Dementia Care Mapping

Dementia Care Mapping is an observation tool for evaluating the quality of dementia care from the perspective of a person living with dementia. Its purpose is to help care workers change their own perspectives on people living with dementia, becoming less task-focused and more person-centred in the process. The approach relies on trained observers sitting in common areas, watching and recording what happens to and around people with dementia over the course of a typical day. [1] This includes interactions between people or changes in the environment such as increased levels of noise. Observers try to observe small things that produce happiness or lead to distress in individuals. They feed this information back to staff who then use it to plan for more effective future interactions with those in their care. [1] 

Dementia Care Mapping is said to have strong support within the field of social care in the United Kingdom where it is recognised in policy and guidance. [1]

This evidence theme on Dementia Care Mapping is a summary of one of the key topics identified by a scoping review of dementia research. If you need more information on this topic, try using the PubMed search below.

There is some promising evidence from large, high-quality studies that Dementia Care Mapping has a positive impact on people living with dementia as well as care home staff. Based on the conclusions of three systematic reviews, [1-3] Dementia Care Mapping appears to reduce:

• The use of psychotropic drugs.
• Rates of hospitalisation.
• Falls in residential aged care.
• Staff rates of stress and burnout (although more studies are needed for confirmation).

There is inconclusive evidence that Dementia Care Mapping:

• Reduces agitation. [1-3]
• Improves neuropsychiatric behaviours such as delirium and psychosis. [1]
• Increases quality of life. [1] 

This is because some studies report a benefit for these outcomes while others have found no difference between using Dementia Care Mapping and some usual practices for managing responsive behaviours of dementia. This inconsistency in findings may be due to differences in the way the mapping was undertaken and how the findings were acted upon.

One study found residential homes providing Dementia Care Mapping had increased rates of people with depression. [1] We also need cost-effectiveness evidence to understand if the benefits to staff and people living with dementia outweigh the costs associated with the approach, especially the amount of staff time needed. [1]

• The principles of Dementia Care Mapping might be applied daily within a residential aged care setting. Carefully observing a single resident over time can help with developing a care plan for that person.
• Care workers might also give each other positive feedback whenever they observe person-centred, mindful interactions between staff and residents.
• Observed interactions with the potential to improve the sense of personhood of someone living with dementia could be acknowledged and shared at staff meetings to help create a profile of what works with whom and what has proven less successful.
• You may get some ideas from this booklet on Dementia Care Mapping from the United Kingdom

• Organisations might use a modified version of this approach from time to time (perhaps every 6 to 12 months) as an audit tool.
• Dementia Care Mapping might also be used to remind staff of the importance of viewing what they do and how they do it through the eyes of the person living with dementia.
• Sharing examples of positive and productive interactions observed between staff and residents can work towards changing a task-oriented workforce to a person-centred one.
• Learn more about Dementia Care Mapping by undertaking this online course at the University of Bradford, UK.
• Read this systematic review by Surr (2018) on implementing Dementia Care Mapping in a dementia care service.

1. Barbosa A, Lord K, Blighe A, Mountain G. Dementia Care Mapping in long-term care settings: A systematic review of the evidence. Int Psychogeriatr. 2017;29(10):1609-18.
2. Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N, et al. A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technol Assess. 2014;18(39):1-226.
3. Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N, et al. Non-pharmacological interventions for agitation in dementia: Systematic review of randomised controlled trials. Br J Psychiatry. 2014;205(6):436-42.