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All staff working more closely with people with dementia and carers have an understanding of behaviour that challenges (BtC) and know where and how to offer support or refer on as needed.

All staff working to support you have an understanding of behaviour that challenges (BtC) and know where and how to offer support or refer on as needed. Recognising that behaviours that staff may consider challenging is often a way of you maintaining a sense of control, dignity and wellbeing, and/or to ease discomfort or distress.

BtC can be defined as: ‘An expression of distress by the person living with dementia (or others in the environment) that arises from unmet health or psychosocial need(s). The behaviours often reflect attempts by the person living with dementia to maintain a sense of control, dignity and wellbeing, and/or to ease discomfort or distress.’
 
For extra information, evidence and best practice please scroll down to the bottom of the page.

Regional offerings

Delirium Toolkits in Greater Manchester; Dementia United

The Greater Manchester delirium toolkits were designed for health and social care staff to use to help them identify and manage delirium in people over the age of 18 and not under the influence of drugs or alcohol. They are based on national evidence and include resources and training for both professionals and people with delirium and their families.
Weblink: https://dementia-united.org.uk/delirium/

National offerings

Age UK

Age UK is the country's leading charity dedicated to helping everyone make the most of later life. Providing advice, support, information, fundraising, local services
Telephone: Advice line 0800 678 1602 free to call 8am - 7pm 365 days of the year
Weblink: https://www.ageuk.org.uk

Alzheimer’s Society

The Alzheimer’s Society provides reliable and up to date information to help you with every aspect of living with dementia.
Telephone: National Dementia Helpline: 0300 222 1122. Open 9.00am. – 5.00pm. Monday to Friday & 10.00am. – 4.00pm. Saturday and Sunday.
Weblink: https://www.alzheimers.org.uk/

Dementia UK

Dementia UK is a national charity, committed to improving quality of life for all people affected by dementia. They provide Admiral Nurses, who work with family members and carers in all care settings along with a helpline for family members or carers who would welcome accessing advice and support.
Telephone: 0800 88 6678
Email: direct@dementiauk.org
Weblink: https://www.dementiauk.org/

Lewy Body Society

The Lewy Body Society is a charity whose mission is to fund research into Lewy body dementia and to raise awareness of the disease. The website provides information, support, resources and advice.
Telephone: 01942 914000
Weblink: https://www.lewybody.org/

NHS England Dementia

Dementia is a key priority for both NHS England and the Government. NHS England's work includes:
  • Developing an access and waiting time standard for dementia, so people with dementia have equal access to diagnosis as for other conditions; setting the national average for an initial assessment
  • Achieving and maintaining the dementia diagnosis rate. NHS England agreed a national ambition for diagnosis rates that two thirds of the estimated number of people with dementia in England should have a diagnosis with appropriate post-diagnostic support
  • Post diagnostic care and support; as there has been substantial progress on diagnosis, NHS England will focus on improving post-diagnostic support
Other organisations and sectors are crucial to helping NHS England deliver improvements to services for those with dementia and their carers. NHS England are working in collaboration with: Alzheimer’s Society, Public Health England, Department of Health, ADASS, Care UK, clinical commissioning groups, GP practices, Royal College of General Practitioners, Royal College of Psychiatrists, amongst other stakeholders to develop NHS England’s five year transformation plan for people with dementia.
NHS England have developed a Dementia Well Pathway which outlines standards across all aspects of the Pathway from prevention, diagnosing, supporting, living and dying well.
Weblinks:
The NHS England dementia-well-pathway can be accessed here: https://www.england.nhs.uk/mentalhealth/wp-content/uploads/sites/29/2016/03/dementia-well-pathway.pdf
You can access the NHS England dementia programme of work here: https://www.england.nhs.uk/mental-health/dementia/

NICE Dementia Guidance

This guideline brings together all the research and evidence which covers assessment, diagnosis, treatment and support. It is for people at risk of developing dementia, people who are referred for assessment, people living with dementia as well as being for family and friends and health and social care staff and commissioners. It aims to improve care by making recommendations on standards people should expect to receive from their assessment, care and support as well as on training.
Weblinks:
We have provided links to the NICE guideline for dementia and a further link is provided to guidance on how to delay or prevent the onset of dementia.
National Institute for Health and Clinical Excellence (NICE) NG16 (2015) Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset: https://www.nice.org.uk/guidance/ng16
National Institute for Health and Clinical Excellence (NICE) (2019) Dementia: assessment, management and support for people living with dementia and their carers: https://www.nice.org.uk/guidance/ng97

Healthwatch

Healthwatch is your health and social care champion. If you use GPs and hospitals, dentists, pharmacies, care homes or other support services, we want to hear about your experiences. As an independent statutory body, we have the power to make sure NHS leaders and other decision makers listen to your feedback and improve standards of care. Last year we helped nearly a million people like you to have your say and get the information and advice you need.
Telephone: Call: 03000 683 000 between the hours of 08:30 – 17:30 Monday to Friday
Email: enquiries@healthwatch.co.uk
Weblink: https://www.healthwatch.co.uk/your-local-healthwatch/list

Evidence


The British Psychological Briefing (2019): "Central to the management of BtC is both ensuring that the needs of the person with dementia are met and resolving any unmet needs using individually formulated biopsychosocial approaches to intervention. It aims to actively treat episodes of BtC and prevent their frequency or escalation. Clinicians and staff working to minimise BtC should be aware of biopsychosocial formulations in which behaviour and associated needs are identified" - these alternatives to treatment focus on finding and resolving the unmet need"


Best Practice Resources


Understanding memory changes in dementia:

Understanding sensory changes in dementia:

Fundamental needs in dementia:

Formulations in dementia care:

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