Person-Centered Care


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Presentation made by Sonya Barsness on June 21, 2011 at the online webinar titled Aging in Place: A Hallmark of Person-Centered Care

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  • PCC and Aging in Place are hand-in- hand. The fact that we have various options for elders and are continually creating new options is the best evidence that person-centered care is being operationalized in aging. Through this presentation we will give an overview of PCC to set the stage for how aging in place options “live” these values. So let’s start by defining what person-centered care is….
  • There many ways of articulating what person-centered care is- but they hold common messages. I like this definition of person-centered care, developed by an adult day provider, because it speaks to the core of person-centered care, honoring the person in person-centered care. To be more concrete…
  • Also carlrogersStrength based model
  • These values of the Pioneer Network explain the core values of person-centered care. They put focus on relationship, community, self-determination, choice, growth….Person-centered care is most commonly seen in the context of long-term care, particularly residential long-term care like nursing homes and assisted living. But we need to think about it even more broadly, so that these values are operationalized in any settingPerson-centered care is a part of a larger movement to change the culture of aging and how we care for each other as we age.
  • In order to operationalize the core preson-directed values of choice dignity, respect, sefl-determiniation, we need to have this deep system transformation
  • Not the flavor of the month. Or a “program” to be implemented. It is a philosophical shift that changes practice.
  • That being said, we need to look at many different elements of our “system” as we move to change. As we think about the values of person-centered care, they are operationalized not just in where people live and how we care for people, but in the language we use, particularly in long-term care. This slide gives some examples of how the language we use frames how we approach caring for elders. This instiutional language medicalizes care, focuses more on the institution or individual providing care, rather than the person receiving the care. In culture change, if we are trying to make nursing homes and assisted living true homes for people, this language does not support that. Think about the meaning of “admiting” or “discharging” a resident to their home?What this language also does is remind us that person-centered values is really a part of a large change movement.
  • We cannot talk about culture change without talking about the larger context of aging. There is a culture of aging as well.
  • Why is it important to change the way we care for elders? Well, the obvious answer?Not a great understanding of what aging means to us and how we need to care for eldersone out of five Americans projected to be over 65 in 2025Some evidence that percentages of individuals with functional limitations decreasing, although #’s may still be increasing42% 65+ in 2005 reported functional limitationPeople in nursing home and assisted living are generally sicker and have greater needs than before
  • But what is wrong with the current culture?The culture of aging is partly based on ageism.Term coined by Robert Butler
  • Regardless of whether people are in nursing homes, or assisted living, or their own homes, or one of the models Jay is going to talk about. There clearly is a need to change the current models and practice of aging. We have to ask ourselves this question….
  • So, if it is really about the individual experience, we have another question to ask ourselves to help us understand person-centered care….Person-centered care is a way of facilitating who we are, and giving meaning to each of our lives (even if we are sick, disabled, have dementia, etc.)
  • So, in thinking about how we want to live our lives and what is meaningful/important to each of us, let’s do a quick exercise. Say that you were in an accident today and had to go live somewhere to have someone help care for you…..
  • RMF
  • KIf you have 3 slips of paper or post it notes or even the back of an envelope write your 3things down. I think I got mine.
  • KAren
  • Rose MarieTalking on my cell phone. Eat When I want. Books to read & Listen to on tape. My Boston terrier, Tommy could sleep with me. I want to smell good!. Shower 2 times a day – no baths! Hot bath with a book to read. Want my Coke. I will not drink milk. Eat breakfast in my jammies. Tall Nonfat Latte – Starbucks! Leave me with MY music
  • Karen
  • You might say to yourself, this all sounds great on a philosophical level, but what is actually happening out there?
  • This chart outlines some of the changes that are happening in nursing homes that are becoming more person-centeredChanges are happening in long-term care to allow us to live the lives we want, even if the place we live is a nursing home or assisted living or another form of traditional “long-term care”. However, many options are emerging that allow us even broader options to age optimally.
  • In a moment, we are going to take a look at some of these options….so I challenge you to think even more broadly than person-centered care in nursing homes….
  • Person-centered care and living are operationalized in settings in which people have choice, and supported to age optimally, are encouraged to live meaningfully. Let’s take a look at some of these options…..
  • Person-Centered Care

    1. 1. Person-Centered Care& Aging in Place<br />Sonya Barsness, MSG<br />Gerontologist<br />Sonya Barsness Consulting LLC<br />
    2. 2. Placeholder<br />1<br />2<br />3<br />4<br />5<br />What is <br />Person-Centered Care?<br />Person-Centered Care and Creating Meaning<br />What’s Happening in Person-Centered Care?<br />Person-Centered Care and Culture Change<br />Why <br />Culture Change?<br />
    3. 3. “Person-Centered Care is an approach to care that respects and values the uniqueness of the individual, and seeks to maintain, even restore, the personhood of individuals. We do this by creating an environment that promotes personal worth and uniqueness, social confidence, respect, truthfulness, independence, engagement and hope.”<br />-Luther Manor Adult Day Center, Wauwatosa, WI<br />
    4. 4. Defining Person-Centered Care<br />Fosters optimal aging for that individual<br />Rooted in the work of Tom Kitwood, a British gerontologist, on personhood.<br />Empowering<br />PERSON-CENTERED CARE<br />Core values are:<br /><ul><li>Choice
    5. 5. Dignity,
    6. 6. Respect,
    7. 7. Self-determination, and
    8. 8. Purposeful living</li></ul>Care centered and driven by person receiving care, rather then individual or organization providing care<br />
    9. 9. Person-Centered Values<br />The Values of the Pioneer Network<br />
    10. 10. Placeholder<br />1<br />2<br />3<br />4<br />5<br />Person-Centered Care and Creating Meaning<br />What is <br />Person-Centered Care?<br />What’s Happening in Person-Centered Care?<br />Person-Centered Care and Culture Change<br />Why <br />Culture Change?<br />
    11. 11. What is Culture Change?<br />Refers to the common name given to the national movement for the transformation of older adult services.<br />Based on person-centered values and practices<br />Where the voices of elders and those working with them are considered and respected.<br />This deep system transformation may require changes in organization practices, physical environments, relationships at all levels and workforce models.<br />
    12. 12. “The shift from the old culture to the new is not a matter of adding on a few items that were missing, but of seeing almost every feature in a different way.”<br />— Tom Kitwood, Dementia Reconsidered<br />
    13. 13. Schoeneman, K. The language of culture change. Retrieved from<br />
    14. 14. Creating home, regardless of where you live<br />
    15. 15. Placeholder<br />1<br />2<br />3<br />4<br />5<br />Person-Centered Care and Creating Meaning<br />What’s Happening in Person-Centered Care?<br />What is <br />Person-Centered Care?<br />Person-Centered Care and Culture Change<br />Why <br />Culture Change?<br />
    16. 16. The Culture of Aging<br />Vision of the Pioneer Network:<br />A Culture of Aging that is Life-Affirming, Satisfying, Humane, and Meaningful<br /><br />
    17. 17. “In the twentieth century, the industrialized world gained some 30 additional years of life, greater than had been attained during the preceding 5,000 years of human history and transforming what was once the experience of the few to the destiny of many.”<br />— Robert N. Butler, MD <br />
    18. 18.
    19. 19. “Only the newest model is desirable. The old are condemned to obsolescence; left to rot like wrinkled babies in glorified playpens — forced to succumb to a trivial, purposeless waste of their years and their time.”<br />— Maggie Kuhn, Founder, Gray Panthers<br />
    20. 20. Placeholder<br />1<br />2<br />3<br />4<br />5<br />Person-Centered Care and Creating Meaning<br />What’s Happening in Person-Centered Care?<br />What is <br />Person-Centered Care?<br />Person-Centered Care and Culture Change<br />Why <br />Culture Change?<br />
    21. 21. Culture Change and Aging<br />How do we create meaning in the experience of aging, regardless of where people live?<br />
    22. 22. Creating meaning in the experience of aging<br />“Old people do not perceive meaning in aging itself, so much as they perceive meaning in being themselves in old age”.<br />— Sharon R. Kaufman - “The Ageless Self”<br />
    23. 23. What is meaningful to each of us?<br />
    24. 24. What 3 things would you notcompromise on if you had to go live somewhere else?<br />20<br />
    25. 25. Maybe they are things that you could not live without. <br /> Maybe they are little things that make your everyday life good? <br />Things that make you comfortable? secure? happy?<br />21<br />
    26. 26. Here are some real answers from people across the country. <br />22<br />
    27. 27. Used with permission Karen Stobbe, Pioneer Network, 2011<br />
    28. 28. Used with permission Karen Stobbe, Pioneer Network, 2011<br />
    29. 29. Used with permission Karen Stobbe, Pioneer Network, 2011<br />
    30. 30. We all have things that are important to us as individuals and that we hope we can do, regardless of where we live, <br /> …..and even in long-term care. <br />This is what person-centered care is all about- people living the lives they want to live in the best way they can.<br />
    31. 31. Placeholder<br />1<br />2<br />3<br />4<br />5<br />Person-Centered Care and Creating Meaning<br />What is <br />Person-Centered Care?<br />What’s Happening in Person-Centered Care?<br />Why <br />Culture Change?<br />Person-Centered Care and Culture Change<br />
    32. 32. Person-Centered Care & Long-Term Care<br />Changes are happening in long-term care!<br />Movement from institutional medical model to person-centered model<br />30% nursing homes adopting person-centered care values (Commonwealth Fund, 2008)<br />Examples of changes: practice, environment, philosophy<br />
    33. 33. From “Creating Home: A Guide to Better Care Options for an Aging America”, Pioneer Network, 2011<br />
    34. 34. Person-centered values regardless of where you live<br />
    35. 35. Taking it a step further:Person-centered living<br />“Person-centered care (PCC) or living (PCL) is a way of life centered on personal preferences and values that stress dignity, choice, self-determination and individuality.<br />PCL means living as one chooses to. <br />If support is needed, supports are centered on personal preferences and values that stress dignity, choice, self-determination, respect, privacy, and individuality. <br />PCL means being kind, respectful, and sensitive to those being served and honoring their right to make their own choices, regardless of the setting.”<br />- From CCAL- Advancing Person-Centered Living,<br />