How quality of life indices reflect the behaviors of elderly people with dementia on dementia care mapping and the relationship among well-being, ill-being and the behavior category code

• Published in: Nihon Rōnen Igakkai zasshi Vol. 49; no. 3; pp. 355 - 366
• Main Authors: Mizuno, Yutaka, Suzuki, Mizue, Ooshiro, Hajime, Kanamori, Masao, Brooker, Dawn
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 2012
• Subjects: Aged; Behavior; Day Care, Medical; Dementia - nursing; Dementia - psychology; Dementia care mapping (DCM); Elderly with dementia; Female; Homes for the Aged; Humans; Male; Patient-Centered Care; Quality of Health Care; Quality of Life; Well-being
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.49.355

Purpose: Dementia Care Mapping (DCM) is an observation and evaluation technique intended to improve the quality of care for elderly people with dementia, based on aims of person-centered care. The purpose of this study was to clarify that well-being and ill-being (WIB) levels affects the behavior category code (BCC) in long-term care insurance facilities. Methods: In this study, we evaluated people with dementia who used care facilities between April 2005 and July 2007. The evaluation indices used were the 6-hour DCM, the Mini-Mental State Examination (MMSE), and the Gottfries-Brane-Steen Scale (GBS). Results: The total number of subjects whose families submitted written informed consent to participate was 256 (50 men and 206 women). The mean MMSE score of the total subjects was 10.83 (±8.58), and that of individuals receiving home care was the highest 17.14 (±6.38). The next highest mean MMSE score was that of the group home residents: 16.56 (±6.83). The lowest mean MMSE score was of individuals in health services facilities for the elderly (serious dementia ward), at 2.16 (±3.88). Multiple regression analysis was performed after controlling for age, sex, type of dementia and GBS, and we used the WIB value as dependent variables. The BCC variables of L (Labor) in group homes, and E (Expression) and H (handicrafts) variables in welfare institutions and long-term care facilities for the elderly significantly promoted WIB value. Conclusions: Among BCC indices such as L in group homes, and E and H in welfare institutions and long-term care facilities for the elderly, which reflect WIB values (and therefore, quality of life), it was found that those activities associated with work reflected quality of care. However, the BCC indices of B (Borderline) C (Cool), and U (Unresponsiveness) significantly inhibited WIB level; these behaviors are categorized as passive behaviors in the DCM. It is probable that these behaviors in elderly people with dementia reflect problems in long-term care insurance facilities. It is necessary to further examine these passive behaviors, because they can accurately reflect the quality of care for elderly people with dementia.