Impact of Dementia Care Mapping on residential care homes for Chinese older persons

Abstract

Background: Research in Western cultures has suggested benefits of Dementia Care Mapping (DCM) in reducing staff emotional exhaustion and reduced agitation in persons with dementia. The effect of DCM in Chinese population and care context is less researched. Methods: We conducted (1) staff focus groups (n=27) in frontline care workers, dementia care mappers, and management staff to explore staff acceptance and lessons learned from implementing DCM in Hong Kong; and (2) a historical control study in 329 older persons residing in nine residential care homes between 2007 and 2015 to explore the effect of DCM implementation on outcomes available from case records. Mixed logistic regression was used to calculate the odds ratios of occurrence of challenging behaviours, controlling for the following baseline characteristics and potential confounders. Results: Key themes arising from the focus groups include: (1) DCM provided a common language for different professionals; (2) it inspired service management to improve care quality; and (3) it created a humanistic organisational culture, staff cohesiveness towards a common mission, and sense of professionalism. In the historical control study, wandering showed a different trend in the rate of decline before and after DCM implementation. The decline was insignificant in the cohort admitted before DCM implementation (OR = 1.12, p=0.8), compared with a significant decline in the cohort admitted afterwards (OR = 0.45, p<0.01). Conclusion: Our findings suggested benefits of DCM in staff care values, self-efficacy, and residents’ behaviours in Chinese. Research implications included mechanisms of change, resident quality of life, and cost effectiveness.