What is the key to providing person-centered care, identifying behaviors and their triggers?

Oct 11, 2025 5 min read •

healthcare caregiving mental health

According to the World Health Organization, person-centered care empowers individuals to take charge of their own health rather than being passive recipients of services. The key to providing person-centered care, identifying behaviors and their triggers, allows caregivers and healthcare professionals to tailor support to the individual's unique needs, preferences, and goals.

Quick Summary

This article explores the principles of person-centered care, focusing on the critical role of identifying behaviors and their triggers. It provides a comprehensive guide on implementing observational techniques, leveraging tools like ABC charts, and creating a supportive environment to address challenging behaviors. The content also compares person-centered and behavior-centric approaches, discusses implementation strategies and challenges, and outlines the benefits for both individuals and caregivers.

Key Points

Behavior is Communication: Every behavior, especially challenging ones, serves a purpose and is a form of communication stemming from unmet needs, emotions, or triggers.
Systematic Observation is Key: The most effective tool for identifying triggers is an Antecedent-Behavior-Consequence (ABC) chart, which helps reveal patterns and the function of behavior.
Holistic Understanding: A comprehensive approach requires gathering data from the individual, family, and other caregivers to understand the person's unique history, preferences, and circumstances.
Shift from Reactive to Proactive: Instead of reacting to challenging behaviors, focus on identifying and addressing the underlying triggers to prevent issues before they escalate.
Empower the Individual: Person-centered care places the individual as an active partner in care planning, empowering them to make decisions and promoting their autonomy.
Create Supportive Environments: Modifying the physical and social environment to reduce sensory overload, provide consistency, and offer calming spaces can significantly reduce behavioral triggers.
Prioritize Ethical Considerations: Balance the promotion of individual autonomy with the need for safety, especially when dealing with high-risk behaviors.
Invest in Staff Training: Proper, continuous training and support are crucial for staff to shift their mindset from a deficit-based view to a strengths-based, person-centered approach.

Understanding the Core of Person-Centered Care

Person-centered care (PCC) is a holistic approach to health and social care that places the individual at the center of their own support. Unlike traditional models where the patient is a passive recipient, PCC frames the individual as an active partner in their care, with their unique values, preferences, and experiences guiding all decisions. The central tenant is that all behavior has meaning; it is a form of communication, especially for those with communication disorders or cognitive impairments. The key to unlocking effective PCC lies in accurately identifying and understanding these behaviors and the triggers that cause them.

The Function of Behavior: Beyond the Surface

Challenging behaviors are not random acts; they are often the result of unmet needs or internal distress. For example, a person might become agitated due to a sensory overload from loud noises, physical discomfort like pain, or emotional factors such as anxiety. By shifting the perspective from labeling the person as "difficult" to viewing the behavior as a coping mechanism, caregivers can move from reactive to proactive strategies.

Practical Behavioral Observation Techniques

Identifying triggers requires careful, systematic observation and documentation. It involves becoming a detective to understand the context and patterns surrounding a behavior.

ABC Charts: One of the most effective tools is the Antecedent-Behavior-Consequence (ABC) chart. This is a simple, yet powerful, log that systematically records what happened before the behavior (Antecedent), the behavior itself, and what happened after (Consequence). Consistent use of this chart helps identify recurring patterns and allows for hypothesis development about the behavior's function.
Naturalistic Observation: Observing individuals in their everyday settings, without interference, can provide rich, authentic data about their behaviors and interactions. This is especially useful for understanding how environmental and social factors influence behavior.
Reflective Journaling: For individuals who can communicate, encouraging them to keep a journal of their feelings, thoughts, and actions can provide valuable insights into their internal triggers. For those with communication disorders, a caregiver's reflective notes can capture important details that might otherwise be missed.
Involving Family and Friends: Those closest to the individual, like family and friends, can offer invaluable insights into past experiences, preferences, and potential triggers that may be unknown to care staff. Their involvement enhances communication and ensures a more holistic understanding.

Person-Centered vs. Behavior-Centric: A Comparison

To highlight the difference in approach, consider the following comparison of person-centered care and traditional behavior-centric models when faced with a challenging behavior.


Feature	Person-Centered Approach	Behavior-Centric Approach (Traditional)
Core Philosophy	Behavior is communication; focus on understanding the underlying unmet needs and triggers.	Behavior is a problem to be corrected; focus is on eliminating or suppressing the behavior.
Goal	Enhance the individual's well-being, dignity, and autonomy by addressing the root cause.	Control or manage the behavior to maintain order, safety, or convenience.
Process	Proactive. Uses observation (e.g., ABC charts) to identify and modify triggers, followed by teaching coping skills.	Reactive. Intervenes after the behavior occurs, often using strict routines or negative reinforcement.
Individual's Role	Active partner. The individual's preferences, values, and narrative are central to the care plan.	Passive recipient. The individual follows the directives of the caregiver or professional.
Tools Used	ABC charts, life story books, communication aids, and functional behavior analysis (FBA).	Medications, restrictive interventions, or simply increasing supervision after incidents occur.
Environment	The environment is modified to be supportive, predictable, and aligned with the individual's needs.	The individual is expected to adapt to the environment, regardless of their comfort or needs.

Practical Steps for Implementation

Successfully integrating PCC, especially when dealing with challenging behaviors, involves several systematic steps.

Engage and Build Trust: Before any assessment begins, a therapeutic relationship based on empathy, respect, and unconditional positive regard is essential. The individual must feel safe and understood.
Conduct a Comprehensive Assessment: Use a multi-layered approach that includes observation (e.g., ABC charts), gathering historical information from the individual and family, and assessing medical and environmental factors.
Formulate a Hypothesis: Based on the data collected, develop a working hypothesis about the function of the behavior (e.g., is it for attention, avoidance, or sensory needs?).
Co-create the Care Plan: Involve the individual and their family in developing a personalized care plan. This plan should focus on addressing the identified triggers and unmet needs, not just managing the behavior. For example, if sensory overload is a trigger, the plan might include creating a quiet, designated safe space.
Implement and Monitor: Put the plan into action and continue to monitor its effectiveness. The process is not static; it requires ongoing evaluation and adaptation.

Ethical Considerations and Challenges

While the benefits of PCC are extensive, its implementation requires careful navigation of ethical considerations, particularly regarding autonomy and privacy.

Autonomy vs. Safety: In some cases, a person's behavior may pose a risk to themselves or others. Caregivers must balance promoting autonomy with ensuring safety, a delicate ethical tightrope.
Staff Training and Attitudes: Shifting from a deficit-based mindset to a strengths-based one is a major cultural change that requires continuous training and support for staff. Staff shortages and time constraints can also be significant barriers.
Lack of Information: Breakdowns in communication between staff or a lack of detailed personal information about a resident can hinder progress. High staff turnover can exacerbate this issue.
Financial Constraints: Financial concerns can limit access to resources for proper training, education, and implementation of robust PCC strategies.

Conclusion

Providing exceptional person-centered care hinges on the ability to look beyond the surface of a challenging behavior and understand its underlying purpose. By employing systematic observation techniques, such as ABC charting, and actively involving the individual and their support network, caregivers can move from a reactive, behavior-centric model to a proactive, holistic, and dignified approach. This process not only improves the individual's outcomes, satisfaction, and overall well-being but also leads to a more empathetic and effective care environment for everyone involved. While challenges like staff training, funding, and ethical dilemmas exist, the investment in understanding and addressing triggers is fundamental to truly person-centered care.

Frequently Asked Questions

While often used interchangeably, person-centered care is a holistic approach addressing the individual's entire well-being—including social, economic, and environmental factors. Patient-centered care, in contrast, typically focuses more narrowly on clinical interactions and specific health concerns.

An ABC chart is an observation tool that records the Antecedent (what happened before the behavior), the Behavior itself, and the Consequence (what happened after). By analyzing the recorded patterns, caregivers can form hypotheses about why the behavior is occurring and what its function is.

Family members provide invaluable insight into the individual's history, preferences, and potential triggers that healthcare providers might not be aware of. Their involvement improves communication, builds trust, and ensures care plans are truly personalized.

Common triggers include communication misunderstandings, sensory overload (e.g., loud noises, bright lights), changes in routine, physical discomfort (e.g., pain, hunger), unmet needs, and emotional factors like anxiety or past trauma. Documenting these contexts is crucial.

Functional Behavior Analysis (FBA) is a systematic method used to understand the purpose of challenging behaviors by identifying the environmental factors that contribute to them. It is a core component of person-centered care, informing personalized interventions based on the function of the behavior rather than just its form.

Understanding triggers allows for more effective, proactive intervention strategies, improved patient satisfaction, better health outcomes, and a stronger, more trusting relationship between the individual and their caregivers.

Significant challenges include inadequate staff training, high staff turnover, insufficient resources, communication breakdowns, and balancing individual autonomy with safety concerns, particularly with complex or high-acuity cases.

Enhancing communication involves active listening, seeking feedback from the individual and family, providing information in an accessible way, and acknowledging that non-verbal cues can be crucial forms of communication.

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.