Margaret had worked in care for more than 20 years. She’d seen a lot. But one evening shift still caught her off guard.
An evening that didn’t go to plan
One of the residents, a man who was usually chatty and settled, had just had a difficult phone call. Afterwards, he became withdrawn and distressed.
Margaret’s first instinct was the one most of us have. She wanted to fix it: find the right words, cheer him up and get the evening back on track.
Slowing things down
Instead, she slowed things down. She sat beside him. She softened her tone. She stayed present. She didn’t push him to talk, and she didn’t rush to fill the silence.
It didn’t solve everything that evening. But he wasn’t on his own with it.
Later, Margaret said:
“I realised I didn’t need all the answers. I just needed to understand how to respond differently.”
Why it worked
When someone is distressed, a rush of questions, reassurance or problem-solving can feel like pressure, even when it’s kindly meant. A calm, unhurried presence tells the person they’re safe and that their feelings matter.
This is at the heart of trauma-informed care. It recognises that people’s past experiences can shape how they react now, so the question shifts from “what’s wrong with you?” to “what’s happened to you?”
You don’t need to know someone’s whole history to respond this way. You just need to notice, and to slow down.
Responding to distress in care: what helps
- Notice the change. You know the people you support. If someone who’s usually chatty goes quiet, that matters.
- Slow down. Lower your voice, sit at their level and give them time.
- Be there, don’t fix. Listening often does more than the perfect words.
- Acknowledge how they feel. Something as simple as “that sounds really hard” helps a person feel heard.
- Offer choices. Ask whether they’d like company, a drink or some quiet time, and respect their answer.
- Look after yourself, too. Supporting someone through distress can be draining, so talk it through with your team afterwards.
Know when to do more
Staying calm and present is often exactly what’s needed. But a sudden change in someone’s mood or behaviour can also be a sign of something else, such as a physical illness, a side effect of medication or a safeguarding concern.
- Record what you noticed and hand it over, so the next shift knows.
- Tell a senior colleague if you’re worried, and follow your service’s policies.
- If someone talks about harming themselves, or you think they’re at immediate risk, get help straight away and follow your emergency procedures.
Our guide to spotting the early signs of abuse explains what to do if a change in behaviour could be a safeguarding concern.
Confidence comes from understanding
Margaret didn’t say the perfect thing that evening. She didn’t need to. Sometimes confidence in care comes from understanding people better, not from having all the answers.
That kind of confidence can be learned. Courses that help include:
- Trauma Informed Care (half day): how trauma affects people, what can cause distress, and how to support people in a person-centred way
- Mental Health Awareness (half day): the different types of mental health conditions, including those common in older people, and person-centred care planning
- Mental Health First Aid (two days): recognising mental health conditions, responding safely in a crisis and signposting people to the right support
- Stress and Distress (full day): supporting people living with dementia who experience stress and distress, and responding to triggers
