Enhancing the consistency and range of non-pharmacological interventions recommended for people living with dementia in care homes exhibiting Behaviours that Challenge: A service evaluation

‘Behaviours that Challenge’ (BtC) describes how people communicate distress when unable to meet their needs independently. NICE (2018) guidelines for working with people with dementia recommend non-pharmacological interventions as first-line approaches. A 2021 service evaluation within an older adult mental health (OAMH) service found that most care home referrals for BtC resulted in documented recommendations for pharmacological interventions. In response, a BtC information pack was developed to support OAMH staff in taking a consistent approach when working with care home staff and to enhance care staff knowledge, confidence, and use of non-pharmacological interventions. The present service evaluation explored the impact of the information pack on OAMH staff’s clinical recommendations and documentation, compared with the 2021 evaluation. Findings indicated a reduction in the recording of pharmacological interventions and an increase in the recording of non-pharmacological interventions. This suggests that the information pack had a positive impact on practice and/or documentation. The evaluation emphasised the need to understand staff experiences of using the information pack and to identify how OAMH services can be supported to consistently recommend and document non-pharmacological interventions as first-line approaches in dementia care.