Influence of cognitive impairment, functional impairment and care setting on dementia care mapping results

Abstract

Quality of life (QOL) for people with dementia has become a major focus over the past decade. Dementia care mapping (DCM) is an observational measure of quality of care given by staff in formal care settings, as well as a measure of QOL that has been used in many studies of people with dementia in residential care settings. However, the method itself has not been rigorously studied in a scientific manner. For this report, mapping data were collected for 166 persons with dementia in three types of care settings: special care facilities that are licensed nursing homes, assisted living facilities, and adult day centers. The relationships between DCM and several independent variables including cognitive status, functional status, care setting, depression, length of stay, and co-morbid illnesses were assessed. Both cognitive status and functional status were found to be associated with DCM scores. Moreover, DCM was sensitive in differentiating among persons with four levels of cognitive impairment. Implications for practice are discussed.

Dementia care mapping as a research tool

“…As shown in Table 3, higher WIB scores are associated with being more cognitively intact, non-agitated, non-depressed, and socially engaged, relationships that have been reported previously (Brooker et al, 1998;Chung, 2004;Edelman et al, 2004;Kuhn et al, 2004;Thornton et al, 2004). However, such a relationship is not unique to DCM, but is characteristic of many QOL measures (Sloane et al, 2005).…”

Care mapping in clinical neuroscience settings: Cognitive impairment and dependency

“…Relationships were identified between dependency and well-being (WIB scores) and behaviours with the potential to lead to greater well-being (PPE scores). This supports the majority of previous research indicating that those patients with greater dependency were observed to have lower well-being using Dementia Care Mapping (Edelman et al, 2004). Cognitive impairment was identified as being a predictor of well-being and of potential for positive engagement.…”

“…Some DCM research has looked at the effect of cognitive impairment on PCC and well-being, albeit in people with dementia. Much of this evidence is equivocal with Edelman, Kuhn, and Fulton (2004) finding those with greater cognitive impairment displaying lower well-being, while other researchers report no significant relationship between cognitive impairment and well-being or activity as measured by DCM (Gigliotti, Jarrott, & Yorgason, 2004;Jarrot & Bruno, 2003). Research in this area relies on measuring cognitive impairment accurately, with most studies using the Mini-Mental State Examination (MMSE: Folstein, Folstein, & McHugh, 1975) as the primary, or only measure of cognitive impairment.…”

“…Higher dependency has been linked to lower well -ill-being scores (Edelman et al, 2004). Brooker et al (1998) linked this relationship to a mediating factor of poorer care for those with higher dependency, finding that with three cycles of DCM the relationship of lower well-being for those more dependent patients was no longer significant.…”

Kann Lebensqualität bei Demenzkranken valide bestimmt werden?

“…Ein guter Überblick dazu findet sich aber bei Ettema et al [5]. [75], aber fehlende oder schwache Korrelationen nicht als Einschränkung der externen Validität interpretiert werden, sondern nur als Hinweis darauf, dass das Instrument mehr misst als nur Kognition [3]. Bislang gibt es zwar keine verbindlichen Richtlinien für LQ−Mes− sungen bei Demenzkranken, aber die meisten Autoren stimmen darin überein, dass Patienten mit leichter bis mittelschwerer De− menz ihre Lebensqualität selbst valide und reliabel beurteilen können [7 ± 9,15, 36, 72].…”