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How can we put the person into person-centred care?

Person-centred care was at the heart of the recent Perth hearing of the royal commission.

Derived from the ideas of Carl Rodgers and Thomas Kitwood, person-centred care can be defined as care which is unique to the patient – their preferences are the key, not the disease.

Rodgers, an American psychologist, originally developed his idea in relation to therapy situations and the idea was to move away from the maxim that therapist knows best, and towards a process that trusted the innate ability of the individual to find fulfilment.

Originally coined “non-directive therapy” and then “client centred”, the term “person-centred” came to be with the realisation that these principles could be applied to other areas where there is a relationship, such as childcare, patient care and management.

Kitwood applied the theory to dementia care in the early 90s with the foundation of the Bradford Dementia Group, and he went on to develop many educational tools aimed at facilitating person-centred care.

“Personhood is a standing or status that is bestowed upon one human being, by bestowed upon one human being, by others, in the context of relationship and others, in the context of relationship and social being,” he said.

Bryan Lipmann, chief executive of Wintringham, and the manager of one of his homes, Kate Rice, spoke about the very niche type of person-centred care they deliver.

Wintringham is a service for elderly homeless people and people at risk of becoming homeless, and part of the care model includes giving these people lots of choice.

“It’s interesting in the context of all this person-centred care discussion because someone’s right or wish to, say, drink or smoke or participate in gambling or any of those other activities to us are no less important in a sense to honour than someone who might, you know, want to do gardening,” Rice told the commission.

A panel made up of two nurses, a personal carer and a physios also spoke to the commission about some challenges they face trying to deliver care in this way.

RN Gaye Whitford said that not enough is being done despite an emphasis on person-centred care.

“I feel that person-centred care is a term that’s overused. I think we are not fulfilling that term adequately enough. We need to be looking at a holistic view of the person, their emotional and spiritual needs, not just their chronic conditions,” she told the commission.

“I feel that we don’t provide enough time in order to achieve this with these people… when you do provide this time, [it’s] very rewarding.”

Personal care worker Patti Houston has seen the effects of person-centred care at her workplace, where they have implemented the Butterfly Model.

“It’s just a wonderful program that really gets to the heart of people, and their slogan is ‘Feelings Matter Most’ so that’s where the care comes from. And we’re in the process at the moment, a transition of change starting with our memory support area, so we’re changing the environment,” she said.

“We’re not wearing uniforms anymore, we come in colourful clothing. We’re using music. There’s a whole process of about 70 different things that we need to do to actually achieve the Butterfly Model status and we’re working towards doing that.”

Aged Care Insite spoke with professor Lynn Chenoweth from UNSW to delve further into the ideas behind person-centred care.

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