An evaluation of a person-centred care programme for long-term care facilities

Abstract

Person-centred approaches in long-term care focus on providing holistic care to residents in order to improve quality of life, enhance resident wellbeing and autonomy, and mitigate behavioural and/or other symptoms. The results of research on person-centred approaches to care are mixed, with very few high-quality empirical studies examining resident outcomes specifically. The purpose of this investigation was to examine a person-centred care programme implemented in three Canadian long-term care facilities to determine its effect on resident outcomes, approach to care and maintenance of the programme three years after implementation. Using the Resident Assessment Instrument Minimum Data Set (RAI-MDS) scale scores and quality indicators, we retrospectively examined resident outcomes before, after and six months following the initiation of the programme using three additional facilities as control. We did not find any effects on resident outcomes. Focus group interviews with facility staff revealed no systematic differences between the programme and control facilities in their approach to care. All facilities supported aspects of a person-centred philosophy. Focus group interview data from the programme facilities indicated partial maintenance in two facilities and more complete maintenance in one facility. Although staff members supported the programme, implementation and maintenance proved difficult and effectiveness on resident outcomes was not indicated in this research. Additional controlled studies are needed.

Experiences of home and institution in a secured nursing home ward in the Netherlands: A participatory intervention study

“…Through the project, caregivers began working more person-centred through an increasing focus on the residents' individual needs and wishes, rather than treating them all alike (see also de Veer & Kerkstra, 2001;Williams et al, 2015). Our study demonstrates how person-centred care can enhance feelings of home, which confirms other findings (Brownie & Nancarrow, 2013;van Malderen et al, 2013).…”

The academic background of gerontologists and client satisfaction in long-term residential care for older persons

“…In this way, the gerontologist is able to understand the health care needs of each older adult, to plan the physical and organizational environment according to the health status and physical capacity of frail older adults, and to nurture positive interpersonal relationships (Granja & Pereira, 2008;Pereira, 2008;Pereira & Caria, 2014). All these skills and capabilities are the foundation of PCC programs, which are focused on the individual needs, preferences, and abilities of elderly residents; they overcome the hierarchical management of routine-based institutionalized care (Williams et al, 2013). The higher satisfaction level we observed among the older persons from LTRCs managed by a gerontologist could be explained by management's commitment to providing a PCC.…”

“…These dimensions reflect to some extent the aspects related to the PCC in which care is provided according to the individual needs, preferences, and abilities of each resident. PCC is based on knowing the person, nurturing relationships, providing a supportive physical and organizational environment, assuring the residents autonomy and dignity, placing the resident at the center of care, and considering his or her wishes (Brownie & Nancarrow, 2013;Williams et al, 2013). Previous research showed that residents' participation in decision making strategies (Edd et al, 2007) and attention to individual needs and preferences (Boldy, Davison, & Duggan, 2014) are crucial issues when measuring satisfaction levels among LTRC residents.…”

“…These approaches pursued by gerontologists are in accordance with not only the person-centered care (PCC) principles-which are focused on the achievement of a positive emotional/psychosocial environment (Rockwell, 2012;Williams, Hadjistavropoulos, Ghandehari, Yao, & Lix, 2013)-but also the client-centered care (CCC) concept based on the respect for clients and for their choices. These approaches highlight the engagement of clients in the decision-making process (Athwal et al, 2014).…”

Promoting positive perceptions and person centred care toward people with mental health problems using co-design with nursing students

“…In long-term care it focuses on providing holistic care to people to improve quality of life, enhance wellbeing and autonomy, (Williams et al 2015). It contrasts with a task-oriented, dehumanized approach but embraces individual humanity (Tee 2016).…”