A Measure of Person-Centered Practices in Assisted Living: The PC-PAL

Abstract

Objectives Develop self-administered questionnaires of person-centeredness for completion by residents and staff in assisted living (AL), in response to concerns that AL is not person-centered; also, demonstrated person-centeredness is necessary for Medicaid support as a home and community-based services provider. Design Community-based participatory research partnership between a research team, a consortium of 11 stakeholder organizations, and others. Methods included literature review, item generation and reduction, cognitive testing, field testing, exploratory factor analysis, and convergent and discriminant validity testing. Setting Cognitive testing conducted in two AL residences and field testing conducted in 19 diverse, stratified AL residences in six states. Participants Eight residents and staff participated in cognitive testing, and 228 residents and 123 staff participated in field testing. Measurements Feasibility and psychometric testing of draft questionnaires that included 75 items (resident version) and 102 items (staff version), with parallel items on both versions as appropriate. Results The final resident questionnaire included 49 items and four factors: well-being and belonging, individualized care and services, social connectedness, and atmosphere. The staff questionnaire included 62 items and five factors: workforce practices, social connectedness, individualized care and services, atmosphere, and caregiver-resident relationships. Staff scored person-centeredness higher than did residents, reflecting their different perspectives. Conclusion The Person-Centered Practices in Assisted Living (PC-PAL) questionnaires measure person-centeredness from the perspectives of residents and staff, meaning that they reflect the concepts and items considered to be important to these key stakeholders. Use of these instruments to describe, assess, quantify, assure, and ultimately improve person-centeredness in AL is feasible and appropriate for all AL settings, and supported by numerous national organizations.

New Evidence on the Green House Model of Nursing Home Care: Synthesis of Findings and Implications for Policy, Practice, and Research

“…), as might nursing home eligible individuals residing in assisted living who are disillusioned with care that sometimes is not person‐centered (Zimmerman et al. ).…”

“…In this context, it is important to note that establishing a GH home requires an initial capital investment, and operating expenses of GH homes are almost 8 percent higher than the national average ( Jenkens et al 2011). Consumers with more resources may well be willing to pay more for care in a GH home if satisfaction and quality are indeed better (Kane et al 2007;Lum et al 2008), as might nursing home eligible individuals residing in assisted living who are disillusioned with care that sometimes is not person-centered (Zimmerman et al 2015).…”

Nursing assistants' perceptions of their role in the resident experience

“…Several organizations share support for nursing home care that is individualized, less institutional, and meets the standards of PCC. These organizations include professional culture change organizations, such as the Pioneer Network (http://www.pioneernetwork.net); state and federal regulatory agencies; professional nursing and medical associations, such as the American Medical Directors Association; and aging advocacy groups, such as the American Association of Retired Persons (Koren, ; Zimmerman et al, ). PCC requires that providers pay close attention to patients and treat them in a holistic, inclusive way that accounts for their needs as unique individuals by supplying them individualized care plans; interprofessional and interpersonal team care, including the patients themselves; and information sharing (American Geriatrics Society Expert Panel on Person‐Centered Care, ).…”

Psychometric evaluation of the Chinese version of the Person-centred Climate Questionnaire - Staff version (PCQ-S)

“…Internationally, various instruments have been developed to evaluate the PCC perspectives of professionals who work in elderly care facilities, including the Person-centred Climate Questionnaire - Staff version (PCQ-S), 20 the Person-centred Care Assessment Tool (P-CAT), 21 the Staff Assessment Person Directed Care (PDC) measure, 22 individualised care (IC), 23 and the Staff Person-Centred Practices in Assisted Living (Staff PC-PAL) questionnaire. 24 …”