Measuring Well Being for People with Dementia
Ensuring that people with dementia experience a good quality of life and high levels of well being is very important. Given the communicative and cognitive challenges of working with this group of people, innovative methods of measuring well being have been developed.
Dementia Care Mapping
Dementia Care Mapping (DCM) is the product of extensive research into the effective care of people with dementia conducted by the late Professor Tom Kitwood of Bradford University from 1993 onwards.
DCM comprises a framework of observational tools, the aim of which is to provide carers as great an understanding as possible of what the experience of living with dementia and receiving care is like from the point of view of the person with dementia.
In his own words, in 1997 Kitwood described his pioneering approach as being:
“based on a serious attempt to take the standpoint of the person with dementia, using a combination of empathy and observational skill”.
Today, continued research and training in the use of DCM is carried out by the Bradford Dementia Group based at the university.
How Dementia Care Mapping works
DCM takes a person-centred and holistic approach to dementia care provision which encompasses the support of the well-being, psychological and emotional needs of a person with dementia.
DCM is usually conducted by trained DCM specialists who observe every aspect of the daily life and experiences of a person with dementia in six-hour sessions over a period of twenty-four hours. Mapping takes place only in public areas to ensure that the privacy and dignity of the individual is respected when, for example, they are visiting the toilet.
The individual’s behaviour is recorded every five minutes during these observation sessions. Behaviours are categorised and assigned a value on a scale which accords with the individual’s mood and engagement with whatever they are experiencing at the time. For example, if the person with dementia is observed to be very happy or very absorbed in a particular activity a ‘score’ of +5 will be recorded. If, however, they are notably distressed or expressing a highly negative mood a score of -5 will be recorded.
For the person with dementia, the scoring of positive and negative stimuli enables the carer to tailor the care given to the individual in such a way that it accentuates positive moods and behaviours and eradicates anything liable to cause distress, unhappiness or a negative reaction. This in turn will help the person with dementia’s sense of wellbeing and feeling of being in control of their condition.
The benefits of Dementia Care Mapping
DCM helps us to better understand a person with dementia’s view of their everyday life and the care they receive, taking into account their cognitive abilities, physical health, personality, social interactions and background.
Consequently, DCM is beneficial on many levels because:
- It enables the creation of a person-centric dementia care plan which can improve wellbeing and quality of life
- Periodic mapping allows the care plan to be modified in accordance with observed changes in mood and behaviour as the condition progresses to ensure that the person with dementia retains as much control, independence and comfort at every stage as possible.
- It can highlight areas in which carers may require further training and development
- It can help to assure the quality of dementia care provision and,
- It provides valuable data and case studies for ongoing research into dementia.
Dementia Care Mapping was developed primarily for use in communal care settings. The Good Care Group has adopted a tool known as SPECAL Observational Tracking (SPOT)
SPECAL Observational Tracking (SPOT) is based Dementia Care Mapping (DCM) which was developed by Professor Tom Kitwood at the University of Bradford in the early 1990s. It was developed by the Contented Dementia Trust with the support of Tom Kitwood.
DCM evaluators may spend up to five hours monitoring and scoring the activities of as many as six clients, recorded in five minute time frames. Behaviour category codes and scores are designed to reflect the relative state of well-being or ill-being of each client throughout the period. Evaluators remain outside of the direct care being offered.
By contrast, the SPOT evaluator (SPOTter) works only for brief periods of time, and takes account of moment by moment changes in their (single) client’s verbal and non-verbal communication. They may be offering direct care to the client at the time or be shadowing another person. They record as many client quotes as they can during the period that they are SPOTting.
SPOT provides the carer with a simple means of assessing what is and what is not acceptable to their client, on a moment by moment basis, taking into account idiosyncratic speech, gesture and other body language.
SPOT also enables a third person to remain outside of the direct care process and to shadow the impact of care on the client on a moment by moment basis.
The Good Care Group is one of the UK’s foremost providers of live-in home and has won many industry awards and nominations. Specialising in holistic and person-centric care plans for people with dementia we can help you or your loved one to continue to lead an independent and fulfilled life. You can find out more about our live-in dementia care services here. Alternatively, to speak to someone about your dementia care requirements please call 0203 728 7577.