Non-pharmacological prescribing for behaviour that challenges in dementia: An evaluation of 12 months of outcome data

Abstract

BackgroundNon-pharmacological interventions are recommended as a first line treatment for the management of Behaviour that Challenges in Dementia (BtC). For the past decade, The Durham and Darlington Care Home Liaison (CHL) Hub have developed Behaviour Support Plans (BSPs), providing guidance on staff approaches and recommending specific, individualised, non-pharmacological interventions. Until recently, it was left to residents’ families to pay for and provide any items recommended. Clinicians knew what interventions could help, but they could not prescribe them. The CHL Hub was awarded non-recurrent funding in 2021 to prescribe a range of non-pharmacological interventions. This evaluation presents 12 months of routine outcome data for residents receiving such interventions.MethodProxy-rated measures of behaviour that challenges (Challenging Behaviour Scale, CBS, Moniz-Cook et al., 2001) and Quality of Life in Dementia Scale (QUALID, Weiner et al., 2000) were completed as part of routine care pre and post non-pharmacological intervention. Qualitative feedback .from care home staff and families of residents receiving non-pharmacological interventions was collected via telephone interview.ResultsResults show a significant difference between pre and post intervention CBS (z=1.28, p<.01) and QUALID scores (z=1.03, p<.01), with large effect sizes (r=.82, CI [.74-.87] and r=.67, CI [.5-.81], respectively).ConclusionCare home residents showed reduced BtC and improved quality of life following the introduction of non-pharmacological interventions as part of BSPs. Recommendations are discussed.