Managing behaviour that challenges in people with dementia in the emergency department
Intended for healthcare professionals
Evidence and practice    

Managing behaviour that challenges in people with dementia in the emergency department

Sera Nia Manning Senior Lecturer, Nursing, University of the West of England, Bristol, England

Why you should read this article:
  • To recognise the potential causes of behaviour that challenges among people with dementia in the emergency department (ED) setting

  • To understand the issues that may occur as a result of behaviour that challenges in the ED

  • To be aware of strategies to manage dementia-related behaviour that challenges that you can use in your practice

Dementia symptoms can manifest in a variety of ways, such as anxiety, agitation and an inability to communicate unmet needs. In emergency departments (EDs), these symptoms, as well as various environmental factors, can lead to behaviour that challenges in people with dementia. Therefore, ED staff must be skilled in screening, assessing and managing this patient group effectively.

This article details a literature review that was conducted to explore the evidence on managing behaviour that challenges in people with dementia in the ED and what de-escalation strategies may be useful. A literature search of eight databases was undertaken, resulting in 11 articles that were included in this literature review. Four main themes were identified: violence and aggression towards staff; manual and chemical restraint in the ED; identifying delirium and dementia; and environment and person-centred care. Strategies identified to de-escalate and reduce the risk of behaviour that challenges include: making environmental modifications to the ED; providing person-centred care; excluding or evaluating pain and unmet needs; using various tools and strategies to improve communication; and using distraction techniques.

Emergency Nurse. doi: 10.7748/en.2020.e2019

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software


Conflict of interest

None declared

Manning SN (2020) Managing behaviour that challenges in people with dementia in the emergency department. Emergency Nurse. doi: 10.7748/en.2020.e2019

Published online: 30 December 2020

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