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Can person-centred care for people living with dementia be delivered in the acute care setting?
- Authors:
- ABBOTT Rebecca A., et al
- Journal article citation:
- Age and Ageing, 50(4), 2021, pp.1077-1080.
- Publisher:
- Oxford University Press
The need to improve care for people living with dementia in the hospital setting has long been recognised. Person-centred care has the potential to improve the experience of care for persons living with dementia and their carers, and has been shown to improve the experiences of hospital staff caring for the persons living with dementia, however it remains challenging to deliver in a time- and task-focussed acute care setting. This commentary suggests that to embed person-centred care across the hospital environment, cultural changes are needed at organisational and ward levels. In particular there needs to be: leadership that supports and advocates for workforce capacity to recognise and meet both psychological and physical needs of people living with dementia, promotion of physical environments that support familiarisation and social interactions, an inclusive approach to carers and the development of a culture of sharing knowledge and information across hierarchies and roles. An evidence-based set of pointers for service change are described which highlight institutional and environmental practices and processes that need to be addressed in order for person-centred care to become part of routine care. (Edited publisher abstract)
Classifying discharge scenarios to improve understanding and care
- Author:
- HYSLOP Brent
- Journal article citation:
- Age and Ageing, 50(2), 2021, pp.358-361.
- Publisher:
- Oxford University Press
Hospital discharge planning is valuable in improving care and avoiding discharge delays. This is highly relevant to older people. Although usual discharge planning is now well understood and applicable to most patients, a range of different discharge scenarios exist that involve different considerations. These less common scenarios appear less well understood and can be challenging for clinical staff. To improve understanding and care, this Commentary suggests a basic classification of six discharge planning scenarios. These are: usual discharge planning, premature discharge, rehabilitation selection, safety concerns, reluctant discharge and delayed discharge. Clinical and system responses to each scenario are briefly discussed. This classification could potentially be useful in clinical education and quality improvement. (Edited publisher abstract)
Sexuality and dementia: a review of research literature
- Author:
- HEATH Hazel
- Journal article citation:
- Journal of Dementia Care, 20(4), July 2012, pp.35-39.
- Publisher:
- Hawker
Sexuality remains an intrinsic part of being human throughout life and through health and illness. It helps contribute to a person’s identity. Helping people with dementia retain this is fundamental to person-centred care. This article reviews the research literature on sexuality issues for people affected by dementia and evidence to support practice for staff working with these individuals and their families. This review revealed expression of sexuality in care home environments to be particularly complex, and the importance of this research for people with dementia, families and staff is highlighted.
Person centred dementia care: problems and possibilities
- Author:
- ARGYLE Elaine
- Journal article citation:
- Working with Older People, 16(2), 2012, pp.69-77.
- Publisher:
- Emerald
The implementation and efficacy of person centred approaches in dementia care is difficult to measure and there are still huge variations in working practices. In order to address these issues the procedure of dementia care mapping has been developed, which aims to assess the wellbeing of people with dementia and other vulnerable groups through the observation of communal activities. This article assesses the implementation of a person centred approach with a group of care home residents. All were female, their ages ranged from 77 to 92. Findings suggest that while participants potentially experienced many benefits from person centred approaches and the social engagement and integration that derived from this, its efficacy and impact was undermined by contextual factors such as staff shortages. The author concluded that practice should transcend its focus on the promotion of individual wellbeing and address the wider group and social contexts which can facilitate or prevent its fulfilment.
Trajectories of at-homeness and health in usual care and small house nursing homes
- Authors:
- MOLONY Sheila, et al
- Journal article citation:
- Gerontologist, 51(4), August 2011, pp.504-515.
- Publisher:
- Oxford University Press
Long-term care providers across the United States are building new residential environments that weave humanistic person-centred philosophies into clinical care, organisational policies, and built environments. The small house model (SmH) relocates the resident from institutional care to a place that is believed to better emulate home. The aim of this study was to compare and contrast trajectories of at-homeness and health over time between residents remaining in a usual care nursing home and residents moving from that home to a SmH. The setting for the study was a 100-bed nursing home in a continuing care retirement community in the Midwest. Five new SmHs were built as part of this retirement community. Interviews were conducted with residents before the move to the SmHs and 1, 3, and 6 months after the move. The findings showed that prior to the move individuals who decided to relocate to the SmH had more depressive symptoms and lower levels of at-homeness. Their levels of at-homeness increased after the move, and, in addition, their levels of functional dependence decreased. Most participants who chose to stay in the nursing home reported high baseline levels of at-homeness and maintained this over the next 6 months. Qualitative findings highlight the variables that contributed to at-homeness in both groups. The study demonstrates that a ‘one size fits all’ approach may not be best because at-homeness is an individualised construct.
The brain and person-centred care: 2. Making sense of the paradoxes of dementia
- Author:
- MILWAIN Elizabeth
- Journal article citation:
- Journal of Dementia Care, 18(1), January 2010, pp.23-25.
- Publisher:
- Hawker
Dementia is defined as a syndrome of acquired intellectual loss, in which memory and at least one other cognitive function are damaged to such a degree that a person's normal life and functions are adversely affected. In this second article of a series on the brain and dementia care, the author explains how an understanding of the organisation of the human brain, and the fact that it is not one structure but many, can help with understanding some aspects of dementia including Alzheimer's disease. The article gives a brief overview of how the brain is organised, highlighting how certain structures of the brain are vulnerable to the causes of dementia but others less so and that of all the structures of the brain it is the cerebral cortex which is most involved in the symptoms of dementia, and noting that it is vital that each person is assessed individually, because different kinds of dementia will affect different parts of the brain.
Time to drive personalisation
- Author:
- HOPE Phil
- Journal article citation:
- Community Care, 5.2.09, 2009, p.30.
- Publisher:
- Reed Business Information
A key finding from the evaluation of the individual budget pilots suggested that many older people and their carers did not want the additional burden that they associated with planning and managing their own support. This article provides some tips to help older people, their carers and their families experience the benefits of personalisation. These include: taking a person-centred approach; remaining flexible; and providing choice for older people on managing the money they are given through personalisation.
Interpersonal complexity: a cognitive component of person-centered care
- Author:
- MEDVENE Louis
- Journal article citation:
- Gerontologist, 46(2), April 2006, pp.220-226.
- Publisher:
- Oxford University Press
This study concerns one component of the ability to provide person-centered care: the cognitive skill of perceiving others in relatively complex terms. This study tested the effectiveness of a social motivation for increasing the number of psychological constructs used to describe an unfamiliar senior citizen. Forty-four certified nurse aide students participated. Students were mostly 30-year-old females (86%) with a high school education (72%). A quasi-experimental design was used. Early in training, participants completed the Role Category Questionnaire (RCQ), which measured their interpersonal cognitive complexity. On the basis of their RCQ scores, participants were matched and assigned to the experimental or control condition. Five weeks later, participants viewed a 15-min videotaped biography of an unfamiliar senior citizen - Mitch. Participants in both conditions were told they would be asked to describe Mitch as a person after watching the video. Only participants in the experimental condition were additionally asked to imagine that they would be having a personal conversation with him afterward. As hypothesized, participants in the experimental condition used more constructs to describe Mitch than did participants in the control condition. Participants' RCQ scores were significantly correlated with the complexity of their descriptions of Mitch. The findings suggest that new training materials should be created that include experienced certified nurse aides' modelling how biographical and personal information can be used in caregiving tasks to gain residents' cooperation.
Does person-centred care exist
- Author:
- PACKER Tracy
- Journal article citation:
- Journal of Dementia Care, 8(3), May 2000, pp.19-21.
- Publisher:
- Hawker
In the first of a series of articles analysing the obstacles standing in the way of person-centred care, the author asks whether it is an unworkable notion.
An exploration of the challenges of providing person-centred care for older care home residents with obesity
- Authors:
- PARKINSON Mark, THOMPSON Juliana
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.e1112-e1122.
- Publisher:
- Wiley
The aim of this study was to explore care home staff's views on the prevalence of obesity in older people and how well prepared they were for any rise in applications for placements. Thematic analysis was used to analyse focus group interview data collected from seven care homes/33 participants in N.E. England. Findings revealed rises in demand by older people with obesity for care home admittance, consistent with rising prevalence of obesity in this demographic nationally. Findings also highlight implications of rising prevalence of obesity in older people, particularly care home staff's ability to deliver person-centred care (PCC) and the importance of appropriate support/recognition of this as an emergent issue to be addressed at a higher executive level and by health/social care authorities. Ways of ensuring PCC are discussed. Given continuing trends towards rising prevalence of obesity in this population, the findings possess broader translational potential. (Edited publisher abstract)