Imagine walking in the shoes of someone struggling with
dementia. Then, while observing their daily challenges, devising a
map that captures what life is like for them on a typical
day—using their perspective—centered on what
they need and then turning that map into a plan for that
patient’s personalized care.
The University at Buffalo Institute for Person-Centered Care
will be doing just that as a result of recent training and
certification in advanced dementia care mapping (DCM). This
certification will allow institute researchers to map and provide
written as well as in-person feedback to various organizations
locally and throughout the U.S. who wish to improve the dementia
care and services within their facilities.
“DCM takes a person-centered view of care, which means
that the task of care is seen as being much more than meeting basic
physical needs; it is about the whole person, of empowering each
individual to make full use of their abilities and remain a social
being. It is not designed to be critical of staff or monitor
care,” says Davina C. Porock, PhD, associate dean for
research and scholarship in the UB School of Nursing and director
of the Institute for Person-Centered Care.
“When observing from the perspective of the individual,
the mapper ‘sees’ the issues differently and can
evaluate the individual’s quality of life,” she
DCM is the formal name of an observational tool designed by
Bradford University in 1989 in the UK to examine quality of life
from the perspective of the person with dementia. It is a tool for
evaluating and improving the care given to people with dementia in
formal settings such as day centers, residential homes, nursing
homes and hospital wards.
The idea of DCM appeals to Porock because, as director of the
institute, she specializes in person-centered care, specifically
care at the end of life.
According to Porock, people with dementia often conjure up for
us images of individuals who are forgetful, confused and possibly
lost or wandering or behaving in unpredictable ways. We think in
terms of the challenges they present to us—as health care
workers and family members—but we don’t often think of
them in terms of their own personal and social needs.
“Person-centered care, at its most fundamental, is about
ensuring dignity, personhood, and purpose for vulnerable and frail
individuals no matter where they live,” said Porock.
“Its aim is to alleviate the boredom, loneliness and
helplessness these people often feel.”
Rhonda Rotterman, RN, program director for the institute and
certified in advanced mapping says that when using DCM, the mapper
is looking for four things:
- the range of activities in which a person is engaging;
- the relative level of well-being of the person;
- episodes of best practice care provided by the care team;
- episodes of care provision that could be improved.
She says that during an evaluation, which may take several
hours, recordings are made every five minutes. After analysis, the
observations are fed back to the health care teams, and used to
“It is through these observations that you begin to
realize how small deeds and words have a profound impact on
people,” says Rotterman.
At the completion of the mapping process, mappers will analyze
the data, produce a written report and conduct a live feedback
session with the organization that includes the group that was
evaluated as well as individual insights. This information can then
be used to create training pathways to improve care and
Porock adds that the value of tools to better understand and
treat people with dementia goes far beyond individuals or health
care facilities in which they reside.
“According to the Rand Corporation, the cost of dementia
care is expected to double by the year 2040. And, worker stress is
higher in facilities with specialized dementia units. When staff
are ill-equipped to care for these individuals, they experience
higher levels of stress and burn out leading to high rates of
turnover,” she says.
For more information on DCM, person-centered care workshops and
continuing education unit opportunities (CEUs), go to the UB
Institute for Person-Centered Care web site at http://www.ubipcc.com/index.html
or email the institute at firstname.lastname@example.org