Dementia care
Occupational therapy is founded on the principles of access to meaningful activity as a mean of increasing wellbeing and a sense of belonging .”
Dementia care
Feature
I
n February 2024 , I completed a four-day course to become a Dementia Care Mapper . Facilitated by Dementia Care Mapping™ ( DCM ) experts , the course included opportunities to explore and reflect on ways to optimise person-centred care , learn the specifics of behaviour coding and how to use this in observations , and action planning to promote change and improve wellbeing for individuals living with dementia .
DCM is an established approach to achieving and embedding person-centred care for people with dementia ( University of Bradford 2018 ).
Originally a tool developed by Professor Tom Kitwood at the University of Bradford in 1992 , it involves recording observations of individuals with dementia and understanding what they do and what support will help to maintain and improve their care and wellbeing going forward .
Dementia Care Mappers are trained over four days in the areas of behaviour coding , wellbeing , and ill-being markers and how to support settings to improve the support they offer adults in their care .
DCM has 23 behaviour category codes ( BCC ) that DCM mappers will identify and decide upon during five-minute intervals . Mappers will also decide on a mood / engagement ( ME ) value .
The ME value is linked to the BCC and can be a helpful indication as to what may either improve or negatively affect mood and engagement .
Personal detraction or personal enhancer identify what staff may be doing that helps to contribute or hinders an individual living with dementia ’ s psychological needs or personhood .
A Dementia Care Map can take place in several formats : whether that is a ‘ full map ’, which involves at least two DCM trained staff members attending a clinical space for up to five hours and ‘ mapping ’ the patient population ; or an individual DCM trained staff member spending a couple hours mapping an individual to help inform care planning in their clinical area of work .
The decision for either is dependent on need and multidisciplinary team decision making . The multidisciplinary team can advocate for certain individuals not to be mapped if this would be detrimental to them .
The mappers will feed back their findings to the clinical team and encourage an action plan to be created , to aid supporting change that will promote wellbeing to individuals residing in that environment .
Opportunities and challenges
The Prime Minister ’ s Challenge on Dementia , published as part of the coalition government
Occupational therapy is founded on the principles of access to meaningful activity as a mean of increasing wellbeing and a sense of belonging .”
between 2010-2015 , detailed a focused approach on further improving dementia care by 2020 ( DH 2015 ).
As part of this , individuals living with dementia identified that having the ability to ‘ live in an enabling and supportive environment where [ they ] feel valued and understood ’ is of high importance .
I have worked in older adults inpatient mental health services for over three years , and now seven months [ at time of writing this article ] working into the specialist dementia care assessment ward for females .
I was provided with the opportunity to attend DCM training to not only expand on my understanding of dementia care , but to reflect on the role of occupational therapy and how we may contribute to the work being carried out .
Following completion of the course , I asked myself : Why is this the tool to use ? How will it benefit my patients and the service I offer ? I wanted to know how I could link what I had learned to my role in a meaningful way that made sense to occupational therapy , but also the wider service .
Occupational therapy is founded on the principles of access to meaningful activity as a mean of increasing wellbeing and a sense of belonging . I think the purpose and principles of DCM encapsulate this and the strive to improve what is offered and how support is delivered to adults living with dementia .
The ability to observe and understand behaviour is at the forefront of our practice , whether that is through standardised or nonstandardised assessment tools . We are trained to observe and analyse the way people do and why .
It feels like DCM will not only compliment practice and how occupational therapy considers observation as part of a wider understanding of function , but will formalise this in a way that can highlight and then action plan strategies , with colleagues from the wider multidisciplinary team , to develop a greater understanding of what needs to change .
January 2025 OTnews 43