Investigating the causes of behaviours that challenge in people with dementia.

Nurses are the main providers of care to older people and to people with dementia in a variety of settings, including acute hospitals. Behaviours that challenge in people with dementia, such as agitation, aggression and 'resistiveness', can best be understood as a form of communication based on a person's perceived and/or actual unmet need(s). This article explores ways of understanding behaviours that challenge and contains a composite case study of 'Frank', a person with severe dementia who has been admitted to an NHS inpatient mental health assessment ward. A three-step approach to investigate, formulate and personalise a range of interventions is shared (clue finding; motive identifying; and formulating, applying and evaluating interventions) together with ways of intervening in behaviours that challenge.