Nursing Times Award, Nursing in the Community category 2013

A specialist behavioural support service has been developed to support staff in residential and nursing homes to care for people with dementia who display behaviour that staff perceive as "challenging". The aim is to avoid the use of psychotropic medication in line with current government guidelines and to educate staff in relation to best practice in this area. We also use a cognitive behavioural model to work with staff to reframe "problem behaviour" into 'needs' that can be met. We work on the assumption that behaviour that staff find challenging is due to an unmet need, and that it is our challenge to ensure we do everything possible to meet that need. We promote psychosocial interventions and one of the main purposes of the introduction of the new service was to reduce admission to hospital psychiatric in-patient wards and moving the person unnecessarily. We aim to reduce the distress of people with dementia and maximise their potential to lead as fulfilling a life as possible. A key message is that with the right care and support people can "live well" with dementia. Allowing people with dementia to remain distressed and failing to meet needs also leads to situations that can be unsafe but also very undignified for the individual concerned.