Person-Directed Care Planning in Nursing Homes: Resident, Family, and Staff Perspectives

Abstract

Empowering individuals to direct their own care is central to person-centered care and health care policy. However, there is limited knowledge of how "person-directed care planning" (PDCP) can be achieved in particular settings. This study identifies key structures and processes for operationalizing and implementing PDCP in nursing homes. Using participatory inquiry, we convened "stakeholder engagement sessions" with residents, families, nursing staff, and managers/administrators in two North Carolina nursing homes ( N = 24 sessions; N = 67 unique participants). Stakeholders discussed current care-planning processes and provided feedback on an emergent conceptual framework of PDCP. Three themes emerged through directed-content analysis: strategies included providing formal and informal opportunities to engage in care planning and ensuring effective follow-through; different roles were required among leadership, staff, residents, and families to accomplish PDCP; and limits on achieving PDCP included competing priorities and perceived regulatory and resource constraints. Results are discussed in terms of the specific competencies required for accomplishing PDCP.

Nursing home residents’ perspectives on their social relationships

“…In practice, the stakeholder engagement sessions were similar to focus group interviews. The aim of the larger study was to develop a theoretical and operational framework for person‐directed care planning in NHs (Lepore et al, ; Scales et al, ). The stakeholder engagement sessions were carried out in November 2015 and January 2016 at two NHs belonging to the same corporation, both located in suburban areas in North Carolina: one NH had about 90 beds and the other had just over 140 beds.…”

“…A detailed description of the parent study is provided in a separate article (Scales et al, 2019). We followed the COREQ guidelines (Tong, Sainsbury, & Craig, 2007) to ensure rigour in our study (See Supplementary File S1).…”

The Resident VIEW in Nursing Homes

“…; Kitson, Marshall, Bassett, & Zeitz, 2012; McGilton, Heath, et al, 2016). These core elements encompass an explicit emphasis on a holistic approach to care that recognizes the worth and dignity of each person; provides support based on individual goals, preferences, and biography; preserves autonomy; promotes social connection; and is planned and carried out in relationship with the person and his or her family (Behrens et al, 2019; Kogan, Wilber, & Mosqueda, 2016; Scales et al, 2017; Washburn & Grossman, 2017). There is also a growing recognition that the social context of care as well as the organizational and structural characteristics of the care setting influence the ability of an organization to engage in PCC (Kitson et al, 2012; Siegel et al, 2012).…”

“…That is, it is a biopsychosocial approach to thinking about and planning care for and with an individual. “Person-directed” care goes a step further, emphasizing that the individual is in charge of decisions about his or her care, nonmedical issues are paramount in decision-making and empowerment of the person and family is very high (Lines et al, 2015; Scales et al, 2017). With the Resident VIEW, “person-directed” emphasizes the importance of the person receiving support in directing and making decisions about their daily life regardless of their physical and cognitive abilities and environmental constraints.…”

Defining the concepts of a smart nursing home and its potential technology utilities that integrate medical services and are acceptable to stakeholders: a scoping review protocol

“…20 The stakeholders of a nursing home include the elderly people and their family members, healthcare professionals, nursing home administrators and department supervisors. [50][51][52][53][54][55][56][57][58][59][60][61][62][63] In mainland China, the department supervisor for nursing homes is the Ministry of Civil Affairs. Aspects described as integral parts of a smart nursing home include adherence to guidelines, standards and other elements relating to the evaluation of a smart nursing home.…”