Challenging behaviour in dementia: A critical role for psychology

Abstract

Challenging behaviour has been a known feature of dementia for at least 90 years but until recently has been largely ignored by serious research. Unfortunately, for those exposed to it, phenomena such as continuous screaming or violence are impossible to ignore. They can cause severe distress to family members and are a major reason for committal to residential care, where nursing staff also find it hard to cope. The research vacuum means that these behaviours are often inappropriately managed with medication, and has also made possible claims of great efficacy, unsupported by evidence, for various psychosocial “therapies”. Psychology, a discipline supposedly uniquely placed to address behavioural phenomena, has been largely invisible to date. Nevertheless, there are psychologists working with these severe problems, which are extremely complex and not amenable to single-modality solutions or concrete thinkers wedded to one theoretical framework. This paper provides a brief overview of opportunities for psychology to make a significant contribution in four inter-linked areas: conceptualisation and classification, alleviating carer distress, development of management techniques, and development of research methodology.