Scenario: The person I am supporting is becoming angry or agitated

​The scenario

You are a disability support worker who assists people living with disability to participate in activities in the community. Clarke is 64 years old. He experiences severe anxiety which has meant he does not like to leave his home and therefore has become quite isolated. He lives alone and does not receive any assistance with his daily living activities in the home.

Clarke has been referred for support in getting out in the community. You have spoken with him on the phone to organise your first face to face meeting to talk about his interest in attending the local Senior Citizens monthly coffee morning, and maybe walking together to see the centre where these are held.

Clarke meets you at the door and very hesitantly lets you into his home, remaining in the hall because it is not possible to move further due to the piles of his belongings all around. You accidentally knock over a pile of newspapers. He is visibly shaking, his fists are clenched, and he steps close to you and yells, “Don’t touch anything!”

Tips for responding in the moment

How you react is important

• Stay calm.
• Clarke is distressed, don’t take anything he says personally.
• Speak and move in an unhurried way.
• Keep any questions you ask simple. Someone who is upset usually cannot understand or cope with complicated statements.

What you could say:

• Acknowledge Clarke’s distress. For example, you could say, “I can see you’re upset. Was it my knocking over the newspapers that has upset you?”
• Ask if there is anything that could be done to make things better. For example say, "Would you like to talk outside?”
• Let Clarke know that he does not have to talk to you about why he is upset, but that you are concerned and would like to help.

What approach you could take:

• If at any time you are uncomfortable or feel that your safety is at risk, you are able to leave.
• Listen, don’t interrupt or express judgement. Then reflect back what Clarke has said, summarising in your words, to show you are listening and to check that you have understood.
• Let Clarke know it is up to him if he still wants to go to the centre.
• If Clarke insists that he doesn’t want to talk, or you are uncomfortable, let him know that you will leave now but would be able to come back another time, if he wanted.
• Always follow your organisation’s policies and procedures regarding your own and client safety.

Support escalation if needed

You can call the Mental Health Line 1800 011 511. If you feel it is an emergency situation call 000.

Tips to help prepare for next time

• Contact your supervisor and provide the details of what occurred to obtain advice on future contact.
• Follow up with Clarke’s mental health worker or case worker, if relevant, before your next meeting with Clarke to agree the best approach for your future involvement.
• Call Clarke prior to the next meeting to ask him if he still wants you to support him in accessing the centre. Offer to meet outside the front door.
• At the next appointment discuss how Clarke might let you know if anything you are doing is making him uncomfortable and the best way you can respond if it happens again.
• Speak with your supervisor and ask for help if the situation has left you with feelings of unease. Many organisations will have an Employee Assistance Program where you can talk to someone confidentially.

Resources

De-escalation Techniques
This web page has 10 things you can do to de-escalate a situation when someone is angry.
Type: Fact sheet
Estimated reading time: 5 minutes
Produced by: Ambulance Tasmania

Facilitate responsible behaviour
This is a free online eLearning module which covers monitoring of client behaviour, communication strategies to de-escalate conflict and managing conflict. In order to access this training, you will need to set up an account.
Type: eLearning
Produced by: QCOSS Community Door

Hoarding disorder
This is a link to basic information on hoarding disorder on the healthdirect web page.
Type: web page
Estimated reading time: 2 minutes
Produced by: Department of Health