredom or pain. Adjusting the environment and reducing stimulation is safer than forcible restraint.
Machine translation of our Chinese article, without human translation review. Suggestions concerning China remain specific to China.
Automatically reviewed, without human verification. Programmatic checks are not professional review. Seek professional advice where appropriate. Automatically reviewed on 10/4/2026, 7:14:25 AM
Chinese fact summaries and suggestions for China (not a full translation)
Original: How to deal with challenging behaviour in adults - Social care and support guide - NHS · Original language: en
Read the original ↗
Facts from the sources
When a person's behaviour puts themselves or those around them (such as caregivers) at risk, or leads to a decline in their quality of life, it may be defined as "challenging behaviour". View source
Challenging behaviour is often seen in people with health conditions that affect communication and the brain (such as learning disability or dementia). View source
Caregivers can try to understand the reasons behind the care recipient's current behaviour, for example they may feel anxious, bored, or in pain. View source
If a large group of people makes the care recipient feel anxious and become agitated, caregivers can arrange for them to be in a smaller group or provide one-on-one support. View source
Unless the care recipient's behaviour is putting themselves at risk, and they do not have the mental capacity or ability to make decisions, caregivers should not try to restrain the care recipient. View source
The local council may provide respite care services after carrying out a needs assessment for the care recipient or a caregiver's assessment for the caregiver. View source
For older people and families
When an older adult suddenly loses their temper, moves about restlessly, or shouts, don't rush to blame them; think about whether they are physically uncomfortable or feeling anxious inside.
If an older adult becomes agitated as soon as they are in a crowded place, you can reduce visits from relatives in large groups, switch to two people chatting quietly, or sit with them alone for a while.
Don't readily use ropes, straps, or holding down the older adult's body to "control" them, unless they are hurting themselves and are no longer able to make decisions for themselves.
Pay attention in daily life to what situations make the older adult prone to agitation, such as being hungry, sleepy, or needing to use the toilet; write these down and make arrangements in advance next time.
If the older adult hits people or bangs against walls when agitated, first ensure their safety and your own, then ask other family members for help; don't tough it out alone.
When you are tired, your mood also affects the older adult. Take turns caring, or ask a relative to cover for half a day, so you can catch your breath.
Respite care services exist abroad; in China, you can ask community or eldercare institutions whether they offer short-term residential care or day care, so family caregivers can have a rest.
Behind the older adult's behaviour may be illness, pain, or changes in brain function; don't simply dismiss it as "senile confusion". If necessary, take them to the hospital for a check-up.
See what care and community teams can do
One can understand "challenging behaviour" as a communication signal behind the behaviour, and assess whether it is triggered by pain, anxiety, boredom, or environmental overload.
In institutions, for older adults who are easily agitated, small-group activities or one-on-one support can be arranged to reduce crowd stimulation, but the older adult's wishes and current staffing levels need to be assessed.
Physical restraint should only be considered when the older adult's behaviour poses an immediate risk to themselves and the person lacks decision-making capacity; it must be implemented in accordance with China's relevant regulations and institutional policies, and recorded.
Referring to UK NHS advice, develop an individualised behaviour observation chart, record antecedents, behaviour and consequences, look for patterns, and then adjust the care plan.
Provide communication training to family caregivers, teaching them to approach the older adult with a calm tone and slow movements, and to avoid sudden touching from behind.
Carry out needs assessments and caregiver assessments; you can refer to the overseas respite care approach and combine local community resources to provide family caregivers with short-term relief services.
All intervention measures should be assessed by a doctor or mental health/geriatrics professionals; conclusions should not be drawn solely from behavioural observation.
Institutions should establish a referral process for older adults with abnormal behaviour, and when necessary refer them to medical institutions to check for physical causes such as pain, infection, and medication side effects.
What needs local assessment
This content is based on the UK NHS webpage (last reviewed 9 April 2024) and is for caregiving reference only. Different countries have different laws, cultures and services; foreign systems are not equivalent to China's current policies. Families and institutions in China should use this in light of local regulations, medical conditions and professional advice, and should not copy it directly. If an older adult has physical illness, psychiatric symptoms, or restraint measures are involved, be sure to consult doctors and relevant professionals and comply with local laws. Contains public sector information licensed under the Open Government Licence v3.0. Information from the NHS website is licensed under the Open Government Licence v3.0. This article is an independent Chinese-language compilation and recommendation by this website, and is not an official NHS translation or content approved by the NHS. Licence: https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/
Sources
UK National Health Service (NHS)Was this article helpful?
Loading feedback…