Expert-Derived Components of Person-Centred Nursing Intervention for People with Dementia and/or Cognitive Impairment in a Hospital Experiencing Distress

Abstract Background Hospital admissions among people living with dementia are rising across the UK, with distress, often intensified in acute settings, contributing to poorer outcomes (Abbott et al., 2022; Brontsema et al., 2025). This study took place in an acute hospital featuring a Meaningful Activities Centre (MAC), established by a Dementia Nurse Specialist (DNS). Aim To identify expert‑derived components of person‑centred nursing interventions delivered by a Dementia Nurse Specialist to reduce distress in hospitalised people with dementia and/or cognitive impairment. Methods A qualitative approach was employed involving six patients and five relatives referred to the DNS. Data sources included clinical record review; observation of 12 episodes of care; and 28 interviews with patients (n=5), relatives (n=5) and the DNS (n=18). Qualitative data were analysed using Colaizzi’s (1978) seven‑step method. Results The findings from this study describe the DNS’s intervention for reducing the distress of PLWD/C in acute clinical areas in one hospital. They demonstrate that the core element of the intervention was a holistic assessment, focused on identifying underlying contributors to distress, which were then recognised as unmet needs. This assessment frequently identified previously unrecognised symptoms or unmet needs that were often biological in nature, as evidenced by the variation in symptoms reported before and after the DNS’s intervention. Although the assessment process was person-centred, it followed a clear linear structure with defined components that contributed to building a comprehensive understanding of the individual and their distress. Conclusion Thorough and structured assessment is essential for identifying unmet needs and managing distress in people with dementia in acute hospitals. An individualised, assessment-driven approach supports targeted use of pharmacological and non-pharmacological interventions, reducing reliance on non-specific treatments, improving care quality, and promoting person-centredness.