Staff approaches to managing challenging behaviour associated with dementia in the Emergency Department

Study team

Study summary

There are an estimated 850,000 people living with dementia in the UK, and one in three people will develop dementia in their lifetime. In the UK in 2010, approximately 300,000 Emergency Department (ED) attendances were by people with dementia, accounting for 42% of unplanned admissions to an acute hospital.

There is audit data to suggest that over a third of people with dementia attending an ED experience challenging behavioural symptoms, of which aggression is the most common. To manage this behaviour, patients are sometimes given anti-psychotics or manually restrained. However non-pharmacological strategies, such as use of family and reorientation, are often under-used. This approach to managing behaviour can be harmful and upsetting for the patients, family members and staff themselves.

Despite the importance of dementia training recognised by Royal College of Emergency Medicine, there are no standardised processes for managing challenging behaviour exhibited by people with dementia in EDs, and the risk of aggression directed at emergency staff has unfortunately been normalised as part of the job.

Although there is literature suggesting various approaches to managing challenging behaviour exhibited by people with dementia, there is little research on the effectiveness of such de-escalation techniques the EDs setting. Therefore, this study will use semi-structured interviews and a survey to explore EDs staff members’ experiences of managing challenging behaviour exhibited by patients with dementia. Staff will also be asked their views on current de-escalation techniques and what may work in the context of a busy EDs environment.

Key output

Manning, S.N. (2020). Managing behaviour that challenges in people with dementia in the emergency department. Emergency Nurse. doi: 10.7748/en.2020.e2019