Care for older people with a dementia in acute hospital settings.

If nurses plan and approach older people with dementia with positive values, and learn from the person's communication through their behaviour, the outcomes for all parties can be improved. The vignette has offered one example, but also demonstrates that there are no failure-proof ways of communicating, and sometimes nurses need to learn through trial and error. Only in this way can they become more skilled in their interventions to facilitate rather than manage challenging behaviours. Avoidance and ignorance do not help in either the short term or the long term. The good news is that single interventions are successful 45 per cent of the time and multiple interventions, as shown in Box 2, are more successful (Bair et al 1999).