Focussing on the person will mean changes to traditional forms of care delivery.

A man is sitting in his room and shouting incessantly. A carer identifies his behaviour as verbal aggression and reaches for his medication to calm him down.

Another staff member, however, identifies his challenging behaviour as a sign of boredom and offers an alternative solution. She knows he loves the All Blacks and puts on a recording of his favourite football game and places his scarf in his lap.

Knowing how to nourish a person’s attachments, interests and personal identity is critical to delivering person-centred care, which is the subject of an Aged Care Channel program, Person-centred care: It’s my choice.

Person-centred care is about making care about relationships not about tasks or the treatment of disease, says Professor Rhonda Nay, who is the director of the Institute for Social Participation with the Australian Centre for Evidence Based Aged Care; who will lead the program’s discussion.

“It involves knowing the person by name, knowing their history, their temperament and routines.”

By strengthening individual relationships with residents, carers are better equipped to identify individual needs and provide relevant care solutions that empower and foster independence and a sense of self.

‘It’s about finding inventive ways to help a person express who they are spiritually, culturally, sexually and creatively’ says Nay.

Consultation and goal-focused care are central principles underpinning this philosophy of care.

Consultation involves being a good listener and facilitating resident input and consent in care decision-making by acknowledging personal preferences and strengths.

Giving a resident the time to dress themselves by doing up their own buttons and zips not only focuses on skills and strengths but helps them to maintain muscle strength and improves dexterity, says Nay.

The ultimate aim should be to maximise individual freedom whilst minimising carer control by enabling residents to make their own decisions about care, says Rhonda.

“There’s a difference in telling people what they want or asking them what they want,” says Colin McDonnell, Manager at Uniting Care Ageings Starrat Lodge in Hamlyn Terrace NSW.

Just as a resident of Starrat Lodge, Elsie Bolewski, says, “I would like people to really know me, or get to know me.”

According to Chris McMahon, a trainer and consultant with Eden in Oz, the nursing background of many carers in the aged care sector has contributed to the unnecessary “medicalising” of older age.

“Most people in aged care are dying of the plagues of loneliness, helplessness and boredom”, she says. But these are plagues of the spirit not the body.

“By the age of seventy and eighty we are usually living with two to three chronic illnesses, so we get used to living with pain and disease. It’s the spiritual things that we need to be addressing rather than just the physical.”

Encouraging the forming of friendships and companionship as well as offering spontaneity and variety to the lives of residents will greatly improve their wellbeing, says McMahon.

The opportunity to give care, and not only receive care will also help residents overcome a sense of helplessness that is commonly experienced.

Carers need to find a common ground with the residents they support and encourage the sharing of interests, passions and personal experience, says Nay.

Carers should also engage in discussion where residents can lead the conversation. We have a lot to learn from our older people and carers should try to solicit advice on anything from cooking and sport to gardening as a way of boosting confidence, she says.

BOLD: Improved outcomes for both staff and residents

The benefits of person-centred care are not only felt by residents but staff, says Colin McDonnell, as the workplace is more productive and goal-oriented.

“Some of the outcomes of our model of care are that there is hardly any staff turnover. There is limited sick leave and no workers compensation.

“The residents are happier, the carers are happier and the way that they relate with each other is really positive,” says McDonnell.

Research suggests that a person-centred care approach can also reduce agitation in people with dementia and reduce reliance on psychotic medication, says Nay.

A recent study found that discomfort and aggression when bathing was also reduced significantly for residents with moderate to severe dementia when a ‘person’, rather than task-centred approach was adopted. Added verbal support provided a sense of ease and comfort for both staff and residents.

BOLD: Improving the language of care

A person-centred care approach should also influence the language utilised by staff when communicating a resident’s experience and progress.

A person is not their illness or their behaviour and to conflate the two devalues the individual, says Nay

A sense of empathy should govern communication between staff and relatives, providing context to a resident’s symptoms and behaviour.

“You communicate your thoughts to your colleague using empathy, not by listing symptoms and giving a diagnosis, but by putting the situation in the context of a resident’s life,” says Nay.

Carers must analyse the need behind the behaviour and recognise the facility as their space.

BOLD: Implementing person-centred care

Carol Penning, director of residential care with Uniting Care Ageing, Hunter region, believes that strong leadership is necessary to encourage a change in workplace culture and to implement individualised care.

Once the new vision is shaped by management, other staff begin to change their thinking and challenge the way traditional care is provided.

“If you’re going to progress a model of person-centred care in the home, you need to have someone leading it. You need to have someone passionate about the whole concept and be able to recognise the value of it being implemented within that facility.”

Person-centred care is a philosophy that needs to influence the entire way the facility functions, being embedded in all actions and decisions.

END INFO: For more information on this program go to www.agedcarechannel.com.au