A participant who has always been calm suddenly starts hitting out during personal care. Another stops eating, becomes withdrawn and refuses to leave their room. A third has more frequent outbursts in the weeks after a medication change. In each case, it would be easy to see the problem as “behaviour” alone. Often, the real cause is a health issue that nobody has picked up yet.
For people living with disability, physical health and behaviour are closely linked. Pain, infection, constipation, medication side effects and poor sleep can all show up as distress, aggression or withdrawal, particularly for people who cannot easily describe how they feel. At the same time, behaviours of concern can make it harder to deliver the clinical care someone needs.
That is why the best outcomes come when nursing and behaviour support work together. This guide explains how the two connect, the warning signs that should prompt a health check, how joined-up care works in practice and what to ask when choosing a provider.
How Health and Behaviour Affect Each Other
Behaviour is a form of communication. When a person cannot use words to say “my stomach hurts” or “I feel dizzy”, the message may come through actions instead. A sudden or unexplained change in behaviour should always prompt the question: could something be wrong with this person’s health?
The link works both ways. A participant who finds wound dressings, injections or catheter care distressing may resist that care, which can delay treatment and lead to further health problems. Without the right strategies, clinical care can become a source of stress for everyone involved.
For families looking at NDIS Nursing Services Brisbane providers offer, this connection matters. A nurse who understands how a participant communicates, and who follows the strategies in their behaviour support plan, can deliver care more calmly and safely. Equally, a behaviour support practitioner who knows about a participant’s health conditions and medications can build a more accurate picture of why behaviours are happening.
Seven Health Issues That Can Show Up as Behaviour
These are some of the most common health causes behind changes in behaviour. Each one is worth considering before assuming a behaviour is purely behavioural.
- Pain. Toothache, headaches, joint pain, reflux, menstrual pain and injuries are common and often missed. A person in pain may become irritable, refuse activities, rock, hit themselves or resist being touched.
- Constipation and bowel problems. Constipation is a frequent and underrecognised problem for many people with disability, especially those with limited mobility or on certain medications. The discomfort can lead to agitation, poor sleep and reduced appetite.
- Infections. Urinary tract infections, chest infections and skin infections can cause confusion, fatigue and distress. Participants who use catheters or have limited mobility may be at greater risk.
- Medication changes and side effects. Starting, stopping or adjusting a medication can affect mood, sleep, appetite and alertness. Side effects such as nausea, dizziness or restlessness may be expressed through behaviour rather than words.
- Poor sleep. Sleep problems, whether caused by pain, breathing issues, anxiety or an unsettled environment, can leave a person tired and less able to cope with everyday demands.
- Seizure activity. For participants with epilepsy, changes in behaviour can occur before or after seizures. Confusion, irritability or unusual behaviour may be signs that seizure patterns are changing.
- Skin and wound problems. Pressure injuries, wounds and skin irritation can be painful and itchy. A person who is uncomfortable may scratch, pull at dressings or become distressed during care.
When behaviour changes suddenly, the safest first step is often a health check. Recording when the change started, what else is happening and any changes to medication or routine gives nurses, GPs and practitioners valuable information.
How Joined-Up Care Works in Practice
Joined-up care means the people supporting a participant share information and work towards the same goals, with the participant’s consent.
Nursing supports under the NDIS are generally funded where they relate to a person’s disability, such as catheter management, wound care, tracheostomy care or medication management. Behaviour support is funded through capacity building, and involves a behaviour support practitioner assessing why behaviours occur and developing a behaviour support plan with positive, practical strategies.
When choosing NDIS nursing providers, it is worth asking how their nurses work alongside behaviour support practitioners and support workers. In a well-coordinated team, nurses alert the practitioner to health changes that might affect behaviour, and the practitioner shares strategies that help clinical care go smoothly. Support workers, who spend the most time with the participant, record observations that both can use.
Good behaviour support also takes health into account from the start. A good functional assessment looks at medical conditions, medications, pain and sleep alongside environmental and social factors. Where regulated restrictive practices are part of a plan, they must be used only as a last resort, in line with NDIS rules, and their use must be monitored and reported. Reducing reliance on these practices is a core goal of positive behaviour support, and addressing underlying health issues is often part of achieving it.
Consider a simple example. A participant starts refusing showers and becomes upset when workers approach. Instead of simply adding new behaviour strategies, the support worker records the change and alerts the nurse. The nurse finds a painful skin infection, arranges a GP review and adjusts the wound care routine. Meanwhile, the behaviour support practitioner suggests a gentler, more predictable approach to personal care while the infection heals. Within weeks, the participant is settled again.
Regular team communication keeps everyone informed. That might include shared care notes, case conferences when needs change and clear processes for escalating concerns to a nurse, GP or practitioner.
Questions to Ask Before Choosing a Provider
When a participant needs both clinical care and NDIS Behaviour Support Services, these questions help you judge whether a provider can deliver joined-up support.
- Do your nurses and behaviour support practitioners work together? Ask how information is shared between clinical and behaviour support staff, and how often they meet or communicate about shared participants.
- How do you check for health causes when behaviour changes? A good provider will have a clear process for considering pain, infection, medication changes and other health issues before adjusting behaviour strategies.
- Are your nurses registered and experienced in disability? All registered nurses in Australia appear on Ahpra’s public register. Ask about the nurses’ experience with the specific clinical needs involved, such as catheter care, wound management or tracheostomy support.
- How are support workers trained in the participant’s plans? Support workers need to understand both the nursing care plan and the behaviour support plan, and how the two fit together on every shift.
- How do you approach restrictive practices? Ask how the provider works to reduce and eliminate restrictive practices, how their use is authorised and reported, and how families are kept informed.
- How will we be kept informed? Families and support coordinators should receive regular updates and be told promptly about significant health or behaviour changes.
Clear, confident answers to these questions are a good sign that the provider understands how closely health and behaviour are linked.
How Royalty Healthcare Provides Joined-Up Support
Royalty Healthcare (ABN 35 654 251 519) is a registered NDIS provider based in Strathpine, supporting participants across Brisbane, Ipswich, Logan, the Gold Coast and the Sunshine Coast.
Our registered nurses provide wound care, medication management, urinary catheter management, ventilator and tracheostomy management, and subcutaneous and intramuscular injections, in participants’ homes, supported living and community settings. Our behaviour support practitioners take a proactive, person-centred approach, built on the belief that behaviour is a form of communication. They assess triggers and strengths, develop individualised behaviour support plans, coach families and support workers to apply strategies consistently, and review plans regularly. Regulated restrictive practices are used only as a last resort under an approved plan, with monitoring and reporting in line with NDIS Commission requirements.
Because our nurses, behaviour support practitioners and support workers work as one team, health and behaviour are considered together. To discuss your needs, call 1800 467 692 or email info@royaltyhealthcare.com.au.
Final Thoughts
Health and behaviour are deeply connected. A change in behaviour can be the first sign of pain, infection or a medication issue, and distress can make essential clinical care harder to deliver. When nurses, behaviour support practitioners and support workers share information and work towards the same goals, problems are picked up earlier, care is calmer and participants enjoy better health and quality of life. If you or someone you support needs both types of care, look for a team that works as one.
Disclaimer: This article provides general information about the NDIS and is not medical, clinical, legal or financial advice. Always seek advice from a GP or treating health professional about changes in health or behaviour, follow each participant’s care and behaviour support plans, and check current NDIS guidance at ndis.gov.au.