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'We use the term "complex needs" to make us comfortable'


As a learning disabilities nursing student I hear the word complex used to describe aspects of the lives of individuals we support.

Whether it be behavioural or health needs, the word complex is always used to describe them.

However, as students we are encouraged to be critical about everything and advised to question the things we learn, hear and see.

“I must admit I am not a fan of some of the terminology we use as nurses and the phrase complex needs is one that really rattles my cage.”

And this leads me on to my line of inquiry in this blog: the use of the word complex as a blanket term to make us professionals feel more comfortable with topics we don’t quite yet understand or are afraid to admit we can’t ‘make better’.

I must admit I am not a fan of some of the terminology we use as nurses and the phrase complex needs is one that really rattles my cage. When I hear it used in association with individuals I support it immediately encourages negative preconceptions about the individual.

”Who decided that this individual’s support needs were complex?”

All too often mentors on placements have briefed me about the individuals I will support by simply saying ’they have complex needs’. But what exactly does this mean? Who decided that this individual’s support needs were complex?

As we evolve as a profession the areas we provide support in will change, and as we learn new methods of practice or become better equipped to support with new tools the needs we associate with being complex will change as well.

For example, 15 or so years ago supporting an individual with enteral nutrition would have appeared to be a mountainous task and seen as a complex need.

”As we evolve as a profession the areas we provide support in will change.”

However, this is no longer the case as we have learned to overcome certain barriers to enable us to meet these needs effectively. This leads me to believe that perhaps this need was never complex in the first place, and a better term to describe it would have been ‘a health need that is challenging to professionals’.

I suppose the point I am trying to get across is that we need to carefully consider the terminology we use when working with individuals with a learning disability and their families.

”We shouldn’t be defining an individual’s needs by complexity and we should be mindful of the diversity of needs.”

Some of the terminology used can cause negative preconceptions that encourage undesirable thoughts and actions and can influence both a family’s and professional’s support for an individual. We shouldn’t be defining an individual’s needs by complexity and we should be mindful of a diversity of needs.

No need is the same and simply throwing the blanket of complexity over a range of needs is no longer acceptable in modern practices. I want to encourage you all to question the terminology and categories we place upon individuals. We need to encourage patients to live life to the full as independently as possible and support them to the best of our ability.

No health need is too complex, it’s just perceived to be that way as we are yet to discover the tools required to minimise the current impact. 

People may or may not agree with me but I am certain that in my practice as a learning disabilities nurse I won’t be throwing over the blanket but rather reaching for the ladder to climb up to discover or even create the tools needed to meet health needs that are currently challenging me as a professional.

Needs are only complex if you make them that way.

Rebecca Wallett is Student Nursing Times’ student editor for learning disabilities branch


Readers' comments (4)

  • I agree with the article, complex needs is a term that is used so often but it dosn't actually tell us anything about the person what is/are the needs? why are they complex sometimes it is a combination of little/no communication and difficult behaviours and a medical issue but just using the term complex needs tells us none of this and only manages to bring up the most difficult of imagined scenarios

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  • I also agree and have long wondered about the negative impact on individuals and the people who live with and love them of being told that they are 'complex'. Surely it is human nature to be complex and who of us can hand on heart say that our family system does not involve complexity. It is a negative label that doesn't offer clarity and may only serve to justify our professional egos and/or expensive support packages. Either way it isnt about what is best for the individual and those around them.

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  • We've just started a 2nd year module entitled "Supporting people with complex needs" and my thoughts on the title were much the same. The phrase really means very little and informs even less. I'll be honest. At times I have thought that I don't want to have to work with complex needs as it may be too complex! The fact is that in the case of this module it simply refers to those with greater than one diagnosis, be that a physical disability on top of an LD diagnosis OR perhaps some behavioural element. Such a vague term as to be virtually useless.

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  • My favourite meaningless 'label' is Profound and Multiple Learning Disability.

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