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Michelle Harris-Allsop. Photo: Supplied

Person-centred dementia care: the time for change is now

Much has been said about person-centred care for people with dementia, but it’s time for change to make sure the good intentions of person-centred care don’t get lost in busy day-to-day routines.

The crucial component needed to make this approach successful is ensuring sufficient high quality and dedicated dementia care specialists out on the floor: “walking the talk” and backing up the rhetoric that exists around person-centred care for people with dementia in community and residential care.

To develop more high quality and dedicated dementia care specialists delivering person-centred care, there are a number of critical factors needed:

  1. better support for carers in practice and effective communication skills
  2. continuous building of capability through formal training programs
  3. more dedicated mentorship programs

Braemar is a good example of proactivity across these three factors.

Wayne Belcher, chief executive of Braemar, invited me in my capacity as Care Partnerships Australia co-director to meet his leadership team, and explore opportunities to build person-centred care and expand the learning about dementia and the lived experience for people who have a diagnosis of dementia.

Person-centred care is a way of thinking and doing things where the person living with dementia is always seen as an individual first who lives with a disability.

The move away from an “assessed needs model” towards a “perceived needs model” will be advantageous for any aged care provider going forward, and is in line with evolving Aged Care Industry compliance and funding requirements.

Based on all available research and information, a person-centred approach to dementia care leads to improved outcomes for customers, improved job satisfaction and performance for staff and improved financial outcomes for providers.

The delivery of person-centred care in a dementia service requires:

  • A commitment from all stakeholders to undergo the culture change required to implement a person-centred approach to dementia services.
  • A clear vision of best practice, person-centred dementia care and how that looks on the floor.
  • A high degree of specialist skill in the domains included in its organisational approach.
  • Close monitoring and reinforcing of the culture as reflected in every decision made and every interaction with customers.
  • Regular evaluation of the services and their progress and accountability for the results.
  • A volunteer companionship buddy program to reduce loneliness and isolation for the person living with dementia.

Mentorship embedded within care teams helps to bridge the gap between formal training and day-to-day practice, so I introduced the Care Partnerships Australia Mentoring Program to Braemar.

An important piece of the mentorship program in moving toward a person-centred approach is the building of strong care partnerships with families. Families need to be closely involved in care planning and delivery via a case conferencing approach and given education to enable effective communication with their loved one.

While many staff do try their best to liaise with families, they are often overwhelmed with their day-to-day work and have limited capacity to really give families the time and support they require, often leading to unsatisfactory experiences for families.

About the first part of the program

Braemar Presbyterian Care is offering free public workshops on dementia training for its staff and volunteers, which it is also opening up to family members and the wider community.

The first workshops took place in February and March, with more on 23 April, 25 June, 27 August, 29 October and 26 November. The workshops, all of which will take place at Willagee Community Centre, will cover all aspects of good dementia care, including care planning, communication and how to respond to clients who have distress in their mood or in a change in behaviours. Resources from Dementia Training Australia are given to participants.

Part two of the program

Braemar staff work with me two days a month across all shifts in the home with the clients and families, practising effective communication using the principles of validation, reminiscence or reality orientation. They will be supported to learn how to deescalate distress – for example when a person is anxious, frightened or angry. Having effective communication with a person impacts their wellness and quality of life. It enables the carers to support the person to maintain their dignity, including fulfilment and a good quality of life.

Staff in the majority are unaware of a resident’s background beyond work and family. Braemar are looking at a communication profile as being the guide for person centred care.

There is little opportunity for meaningful or purposeful daily life in residential aged care. There is an “entertainment and distraction approach” which has been proven to have a disabling effect on people with dementia. This mentorship program is leading a change of direction for staff and families to understand the person living with dementia and not focusing on the disability.

Conclusion

The time for change is now. The Aged Care Royal Commission is in progress, and I hope more mentorship programs can be funded in Australia. It is essential to support person-centred choice for consumers, and aged care providers will have to comply with this in their admission process and care planning. Knowing how to communicate with a person living with dementia will be the most effective way to start these changes.

Michelle Harris-Allsop is a dementia consultant at Care Partnerships Australia in Western Australia. She is focused on changing the culture of dementia care across all business streams, building knowledge and best practices for ideals of person-centred dementia care in partnership with the client’s staff and family. Michelle is passionate and enthusiastic about the importance for effective leadership to challenge the ‘status quo’ in care delivery, this includes reviewing staff training initiatives and residential care living environments.

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