Person-centred dementia care 'should be standard'
Dementia care that is person-centred should be standard treatment for patients, Alzheimer's Research says
Also In The News
|
Manchester United have beaten Inter Milan 2-0 in the second leg of their Champions League clash to reach the quarter-finals of the competition. |  |
Thursday, 12, Mar 2009 09:05
Dementia care that is person-centred should be made the standard treatment for patients, a new study has argued.
A report from Australian scientists published in Lancet Neurology says person-centred approaches reduce agitation and cost less money than standard practices.
Alzheimer's Research in the UK has hailed the research.
"This is an extremely important trial that might greatly affect clinical practice. One third of people with dementia live in a care home. We would like to see all care homes using person-centred care and dementia care mapping; both can be taught quickly, improve quality of life and are cost effective," said Professor Clive Ballard, the charity's director of research.
"Alzheimer's Society research shows that more intensive person centred care can reduce use of dangerous antipsychotic drugs by up to 50 per cent. More research is needed to develop approaches to care that are easy to implement, improve quality of life and reduce the use of antipsychotic drugs."
People with dementia have complex needs that can be difficult to meet and can lead to need-driven dementia compromised behaviours such as agitation, sleep disturbance, screaming, crying, and pacing, says background material in the Lancet Neurology study.
The traditional approach of nursing in residential care focuses on daily living and leaves many people with dementia spending long hours alone, which is known to exacerbate these behaviours.
With the prevalence of dementia likely to quadruple worldwide by 2041, the challenge is to introduce interventions that can maintain standards of care and quality of life for people with dementia, with only limited funds and staff.
In this study, 15 residential care sites in Sydney involving 289 residents with dementia aged 60 years or older were randomly assigned to person-centred care, dementia-care mapping, or usual care, to examine the effectiveness of these interventions and whether they could improve quality of life, decrease need-driven dementia-compromised behaviours, or reduce the use psychotropic drugs and rates of accidents and injuries.
Findings showed that both interventions reduced agitation compared with usual care at the end of the four-month treatment, and these benefits were continued beyond the intervention period, with a further decrease recorded at four-month follow-up.
However, no other improvement in quality of life or significant reduction in neuropsychotic symptoms such as depression or hallucinations was recorded in either group. The authors also noted that neither intervention was associated with a lower intake of psychotropic drugs, although dementia-care mapping was associated with fewer falls.
In addition, at $2,250 per site, the cost of person-centred care was considerably lower than for dementia-care mapping at $10,034 per site. Dementia-care mapping also requires expert training and is labour intensive, which makes it impractical for most residential care homes, say the authors.
"Consideration should be given to the introduction of person-centred approaches as standard practice in residential facilities… not just to reduce distress in residents, but to enable staff to identify and meet residents' unmet psychosocial needs," the authors write.