Developing an intervention to promote person-centred care to improve management of behaviours that challenge among people living with dementia

Background: This paper reports the development work conducted for a feasibility study (MEDREV) conducted in the UK evaluating: (i) a medication review to reduce the prescription of psychotropic medication for managing behaviours that challenge among people living with dementia: and (ii) a training intervention for care home staff designed to improve the management of behaviours that challenge without medication using person-centred care. This paper reports the development of (ii) the training intervention for care home staff.

Methods: The intervention development was informed by the MRC guidelines for complex interventions and the phases of the Behaviour Change Wheel. We used an iterative approach responding to and consultations with stakeholders throughout the process.

Results: The target behaviours of the intervention were: responding to challenging behaviour as an expression of unmet need; communicating with compassion. The intervention was required to educate about psychotropics and their side-effects, to help care staff relate to people with dementia as individuals with individual needs and wants, to reflect upon how one might deliver the values of person-centred care in care scenarios, and to promote good team communication and self-care. An interactive, brief, in-house training session was developed with a number of recommendations for systemic change.

Conclusions: The intervention was developed in a systematic way taking into account the particularities of the care home context and the target population. These factors prompted many challenges as did the manner in which residential care home interventions are funded in the UK. An ideal intervention package would have incorporated environmental elements, more systemic support from the care home management, and more financial investment to offer a more detailed, longer lasting training intervention.