Care home (CH) residents with dementia may exhibit distressed behaviours due to unmet needs, with non-pharmacological interventions being the first line intervention. This study aims to evaluate the efficiency of the Distressed Behaviour Pathway (DBP), delivered to care homes by a specialist NHS team, using a mixed-methods design.
Retrospective clinical data from 99 patients referred to the DBP (October 2021–December 2022) was reviewed. Missing data was quantified. The Challenging Behaviour Scale (CBS), completed by CH staff, served as an outcome measure. Descriptive statistics and effect sizes were used to derive meaning in relation to pathway duration and intervention type. A purposeful sample of the team was interviewed (n = 7). Questions focused on helpful elements, barriers and potential pathway improvements, examined using reflexive thematic analysis.
Overall, patients (n = 88) were on the pathway for an average of 153 days. CBS scores decreased from pathway acceptance to discharge (M = −23.97, SD = 53.12), reflective of a medium effect size (d = 0.5), with 31.8% showing reliable change. Four themes and five sub-themes emerged: collaborative success – “Useful framework”, “MDT working”, “Positive Outcomes”; operational hurdles – “Resourcing Difficulties”, “Implementation Challenges”; communication; and ongoing reviews. Communication quality appeared to mediate operational challenges and collaborative success, each feeding into the process of ongoing reviews.
Whilst quantitative results require cautious interpretation, findings suggest that the DBP shows promise in reducing CBS scores and supporting CH staff in managing distressed behaviours. Further evaluation is recommended, following more robust reporting of outcome data.
