Published July 25, 2013
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.
UB’s 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. that 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, associate dean for research and scholarship in the 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.”
DCM is the formal name of an observational tool designed in 1989 by Bradford University, 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,” says Porock. “Its aim is to alleviate the boredom, loneliness and helplessness these people often feel.”
Rhonda Rotterman, program director for the institute and certified in advanced mapping, explains that when using DCM, the mapper is looking for four things:
Rotterman says that during an evaluation, which may take several hours, recordings are made every five minutes. After analysis, observations are fed back to the health care teams and used to improve care.
“It is through these observations that you begin to realize how small deeds and words have a profound impact on people,” she says.
At the completion of the mapping process, mappers 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 then can be used to create training pathways to improve care and services.
Porock adds that the value of tools to better understand and treat people with dementia goes far beyond individuals or the 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,” she says. “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.”
For more information on DCM, person-centered care workshops and continuing education unit opportunities, visit the Institute for Person-Centered Care website or email the institute at firstname.lastname@example.org.