Dementia Care Mapping

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Dementia Care Mapping (DCM, Engl .: Positioning of care dementially ill ) is an in England by Tom Kitwood developed and Kathleen Bredin evaluation - and observation method, which centered person-to optimize the care is of dementia ill people.

Putting yourself in the shoes of someone living with dementia is not easy. DCM is a tool to help caregivers / teams to do just that when assessing quality.

DCM promotes the learning process in a person-centered attitude, team development in practice and thus the quality of life of people with dementia. This results in a high level of job satisfaction among the carers.

Emergence

The social psychologist Tom Kitwood developed the DCM with Kathleen Bredin and a group of statisticians, psychologists, sociologists and nursing scientists at the University of Bradford UK in the 1990s. It was conceived as a method of qualitative social research . It serves to develop and improve gerontopsychiatric care and the care culture.

It was transported to Germany by Christian Müller-Hergl. In German-speaking Switzerland, Careum Training Aarau has been offering DCM courses since 2003.

Use and use

DCM is the instrument and method to promote person-centered care and support and to support the caregiver in developing a person-centered attitude throughout.

Approach - the DCM evaluation

Up to eight people with dementia are observed for at least six hours per evaluation. Every five minutes a letter is assigned to each person, which stands for a behavioral category. Examples:

  • Walking / standing / moving independently
  • Eat Drink
  • Work or work-related activity
  • Observe, passive but committed.
  • Leisure, fun
  • Direct involvement of the senses

And so on. There are 23 behavior categories available.

From this data z. For example, you can see how varied the day was for the individual and for the group. Each of these behavior codes is assigned a value that results from the affect-related state of mind and from the contact / participation.

These values ​​show how the people fared, for how long they were E.g. very happy or deeply involved in a contact / activity, or how often and for how long they were withdrawn or unhappy.

Personal detractions and personal enhancers

In his book Dementia: The Person-Centered Approach to Dealing with Confused People (Kitwood, 2000, Original: 1997), Tom Kitwood describes five overlapping psychological needs that are particularly significant for people with dementia:

  • Security and comfort
  • identity
  • binding
  • Activity (not only initiated by employees)
  • Inclusion / inclusion

By making sure these needs are met, we are helping people with dementia feel relaxed, safe, comfortable, valued, and useful. People with dementia are sometimes unable to act on their own to have their needs met.

The recording of 'personal detractions' and 'personal enhancers' shows which interactions between nurses and people with dementia have the potential to maintain being a person and to meet one or more needs or to leave them unconsidered.

To be a person

'Status or status that is given to the individual by others in the context of relationships and social being. It implies recognition, respect and trust '(Kitwood, 2005).

Nursing and care professionals who maintain being a person and who focus on people and their needs support a quality of life with dementia in this humane attitude. They ensure a life in dignity.

What will happen to the data?

After the evaluation, the data is discussed in the team, which makes sense to create an action plan. The data then remain in the home, in the resident's care documentation, the group summary in a DCM folder.

The care service and the home management receive an anonymized summary of the observed and the resulting fields of action.

Compliance principles

  • All actions of the sick person have a meaning and purpose
  • The mapper has an empathic attitude towards the observed .
  • The subjectivity of the mapper is disciplined through rules and training to ensure the reliability of the statements.
  • When passing on the collected data, the mapper is appreciative and loyal to the care team, has basic knowledge of group dynamics and is able to moderate a conversation.
  • The mapper sees the change from the active role as a nurse to the passive role of the observer as a challenge.

Problem areas

Because of its external perception, which cannot be based on reliable information from people with dementia, the DCM is very dependent on the mapper's sensitivity, empathy and ability to reflect and should only be carried out by professionally trained and gerontopsychiatric experienced nurses.

literature

  • Christian Müller-Hergl (Ed.), Tom Kitwood: Dementia. The person-centered approach to dealing with confused people. 6th revised and expanded edition. Hogrefe Verlagsgruppe, Bern 2013, ISBN 3-456-83914-6 .
  • Christian Müller-Hergl, Detlef Rüsig (eds.), Dawn Brooker: Person-centered care, the VISP model for the care and support of people with dementia. Hogrefe Verlagsgruppe, Bern, ISBN 978-3-456-84500-5 .
  • Caroline Baker: Developing excellent care for people with dementia. Hogrefe publishing group, Bern ISBN 978-3-456-85547-9 .

Web links