Care research involves systematically studying different types of care for people with dementia. One goal of care research is to establish effective approached to care and management of various symptoms of dementia. Care research also investigates particular factors that are associated with better outcomes such as functioning in daily life, quality of life, and quality use of medicine. Care research may be observational or involve an intervention. In observational studies, assessments of the type and quality of care may be linked with outcomes for residents over time. Intervention studies may involve trialling a different approach to care and measuring changes in outcomes for people living with dementia and their carers in various settings including hospital, residential aged care and home and community.
Care research is needed to improve methods of supporting people who have dementia now and the future, and to make informed decisions about applying best practices in the present. This is important for institutions, home and community care organisations, general practice, residential care staff, carers, and particularly for individuals with dementia.
Health and aged care organisations, their management and staff, as well as individual carers can help to improve care research by participating in research studies. Generally, the researchers will cover any costs associated with the research.
Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial (The Lancet Neurology; Chenoweth et al., 2009)
This study compared two person-centred care interventions – basic person-centred care and dementia care mapping – with usual care. Outcomes measured included agitation, quality of life, use of psychotropics, incidents and falls. The study was carried out at 15 residential aged care sites in NSW, and included 289 residents with dementia.
Training in person-centred care involved explaining to care staff that behaviour can be a form of communication, explaining that emotions and feelings remain despite cognitive impairment, and focusing on the unique way that residents express their feelings and needs to tailor care. It was emphasised that social interactions, especially those that engage residents on an emotional level, help to preserve their sense of personhood and build meaningful relationships. The life history of each resident was carefully reviewed.
Training in dementia care mapping involved observing and assessing positive and negative care delivery by staff, and well-being of residents. Feedback was then provided to staff, and individual care plans were devised for residents, depending on their histories, needs and preferences.
At follow up, there were significantly lower levels of resident agitation and falls in both intervention groups compared to the group who received care as usual. The study also demonstrated that a basic person-centred care model can be delivered at a substantially lower cost than DCM which is a more elaborate and comprehensive method of delivering person-centred care.
