Identity and relationships are central to the construction of patient centred care

How could discourse theories of identity formation critically engage patient-centered care in older adults?

“…PCC scholars have highlighted the fundamental changes in the nature of the clinical encounter implied by PCC, reconfiguring the relationship between patient and practitioner (Gardner and Cribb, 2016; Gershater and Forbes, 2013; Kitson et al , 2013; Pulvirenti et al , 2011; Charles-Jones et al , 2003). Patients are being asked to shift from directive to performative ways of being, from “seekers of health care to informed consumers of medical services” (Dubbin et al , 2013, p. 3).…”

“…Kitwood, 1997a) or a sense of self, beliefs and values (e.g. Gershater and Forbes, 2013; Mead and Bower, 2000; McCormack and McCance, 2006), but is one which remains relatively underconceptualized (Dubbin et al , 2013; Edvardsson et al , 2010; Jesus et al , 2016; Kogan et al , 2015) and unevenly enacted across different professional groups and contexts (Kitson et al , 2013). Higgs and Gilleard (2016b) argue that Kitwood’s position that “personhood is an attribute of relationships, not of capabilities” (p. 24) fails to address key components of personhood, namely, “agency and autonomy, consciousness and memory, self-hood and personal identity” (Higgs and Gilleard, 2016a, p. 774).…”

“…Scholars have acknowledged that patient identity has been underconceptualized in the PCC literature, and there have been calls for further research to understand identity and the effects of labels in health care interactions (Gershater and Forbes, 2013). Through their study of patient-centered medicine, Gardner and Cribb (2016) highlight how PCC interactions actually entail instrumental power dynamics, which under close scrutiny are asymmetrically distributed and more complex than those promoted by advocates of PCC.…”