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Care homes should adopt person-centred care for dementia

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A person-centred care approach for people with dementia should become routine practice in care homes, say Australian researchers.

They said that the traditional focus of residential care, which usually concentrates on daily routines, based around meal times, leaves many people with dementia spending long hours alone – often leading to an exacerbation of dementia behaviours, such as agitation and sleep disturbance.

Person-centred care puts the person with dementia at the centre of the care-planning process, the authors said. But they added that while there was previous evidence to show that it improves outcomes for people with dementia, this has mostly been observational and descriptive.

The researchers studied 289 people with dementia, from 15 care homes in Sydney. Subjects received either normal care, a person-centred approach involving individuals in their care decisions, or care designed around an assessment of individual need using a process called dementia-care mapping.  

They found that, at the end of the four-month treatment period, both person-centred interventions significantly reduced agitation in people with dementia, compared with usual care.

Benefits were still evident four months after treatment, with both interventions showing a further decrease in agitation. Dementia-care mapping was also associated with a decrease in the number of falls, but it was more costly to implement than the other person-centred intervention and required expert training, the researchers said.

‘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,’ they said online in The Lancet Neurology.

Rachel Thompson, lead practice development Admiral Nurse at the charity For Dementia, said: ‘The principles of person-centred care are absolutely essential for good dementia care and should be embraced as standard practice.

‘Person-centred care encourages staff to think about them as an individual not just as someone with dementia, and then adapt the care given accordingly,’ she added.

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