Resident‐Centered Care in 10 U.S. Nursing Homes: Residents’ Perspectives

Abstract

Purpose With increased focus on resident‐centered care (RCC) as an organizational imperative and a guiding principle of culture change for long‐term care communities, evaluation of its success has centered primarily on the organizational perspective. Methods For this case report, we examine resident perspectives of RCC in 10 nursing homes across the United States that had adopted RCC as a philosophy and model of care for at least 12 months with a maximum engagement of 3 years using a phenomenological approach. Findings Qualitative findings from 20 focus groups with residents in 10 nursing homes suggest that RCC has meaning in ways that are consistent with intentions at the national and state levels to advance culture change in nursing homes, including efforts to create a more homelike environment, increase resident decision making and direction of his or her lifestyle, and put residents first. Clinical Relevance Residents attribute increased choice in wake and bed times, being heard by organizational leaders, and consistent staff assignment as positive changes since RCC began. However, according to residents, aspects of institutional life in nursing homes, inconsistent with RCC, remain. Residents identified three areas of improvement that would make nursing homes more resident centered. The three areas are response time, access to nature, and transparency about illness and death in the community.

Resident Preferences and CNA Empowerment: Testing Validity and Reliability of a Culture Change Survey Tool

“…Previous studies have emphasized the importance of empowering the direct care worker as one of the core components of any CC initiative. Although some studies found an association between staff empowerment and positive resident outcomes (Harrison & Frampton, 2017;White-Chu, Graves, Godfrey, Bonner, & Sloane, 2009), others have shown that empowering direct care staff increases staff satisfaction and retention (Berridge, Tyler, & Miller, 2018;Bowers & Nolet, 2011). For example, providing direct care workers with power and autonomy to make decisions increases satisfaction and feeling of empowerment among Shahbazim/CNAs in the Green House model (Bowers & Nolet, 2011).…”

Health personnel's experience with resident-centered care in nursing homes in Korea: A qualitative study

“…Therefore, building trust and promoting the maintenance of daily life functions after facility admittance are necessary. Since the late 1990s, resident-centered care, in which preferential value is placed on the choices of the elderly residing in an elderly-care facility and the philosophy and belief in creating a home-like atmosphere, has emerged [6,7]. Various terms are used to define this shift toward providing home-like nursing homes that are receptive to residents’ preferences, such as person- or resident-centered care [6].…”

“…Since the late 1990s, resident-centered care, in which preferential value is placed on the choices of the elderly residing in an elderly-care facility and the philosophy and belief in creating a home-like atmosphere, has emerged [6,7]. Various terms are used to define this shift toward providing home-like nursing homes that are receptive to residents’ preferences, such as person- or resident-centered care [6]. In addition, the terms refer to a collection of principles for nursing homes, including a relationship-based model of care, resident direction of his/her lifestyle, stability in staff who support residents, design of the physical space, and other foundations that contribute and define the quality of life on a personalized basis in nursing homes [6,7].…”

Meanings of ‘centredness’ in long-term care facilities: a scoping review protocol

“… 13 Many long-term care facilities operate using the traditional medical model where people are often medicalised, subjected to ageism and have little or no power and control over their lives. 15 16 …”