Formulation-led care in care homes: Staff perspectives on this psychological approach to managing behaviour in dementia care

Abstract

Introduction: Many people living with dementia will move to specialist care facilities as the syndrome progresses. Psychological formulation offers a promising non-pharmacological approach to managing behaviours that challenge in dementia care. However, little is known about how formulation is viewed by non-qualified care staff who are responsible for the day-to-day care of residents. Therefore, the present study aimed to explore the experiences of care staff in relation to formulation as an approach to managing behaviour in dementia care. Design: This was a qualitative design involving semi-structured, individual interviews. Method: Interviews were conducted with 13 care staff with experience of psychological formulation from five care facilities. Data were analysed using thematic analysis. Results: Three themes emerged from the data that offer an insight into the factors contributing to care staff's perspectives of formulation-led care. The themes were defined as expectation, working together and understanding. Conclusion: The findings suggest that formulation-led care approaches are viewed by care staff as a favourable approach to supporting people living with dementia who present with behavioural difficulties. Psychologists can aid care staff's investment within formulation approaches through managing expectations and fostering effective working relationships with care teams to develop understanding of the context around behaviours that challenge. Implications for Practice: By aiding effective, collaborative communication between nursing and psychology team members and providing clear feedback to aid nurses' understanding of formulations, this study highlights that consideration of biopsychosocial factors when attempting to understand behaviour offers a safe, person-centred alternative to pharmacological approaches.