The role of leadership in the implementation of person‐centred care using Dementia Care Mapping: a study in three nursing homes

Dementia Care Mapping is an internationally applied method for enhancing person-centred care for people with dementia in nursing homes. Recent studies indicate that leadership is crucial for the successful implementation of Dementia Care Mapping; however, research on this topic is rare. This case study aimed to explore the influence of leadership on Dementia Care Mapping implementation in four nursing homes. Twenty-eight interviews with project coordinators, head nurses and staff nurses were analysed using qualitative content analysis. Nursing homes that failed to implement Dementia Care Mapping were characterised by a lack of leadership. The leaders of successful nursing homes promoted person-centred care and were actively involved in implementation. While overall leadership performance was positive in one of the successful nursing homes, conflicts related to leadership style occurred in the other successful nursing homes. Thus, it is important that leaders promote person-centred care in general and Dementia Care Mapping in particular. Furthermore, different types of leadership can promote successful implementation. Trial registration of the primary study: Current Controlled Trials ISRCTN43916381.

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Dementia care mapping: effects on residents’ quality of life and challenging behavior in German nursing homes. A quasi-experimental trial

International Psychogeriatrics ◽

10.1017/s1041610215000927 ◽

2015 ◽

Vol 27 (11) ◽

pp. 1875-1892 ◽

Cited By ~ 40

Author(s):

Martin Nikolaus Dichter ◽

Tina Quasdorf ◽

Christian Günter Georg Schwab ◽

Diana Trutschel ◽

Burkhard Haastert ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Homes ◽

Challenging Behavior ◽

Dementia Care ◽

Experimental Trial ◽

Quasi Experimental ◽

Secondary Outcomes ◽

Care Mapping ◽

Dementia Care Mapping

ABSTRACTBackground:Person-centered care (PCC) is a widely recognized concept in dementia research and care. Dementia Care Mapping (DCM) is a method for implementing PCC. Prior studies have yielded heterogeneous results regarding the effectiveness of DCM for people with dementia (PwD). We aimed to investigate the effectiveness of DCM with regard to quality of life (QoL) and challenging behavior in PwD in nursing homes (NHs).Methods:Leben-QD II is an 18-month, three-armed, pragmatic quasi-experimental trial. The sample of PwD was divided into three groups with three living units per group: (A) DCM applied since 2009, (B) DCM newly introduced during the study, and (C) a control intervention based on a regular and standardized QoL rating. The primary outcome was QoL measured with the Quality of Life-Alzheimer's Disease (QoL-AD) proxy, and the secondary outcomes were QoL (measured with QUALIDEM) and challenging behavior (measured with the Neuropsychiatric Inventory Nursing Home version, NPI-NH).Results:There were no significant differences either between the DCM intervention groups and the control group or between the two DCM intervention groups regarding changes in the primary or secondary outcomes. At baseline, the estimated least square means of the QoL-AD proxy for groups A, B, and C were 32.54 (confidence interval, hereafter CI: 29.36–35.72), 33.62 (CI: 30.55–36.68), and 30.50 (CI: 27.47–33.52), respectively. The DCM groups A (31.32; CI: 28.15–34.48) and B (27.60; CI: 24.51–30.69) exhibited a reduction in QoL values, whereas group C exhibited an increase (32.54; CI: 29.44–35.64) after T2.Conclusions:DCM exhibited no statistically significant effect in terms of QoL and challenging behavior of PwD in NHs. To increase the likelihood of a positive effect for PwD, it is necessary to ensure successful implementation of the intervention.

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Evaluation of a Music Intervention on Well-being and Behavior of People with Dementia Using Dementia Care Mapping

Elderly Health Journal ◽

10.18502/ehj.v6i2.5020 ◽

2020 ◽

Author(s):

Rebecca Dahms ◽

Cornelia Eicher ◽

Drin Ferizaj

Keyword(s):

Nursing Homes ◽

Well Being ◽

Dementia Care ◽

Music Intervention ◽

Intervention Phase ◽

People With Dementia ◽

Essential Components ◽

And Behavior ◽

Care Mapping ◽

Dementia Care Mapping

Introduction: Dementia Care Mapping (DCM) was originally developed as an observation tool to examine person-centered care in long-term care facilities and to evaluate the quality of life and well-being of people with dementia (PwD). However, the effects of a music intervention using this tool have not been investigated so far. This leads to the following research question: How does a music intervention which involves music therapy and other music-based interventions affect the observed well-being and behavior of PwD living in nursing homes? Methods: In this 14-week, non-controlled music intervention study, data from 30 PwD aged between 52 and 97 (M = 81.4 years) were analyzed. DCM coding involves continuous observation for five hours on four days in the baseline and intervention phase. In the follow-up phase PwD were mapped on two days for five hours. The DCM method were used to measure well-being and certain behaviors of PwD. Results: The well-being during the observation remained almost constant and corresponds to a neutral state of affect and focused contact, with no indication of positive or negative sensations. Significant improvements in certain behaviors were observed in the course from baseline to intervention phase. For example, it was shown that physical activities of the participants, such as (instructed) sports exercises, strengthening or physically challenging exercises in the intervention phase were significantly higher (M = 0.99, SD = 1.82) than at baseline phase (M = 0.00, SD = 0.00) (z = -2.37, p = .02, n = 26). Similar results were shown for expressive/creative activities or work-related activities (e.g. washing dishes). Conclusion: In summary, it can be stated that music interventions can promote communication and movement. However, musical stimulation is not one of the essential components of improving behavioral and psychological symptoms or well-being for PwD in nursing homes.

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