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Vital work by Centre for Dementia Research helps improve care for people living with dementia
Researchers have been carrying out a randomised controlled trial for several years to test the effectiveness of a tool called Dementia Care Mapping (DCM) which is used in care homes to improve care for people living with dementia. DCM works by asking staff to put themselves in the place of residents, through watching and assessing their experiences, and feeding those back to the staff team who then develop action plans to improve residents’ experiences and care.
The DCM-EPIC Study found that, although DCM is widely used in care homes across the UK, it doesn’t lead to beneficial outcomes for care home residents when compared against usual care and it isn’t providing good value for money. Researchers found that the standard implementation of DCM, which relies on care home staff to implement it, was patchy and vulnerable to issues such as staff and manager turnover, care home staff not having the confidence or skills to lead changes in practice and inadequate staffing and funds.
Professor Claire Surr, from the School of Health at LBU, who led the research, said: “The findings suggest that even with established tools like DCM putting them into practice can be extremely challenging. Even with the additional support to implement DCM offered within the trial, the majority of care home managers were unable to support staff to use DCM regularly. This was due to lack of time, money and staff with the right skills and confidence use DCM. Managers were often unable, unwilling or needed further support to prioritise use of DCM in the light of other demands on resources.”
“We are delighted that the NIHR has picked up on these important findings and has chosen to highlight them on their website and share them with organisations who can use them to inform future practice and design of research in care homes.
Dr Rachael Kelley, Research Fellow in the Centre for Dementia Research and author of the paper about the DCM-EPIC Study said: “The findings are important because around 70% of care home residents have dementia, and they can have complex needs which staff can struggle to meet. We need evidence-based ways of supporting care home staff to provide people with dementia with high quality care. Knowing that DCM can be difficult to implement in its current form, and may not lead to benefits for residents, is really important information for care homes when deciding whether to invest time and money on implementing DCM. The findings are also useful for those who train people to deliver DCM, and for designing similar care improvement tools for care homes, as they suggest ways in which these tools need to be designed to improve their effectiveness.”
Candace Imison, Associate Director of Evidence and Dissemination, NIHR Centre for Engagement and Dissemination (CED) said: "The role of Care Home Managers in putting complex interventions into practice is too often overlooked. We chose to highlight the research as an NIHR Alert because it had important findings that if actioned would improve care. For example, the need for additional support and dedicated staff time in order to deliver dementia care mapping. The study also has lessons for future research."
The research team worked with colleagues from the University of Leeds, the University of Exeter and the University of Bradford.
The current study was part of a UK research trial that looked at whether DCM, when implemented by care home staff in the UK, led to reductions in resident agitation, neuropsychiatric symptoms, use of anti-psychotics, use of healthcare resources and improvements in quality of life.