Dementia Care Mapping and Patient-Centred Care in Australian residential homes: An economic evaluation of the CARE Study, CHERE Working Paper 2008/4

with such programs can be justified in terms of improved behavioural outcomes for
patients. This paper reports the results of an economic evaluation of the Caring for
Aged-Care REsident Study (CARES), a cluster-randomised trial, which investigated
the relative effectiveness of DCM, PCC and Usual Care (UC).

Person-Centred Care, both as a philosophy and a method of care, is based on the
social-psychological theory of personhood in dementia.[7] This approach recognises
the persistence of “personhood” despite other losses occurring in dementia, hence
achieving well-being is a central focus of care. Kitwood proposed that the care
environment must not only be informed by a person’s clinical history but also the
person’s social and functional history, and be designed to cultivate the retention of
capacities by enhancing remaining strengths rather than managing deficits. PCC
methodology prescribes individualised care planning informed by the person’s
history, needs and preferences, material and management environments that reflect
the principles described above, and care staff who are sensitised to the person’s
unique personality and preferences, able to interpret responses and behaviours and
adjust care practices accordingly. PCC has been implemented most successfully in
residential aged care for persons with dementia. In particular, it has been shown to
reduce the use of physical and chemical restraints to manage behavioural
disturbance.[8]

Dementia Care Mapping (DCM), which was developed by the Dementia Research
Group at Bradford University (UK), also aims to assist staff in identifying and
addressing factors which impact on the well-being of the person with dementia based
on the philosophy of PCC [7].When DCM is used as a vehicle for closely analysing
and correcting contextual factors which stimulate ill-being for the person with
dementia, it has been shown to assist staff significantly to reduce the triggers for
behavioural disturbance. It is also an effective education vehicle for introducing
person-centred care in any formal care setting.[9] DCM entails specially-trained staff
making continuous and systematic observations of residents going about their daily
life for 6-8 hours, to identify factors associated with their expressions of both well-
being and ill-being. These observations are carefully documented and scored and are
fed back to care staff, with the aim of assisting them to devise person-centred care

<<   3   4   5   6   7   8   9   >>

More intriguing information