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Effects of dementia-care mapping on residents and staff of care homes: a pragmatic cluster-randomised controlled trial


van de Ven, Geertje, Draskovic, Irena, Adang, Eddy M. M., Donders, Rogier, Zuidema, Sytse U., Koopmans, Raymond T. C. M., Vernooij-Dassen, Myrra J. F. J.


Plos One, Volume: 8, No.: 7, Pages.: e67325-e67325

Year of Publication



Background: The effectiveness of dementia-care mapping (DCM) for institutionalised people with dementia has been demonstrated in an explanatory cluster-randomised controlled trial (cRCT) with two DCM researchers carrying out the DCM intervention. In order to be able to inform daily practice, we studied DCM effectiveness in a pragmatic cRCT involving a wide range of care homes with trained nursing staff carrying out the intervention.; Methods: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training and conducted the 4-months DCM-intervention twice during the study. The primary outcome was agitation, measured with the Cohen-Mansfield agitation inventory (CMAI). The secondary outcomes included residents’ neuropsychiatric symptoms (NPSs) and quality of life, and staff stress and job satisfaction. The nursing staff made all measurements at baseline and two follow-ups at 4-month intervals. We used linear mixed-effect models to test treatment and time effects.; Results: 34 units from 11 care homes, including 434 residents and 382 nursing staff members, were randomly assigned. Ten nurses from the intervention units completed the basic and advanced DCM training. Intention-to-treat analysis showed no statistically significant effect on the CMAI (mean difference between groups 2·4, 95% CI -2·7 to 7·6; p = 0·34). More NPSs were reported in the intervention group than in usual care (p = 0·02). Intervention staff reported fewer negative and more positive emotional reactions during work (p = 0·02). There were no other significant effects.; Conclusions: Our pragmatic findings did not confirm the effect on the primary outcome of agitation in the explanatory study. Perhaps the variability of the extent of implementation of DCM may explain the lack of effect.; Trial Registration: Dutch Trials Registry NTR2314.;

Bibtex Citation

@article{van_de_Ven_2013, doi = {10.1371/journal.pone.0067325}, url = {}, year = 2013, month = {jul}, publisher = {Public Library of Science ({PLoS})}, volume = {8}, number = {7}, pages = {e67325}, author = {Geertje van de Ven and Irena Draskovic and Eddy M. M. Adang and Rogier Donders and Sytse U. Zuidema and Raymond T. C. M. Koopmans and Myrra J. F. J. Vernooij-Dassen}, editor = {Jerson Laks}, title = {Effects of Dementia-Care Mapping on Residents and Staff of Care Homes: A Pragmatic Cluster-Randomised Controlled Trial}, journal = {{PLoS} {ONE}} }


aged, aged, 80 and over, care, carers, dementia, disease management, female, homes for the aged, humans, job satisfaction, male, mapping, nursing homes, nursing staff, physiopathology, prevention & control, professional, psychology, psychomotor agitation, quality of life, satisfaction, staff, therapy, training

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Behaviour, Carers’ Mental Health, Other, Quality of Life of Person With Dementia


Nursing Homes

Type of Interventions

Non-pharmacological Treatment, Workforce oriented interventions

Non-Pharmaceutical Interventions


Workforce Interventions

Professional Training / Continuing Professional Development