When should someone in care's behaviour give cause for concern?
And what words should we use to describe it?
These are two issues that are at the heart of good practice for professional carers.
And they were recently brought into stark focus by the Whorlton Hall scandal - where so-called carers were using horrible names for the patients as well as abusing them psychologically and physically.
NAPPI UK operations director Scott Edwards said: "Around 200 years ago people were using terms such as 'idiots', 'imbeciles' and 'morons'."
"I would hope that today we are treating all people in need of care as human beings. That is why we are supportive of the latest change of description from 'challenging behaviour', which has negative connotations, to 'behaviour of concern' - which is more attuned to recognising someone is human and needs support.
That also raises the issue of when we should be concerned about behaviour - which is at the very first signs of distress such as pacing or fidgeting, and long before it escalates.
The term 'challenging behaviour' or 'behaviour that challenges' is an umbrella term which covers a diverse range of behaviours which employees may find difficult to manage, may challenge their own behaviours and attitudes; and which may threaten or impact on the person's quality of life.
Challenging behaviour has been described as 'Culturally abnormal behaviour of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities.' (Emerson, 1995).
However, with a fresh focus on identifying behaviours 'of concern', we respond with respect, show empathy and acknowledge the need for dignity. Recognising behaviour only when it becomes challenging to the degree safety is compromised is a poor show."
Scott added: "We should be 'concerned' the very instant a fellow human being presents with distress. To not be concerned by a human's distress is quite frankly inhumane. This is one terminology change that we must embrace - and make others passionate about it."