When a person with dementia presents with distressed behaviour, a holistic assessment should be undertaken, including consideration of the possible reasons underlying the person's distress. Structured and objective measures can assist in the identification of distressed behaviour. Functional analysis can help identify possible triggers or reasons for the behaviour.

For managing distressed behaviour symptoms in people with dementia, tailored activities based on a comprehensive structured assessment may be considered. Activities should be individualised, focus on preserved capabilities and consider previous roles, interests and preferences.

For managing agitation and aggression in people with dementia in care homes a multicomponent programme, including staff training and support and interventions tailored to the needs of the person with dementia, may be considered.

For carers of people with dementia, provision of tailored psychoeducation and skills training may be considered.

Components may include:

• problem solving
• identifying triggers
• coping strategies for distressed behaviour
• stress reduction
• cognitive restructuring
• communication skills
• crisis management.

Staff training in the management of distressed behaviours, to improve the quality of life for people with dementia, should be linked to the Promoting Excellence Framework.¹¹ Training should be part of ongoing multidisciplinary skills development and supported by appropriate leadership, infrastructure and resources to facilitate sustained implementation and staff engagement.