Implementing Dementia Care Mapping in Dementia Care: A Narrative Realist Literature Review

Context: Dementia care mapping (DCM) is a multicomponent intervention to deliver person-centred care (PCC) for people with dementia. While the research has demonstrated the positive impact of DCM in care homes, more needs to be understood about the contexts and underlying mechanisms that may affect its implementation and uptake. Objective: This review aims to develop a theoretical understanding of what influences the successful implementation of PCC, specifically DCM in care homes. Method: A realist review was conducted using an iterative, stakeholder-driven, two-stage approach. Several databases were searched to identify studies published in English from 2000 to 2022. Seven DCM expert mappers took part in the focus group. We followed a descriptive, narrative approach to explain the results. Findings: We found that an individual’s knowledge and skills of DCM can either be a barrier or a facilitator. Limited managerial support and communication among staff and high staff turnover rates were identified as significant barriers to implementing DCM. Leadership support, open communication channels and supportive relationships between staff members facilitated implementation. Limitations: There may be documents used in practice in diverse care settings that provide information to build on the review. Literature from other countries could have been missed. Implications: A successful intervention in care homes requires facilitating mechanisms that can support the staff and wider care team to engage with the intervention. Long-term care policies should prioritise evidence-based practices, leadership development, effective communication, and a deep understanding of staff motivations and organisational culture to successfully implement DCM and other PCC interventions.