Person-centered care is “providing care that is respectful of and responsive to individual patient
preferences, needs and values, and ensuring that patient values guide all clinical decisions,” according to The Institute of Medicine.
It is not about giving people whatever they want. It is about considering their wants, needs, values, personal and family situations and social aspects. It is about caregivers seeing the patient as a person – an individual – and working with that person to develop appropriate solutions.
This type of care isn’t a new concept. It was developed in the 1980s by the Bradford Dementia Group in England. Nowadays, as baby boomers inch toward retirement while possibly also caring for their elderly parents, the expectations to provide individualized care are at the forefront. As a result, institutions of almost every kind are now adopting person-centered care as their care philosophy.
“Being person-centered is about focusing on the needs of the person, rather than the needs of the service,” says Cheryl Doyle, home care consultant and owner of Senior Helpers.
“People have their own views on what is best for them, and their own priorities in life. We need to be flexible to meet their needs.”
Doyle has experienced being a part of a non-person-centered care system. When she was diagnosed with Hodgkin’s Lymphoma at the age of 25, healthcare providers treated her more like a number than an individual. “Having little to no choice in treatment options or my care plan, my dignity was checked at the door, and it was a very dehumanizing experience,” says Doyle.
Fortunately in today’s world, there are many senior care agencies that enthusiastically embrace the person-centered care philosophy, caring for the whole person instead of just their ailment.
In Practice While most senior communities, adult day centers and home health agencies have adopted a person-centered care philosophy, there is no state or government mandate requiring agencies to enforce person-centered care.
And while person-centered care isn’t mandated, if an agency were to exclude some practices that are considered to be patient-centered, they could be penalized, says Sue Slama, director of nursing at Saint Simeon’s Senior Community.
“For example, if you were forcing every resident to get up for breakfast, you could be cited for that,” Slama says.
Senior Living Communities
According Slama, it’s important for staff members to learn a resident’s preferences from the beginning. “It’s important from the get-go to get to know them, to know what their interests are.”
Person-centered care includes giving residents options at meal times, Slama says. “At Saint Simeon’s, we have extended meal times, so they have a bigger window to be able to eat. We have ‘anytime’ menus that are always available.”
Other areas in which residents are encouraged to make their own choices include selecting what they want to wear, when they want to get out of bed, whether they want a shower or bath, and when they want it, Slama says.
It is obvious when visiting senior communities which ones implement person-centered care and which do not, Slama says. “Watch to see how staff members are treating residents. Are they hugging residents, holding their hands, making eye contact? Do they call them by the name they want to be called, not just ‘honey’ or ‘sweetie?’”
Adult Day Health
Person-centered care is also implemented in adult day health settings. “We don’t look at the person as a group, but as a unique individual,” says Mike Fauvell, LIFE Senior Services Broken Arrow site manager. “That helps us treat the individual according to their likes and dislikes.”
According to Fauvell, an individual’s preferences can influence anything at the Broken Arrow site, including lighting, furniture, decorations and how many participants are seated together at mealtime. “Everything we do, we try to make sure the participants are comfortable and enjoying it.”
In an adult day setting, the preferences of the individual participants can also influence the activities the staff members select for that person. “One of the men enrolled was very quiet and preferred to be by himself. That’s difficult in an adult day environment because we have large rooms.” However, the staff members were able to come up with a solution for the man by finding a small room where he could go to be alone, read and listen to music.
Person-Centered Care and Dementia
Megan Wiley, Oklahoma regional sales director for Legend Senior Living, believes person-centered care is especially important when dealing with individuals with dementia. “Separate and customized routine schedules are established for each resident based on their personal dementia needs.”
Legend Senior Living has found that targeting activities to an individual’s preferences can even have an effect on the use of psychotropic medications. “Psychotropic medications affect the central nervous system and can cause a variety of changes in behavior or perception,” Wiley says. “The use of synchronized activities, like aroma therapy, emotion, normalized and sensory activities, exercise, memory enhancing, music, and lighting can have a calming effect in most situations.”
“In some cases the need for medication has decreased as a result of parallel programming,” Wiley says.
Julie Ryker, volunteer and advocacy coordinator with LIFE Senior Services, concurs. “They’re not the disease; they’re an individual person who has likes and dislikes,” Ryker says. “Matching that up with their health and safety is really important.”
Person-centered care becomes especially important when the senior is in the late stages of dementia and cannot verbalize or communicate their wants and needs, Doyle says. “Understanding his or her past life experiences, interests and values becomes core to why person-centered care is so powerful. The end game does not change, but how we get there and which emotional journey we take, will make the difference to how we all arrive.”
by Lindsay Morris