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Managing behaviours that challenge within English care homes: an exploration of current practices

Mallon, Charlotte Marie (2015) Managing behaviours that challenge within English care homes: an exploration of current practices. Doctor of Philosophy (PhD) thesis, University of Kent. (KAR id:54752)

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Abstract

Behaviour that challenges in people with dementia is complex and multifactorial; there is no single solution for its management. In 2009 the Department of Health in England called for a reduction in the use of antipsychotics for people with dementia. Instead, individualised non-pharmacological interventions were recommended first-line. The aim of this study was to explore how behaviour that challenges in people with dementia is managed by care homes in England, and how they are managed in practice.

The findings from this study suggest that there is no one way to manage behaviour that challenges in dementia. Care staff did not believe that one size fits all, and the management of these behaviours changes from day to day and from person to person. Varying strategies were used; however these were not those advocated by practice guidelines, instead involving predominantly distraction and emotional reassurance. The level of antipsychotic use was lower than anticipated, however there was extensive use of other medications which were found to be questionable, indicating that perhaps the problems of managing behaviour that challenges are still present. Finally, relatives of people with dementia have valuable experience and opinion which must not be overlooked by researchers, or care home managers and staff.

This thesis provides an important examination of the ways in which behaviours that challenge in people with dementia are managed by care homes in England. It provides a picture of how care is delivered to people with dementia in care homes, particularly during incidents of behaviour that challenges. It has established the ways in which people with dementia are cared for during these incidents, and has exposed that, rather than following current guidelines, knowing the resident, understanding causes of the behaviour, use of the care team and the use of the care environment play a vital role in enabling staff to manage these behaviours.

Item Type: Thesis (Doctor of Philosophy (PhD))
Thesis advisor: Krska, Janet
Thesis advisor: Gammie, Shivaun
Uncontrolled keywords: Dementia; Care homes; behaviours that challenge
Subjects: Q Science
Divisions: Divisions > Division of Natural Sciences > Medway School of Pharmacy
Depositing User: Users 1 not found.
Date Deposited: 31 Mar 2016 09:26 UTC
Last Modified: 16 Feb 2021 13:34 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/54752 (The current URI for this page, for reference purposes)
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