A person’s wellbeing in dementia isn’t straightforward. It’s made up of a complex mix of their cognitive state, their general health, as well as their personality, background and social interactions. It’s difficult to get a full understanding of any individual’s abilities and requirements from one short assessment; dementia care mapping can be a useful tool to help us understand and learn more so that we can respond to their needs and plan effective care.
What is it?
Dementia Care Mapping (DCM) is an observation tool designed to examine the quality of care from the perspective of the person with dementia. When developing the process it was described as:
‘‘A serious attempt to take the standpoint of the person with dementia, using a combination of empathy and observational skill’’
That’s a pretty good summary. It’s a person-centred approach, emphasising the perspective of the person with dementia, stressing the importance of relationships and promoting patient-focused holistic practices.
Who could benefit?
Well the short answer is anyone and everyone. Dementia Care Mapping may be carried out for a resident to assist in care plan development, to help facility feedback and education, to guide staff development and to monitor the way the individual and facility change over time.
The advantages include the improvement of people’s well-being and helping staff see care from the point of view of the person living with dementia. This can lead to evidence-based feedback and action planning that motivates staff and helps them to feel more confident in implementing person-centred care.
What is the process?
An individual with dementia is observed for between two and six hours. Every five minutes the patient’s behavior is watched and coded. Scores of well-being and
ill-being are noted, as well as whether they are brief or sustained. Any positive events or personal detractions are also documented.
A mapper should watch and listen unobtrusively, so that they don’t influence behavior. It’s important not to initiate contact or encourage activity and to intervene only if the patient is at risk or in danger.
Afterwards the data is analysed and the behaviours are divided into those that are thought to have high potential for well being, and those with low potential. The information is used to help plan effective, individualized care. Feedback can also be provided to staff as a means of changing and improving the patients’ care.
DCM should be repeated every six to twelve months to monitor progress and track the quality of care improvements
Does it work?
Dementia Care Mapping has been in use for twenty years and there is good research evidence that when it is utilised in a framework that supports person- centred care, it can improve levels of wellbeing, increase the amount and diversity of activities, and dramatically decrease the incidence of personal detractions.
We’ve also heard from teams we’ve worked with that the patient-centred approach really makes a difference. Facilities reported fewer incidents of challenging and disruptive behavior and a reduced need for medication. This is beneficial for the individuals with dementia and those that care for them. Staff using DCM reported greater job satisfaction, which was reflected in decreased turnover and a fall in complaints- a job well done.
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