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

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.