Dementia care mapping (DCM) is a way of observing how people with dementia experience everyday life in a care setting. Developed at the University of Bradford, it involves trained mappers observing people, recording what they see and feeding their findings back to staff. The aim is to identify practical ways to improve care and make it more person-centred.
You may come across dementia care mapping in a care home brochure, inspection report or hospital information. If you are trying to understand what it means, this guide explains how DCM works, where it is used and what it can tell you about the care a provider offers. It also looks at how the same principles can be applied to dementia care at home.
What is dementia care mapping?
Someone with dementia may find it difficult to explain how they are feeling or whether they are comfortable, bored, anxious or included. Careful observation can provide another way of understanding their experience.
Dementia care mapping was developed by the late Professor Tom Kitwood at the University of Bradford. The university continues to maintain the method and provide training.
DCM can be used to:
- Monitor and improve the quality of care in a setting
- Understand an individual’s experience and use this to inform their care plan
- Look closely at particular parts of the day, such as mealtimes
- Identify areas where staff may benefit from further training
It is important to understand what DCM does and does not do. It is not a diagnostic test and it does not replace a care plan. Instead, it gives care teams a structured way to observe people’s experiences and think about what could be improved.
Where the idea comes from: Kitwood and person-centred care
Tom Kitwood’s work helped change the way dementia care was understood. He argued that a person’s wellbeing is affected not only by dementia itself, but also by how they are treated and supported.
He used the term “personhood” to describe the value, identity and status that every person should retain. He also identified five psychological needs: comfort, attachment, identity, occupation and inclusion, with love at the centre.
In everyday care, these ideas can be surprisingly simple.
Someone may feel more comfortable when a familiar person sits with them. Being asked how they like their tea recognises their preferences and identity. Being invited into a conversation rather than talked over gives them a chance to take part. Having something meaningful to do can bring purpose to the day.
These small interactions can affect how someone experiences their care. They are also behind many of the practical principles in person-centred dementia care, including guidance on what not to say to someone with dementia.
How does dementia care mapping work?
Dementia care mapping follows a series of steps rather than being a one-off observation.
- Briefing: The mappers meet with the staff team and explain what will happen.
- Observation and recording: One or two trained mappers observe people in shared areas such as lounges or dining rooms, usually for several hours. They use the DCM coding framework to record each person’s activity, mood and engagement at five-minute intervals.
They also record staff interactions that support person-centred care, known as personal enhancers, or interactions that may undermine it, known as personal detractions. An example of a personal detraction might be talking about someone as though they were not present. Observations are made in shared spaces rather than during personal care.
- Analysis and reporting: The information and notes are reviewed to identify patterns, strengths and areas where care could improve.
- Feedback: The findings are discussed with the staff team in a constructive way.
- Action planning: The team agrees on practical changes based on what the mapping has shown.
The process can then be repeated after an agreed period to see whether changes have made a difference and identify anything else that needs attention.
Formal DCM should be carried out by people trained in the method. The University of Bradford provides training for individuals and organisations. This overview also draws on published research on DCM.
Where is dementia mapping used?
Dementia care mapping is mainly used in settings such as care homes and hospitals, where trained mappers can observe people’s experiences and interactions with staff.
The findings can be used to improve care across a whole service or to understand more about an individual’s experience and inform their care plan.
Observation is also used as part of care inspections, although inspectors use a different method. The Care Quality Commission in England and Care Inspectorate Wales use the Short Observational Framework for Inspection (SOFI). Developed with the University of Bradford, SOFI helps inspectors understand the experience of people who may not be able to describe their care easily.
What dementia care mapping can tell families
If a care home or hospital uses dementia care mapping, it can be a useful sign that the provider is interested in how people experience their care, rather than simply whether a list of tasks has been completed.
It is not, however, a guarantee of good care. Research into how effective DCM is has produced mixed results. A large UK trial in care homes found no difference in agitation compared with usual care, while many of the homes involved found it difficult to repeat the mapping cycles.
So if you are choosing care for a relative, think of DCM as one piece of information rather than a reason on its own to choose a provider. Look at inspection reports, visit the service, talk to staff and ask how they respond to what they learn about the people they support.
You could ask:
- How do you find out what matters to my relative and what their usual routines are?
- How do you notice changes in someone’s mood or behaviour?
- If you use dementia care mapping, what have you changed as a result and how did you know it helped?
- How often is the care plan reviewed, and who is involved?
Person-centred dementia care at home
The questions behind dementia care mapping can be just as useful when someone is living in their own home.
What matters to the person? How are they experiencing their day? What seems to help them feel settled, interested and comfortable? What could make things easier?
These questions can be explored through everyday observation and care-plan reviews, although this is not the same as formal DCM.
At Independent People Live-in Care, this approach forms part of how dementia live-in care is planned and delivered.
Knowing the person
Care starts with an assessment that covers more than tasks: routines, preferences, relationships and what makes a day feel like an individual’s own.
That understanding is written into a personalised live-in care plan that reflects their needs, preferences and choices, so they keep a say in how their day runs.
Matching a carer to the person
The right carer needs to have the skills and experience required for the care plan, but the relationship matters too. When matching a carer, Independent People Live-in Care considers personality, interests, experience and the home environment alongside the person’s care needs.
Continuity can also make a difference. Having a regular carer gives them time to get to know the person’s routines, communication and preferences. When a carer takes a break, clear handovers help maintain that familiarity.
Noticing and recording
A live-in carer sees how someone experiences their day. They may notice that the person eats better when lunch is later, becomes anxious towards the end of the afternoon, enjoys a particular visitor or is more settled after going for a walk.
Care records can capture these observations and help identify patterns over time. They can also show which activities and routines the person enjoys. A daily activity planner can then help organise the day around those preferences, while leaving plenty of room for choice.
Reviewing together
Care needs can change as dementia progresses, and other health or mobility needs can change too. Regular reviews give the person, their family or representatives and the care team an opportunity to discuss what is working and whether anything needs to change.
These reviews can help ensure the dementia care plan continues to reflect the person’s needs and preferences.
Clinical oversight where it is needed
Some people with dementia also have more complex health needs. Where appropriate, the care plan can include nurse-led oversight from the Independent People Live-in Care clinical team.
This means registered nurses provide clinical assessment, supervision and oversight. It does not mean a registered nurse lives in the home.
Independent People Live-in Care’s managed service in England is regulated by the Care Quality Commission and is currently rated Good.
Neither dementia care mapping nor everyday observation can diagnose dementia. If you are concerned about changes in a relative’s memory, behaviour or ability to manage everyday life, speak to their GP or local memory service. Dementia UK’s Admiral Nurse Dementia Helpline also provides free, specialist advice on 0800 888 6678.
Talk to us about dementia care at home
If you are considering care at home or comparing it with a care home, we can talk through what person-centred dementia care could look like for your family.
Call Independent People Live-in Care on 0800 471 4741, enquire online or download our free care guides. We support people across England, Scotland and Wales.
Frequently asked questions
Who developed dementia care mapping?
Dementia care mapping was developed by the late Professor Tom Kitwood at the University of Bradford. He developed the method as a way of putting his person-centred approach to dementia care into practice.
The University of Bradford continues to maintain the method, update it periodically and provide training for people who want to become DCM mappers.
Is dementia care mapping used in home care?
DCM is mainly used in care homes and hospitals, where trained mappers can observe people in shared spaces.
Care at home can explore many of the same questions through assessment, everyday observation and care-plan reviews. This is not formal dementia care mapping unless a trained mapper carries out the DCM method.
Can families use dementia care mapping themselves?
Not formally. Dementia care mapping is a structured method that should be carried out by people trained to use it, and the University of Bradford provides DCM training.
Families can still take a similar approach in everyday life. Notice what seems to lift or lower your relative’s mood, make a short note of any patterns and share what you notice with their carers and other professionals involved in their care.
What is the difference between dementia care mapping and a care plan?
Dementia care mapping is a way of observing and reviewing the experience of care. It can be used across a group of people in one setting or to understand an individual’s experience.
A care plan is specific to one person. It records their needs, preferences and the support they will receive.
The findings from DCM may contribute to someone’s care plan, but a live-in care plan can be created and reviewed without dementia care mapping taking place.
What does person-centred dementia care mean?
Person-centred dementia care means building support around the person rather than around their diagnosis or a list of tasks.
It means taking account of their history, preferences, relationships and routines, and giving them as much choice as possible.
For example, it could mean asking someone who has always been a late riser when they would like breakfast rather than expecting them to eat at a fixed time. Small choices like this can help someone retain a sense of control over their day.