How to use a formulation approach to understand behavioural expressions of need in people with dementia

RATIONALE AND KEY POINTS: Distress, also known as behavioural expressions of need, is highly common in people with dementia. The Newcastle Model offers a formulation-based approach in which holistic information is gathered to generate hypotheses about the causes of a person's distress. It encourages health and social care professionals to use curiosity in order to understand the individual's underlying unmet needs and respond with person-centred support. This article provides a step-by-step guide for nurses on how to apply this approach in practice. • Behavioural expressions of need are common in people with dementia and often challenging for the person, their families and professional carers. • The Newcastle Model is an evidence-based approach that can be used by nurses and other health and social care professionals in all settings to think about a person's needs holistically. • Recognising and understanding a person's behaviour as an expression of need can enable the provision of physical, psychological and social support. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when caring for a person with dementia who is experiencing a behavioural expression of need. • How you could use this information to educate nursing students or your colleagues on the appropriate technique and evidence base for supporting a person with dementia who is experiencing a behavioural expression of need.