Beyond ‘person‐centred’ care: a new vision for gerontological nursing

Abstract

Currently considerable emphasis is placed on the promotion of person-centred care, which has become a watchword for good practice. This paper takes a constructively critical look at some of the assumptions underpinning person-centredness, and suggests that a relationship-centred approach to care might be more appropriate. A framework describing the potential dimensions of relationship-centred care is provided, and implications for further development are considered.

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

“…It is ethical in the sense that acknowledges the relevance of activities in this phase of life and context. This engagement, as revealed in the exemplars, could be enacted through small‐scale events within everyday activities, adding the acting dimension to care The understanding of influence illuminated in this study differs from conceptualizations of autonomy and decision‐making grounded in individualism, proposing a relational and acting understanding instead (Abma & Baur, 2015; Baur et al., 2013; Cardol et al., 2002; Ceci, Ttir, et al., 2013; Katz & Alegria, 2009; Nolan et al., 2004). …”

“…More specifically, this framework makes explicit the need to move beyond technical competences and engage in the promotion of partnerships and collaborative practices with older adults (McCormack, 2004; McCormack & McCance, 2006). This relational perspective (Cardol, De Jong, & Ward, 2002; Nolan et al., 2004; Smebye & Kirkevold, 2013) also serves to counteract and problematize concepts such as autonomy, decision‐making, and self‐determination in person‐centered care, which assign a central value to individualism and cognitive competences (Boyle, 2008). …”

“…The term influence, simply put as ‘having a say in everyday matters of concern for the person’ (Harnett, 2010), recognizes interdependence with others (Nolan et al., 2004; Wray, 2004) as a central aspect in the context of frail older adults’ care. Harnett (2010) identified individual attempts to influence everyday practices performed by frail older adults in a NH.…”

Sustaining care for a parent with dementia: an indefinite and intertwined process

“…Thirdly, our findings demonstrated that personality and value differences shaped these interdependent relationships between care stakeholders, particularly between adult children siblings, and between adult children and their parents (PwDs). We therefore encourage future research to examine the nature and quality of care relationships through relationship-centred frameworks which promote equitable, synergistic care relationships that reconcile the needs of all partners in care (Dupuis et al, 2012a; M. R. Nolan, Davies, Brown, Keady, & Nolan, 2004). Moreover, it is crucial that policy and services aim to be value-sensitive and flexible to accommodate a wide range of personalities, values, and care arrangements, from no adult child involvement to active care collaboration with multiple adult child siblings.…”

Resident-centred care and architecture of two different types of caring residences: a comparative study

“…Resident-centred care is holistic and aims to satisfy the older individual’s needs, wishes and choices, provide individualized care, and strengthen his or her autonomy and self-determination (Brownie & Nancarrow, 2013; Li & Porock, 2014; McCormack et al, 2010; Morgan & Yoder, 2012; Yee et al, 1999). Resident-centred care concerns not just a relationship between a nurse or caregiver and an older person, but needs to be considered in a wider context of relations including, for instance, family, community, caring culture and, of particular relevance to this paper, the built or physical environment (McCormack & McCance, 2006; Nolan, Davies, Brown, Keady, & Nolan, 2004). This paper aims to contribute to the existing research by putting resident-centred care in a theoretical context of relationality and emergence (DeLanda, 2016).…”