Skip to main content

Managing behaviour that challenges

"Any behaviour, including apathy, that causes emotional distress within the carer or others in the environment."

Mackenzie and James (2011)


Behaviours that challenge in dementia care are understood to be a communication or expression of need that the person living with dementia may be not able to communicate coherently and which may not be immediately recognised by care providers.

The causes of behaviours that challenge are multifactorial and may be associated with beliefs, disorientation in time place and person; drug related issues; mental health status; physical health status; perceptual and sensory deficits; premorbid personality; cognitive and neurological status; metabolic status. In addition factors in the physical and interpersonal environment may trigger behaviours that challenge.

Behaviours that challenge may require referral to a specialist dementia care team however there are approaches to care provision that non-specialist services and care providers can take to make a difference.

The following model is an adaptation of the Understanding Behaviour in Dementia that Challenges Nottingham Model:


James, A. (2011) Understanding Behaviour in Dementia that Challenges A Guide to Assessment and Treatment. London: Jessica Kingsley.

Alzheimer's Society information for dementia professionals

Follow us: