Person-Centered Care
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Author Note
Person-Centered Care
Person-centered care is getting increasingly popular because of its wide range of benefits for patients and healthcare providers. This document aims to discuss the type of person-centered care provided to Fiona in the movie “Away from her”. Additionally, it also critically analyzes the advantages, disadvantages and limitations of this type of care and considers its implications. Moreover, suggestions have been made for the improvement of person-centered care given to Fiona and conclusions have been presented towards the end of the document.
Development
Person-centered care is an approach towards the improvement of quality of healthcare and quality of life for older people suffering from chronic diseases. The approach has been rapidly growing in healthcare policy and research, however, no standard definition has been developed. Person-centered care was previously defined as ‘patient-centered care’. The person-centered care has been identified as one of the six health quality pillars by the Institute of Medicine (American Geriatrics Society Expert Panel on Person‐Centered Care, 2016). According to the American Geriatrics Society Expert Panel on Person‐Centered Care (AGSEP,2016), person-centered care is the provision of care, based on patient’s individual needs, values and preferences with patient’s values serving as the basis of decision making ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"zBycA4OJ","properties":{"formattedCitation":"(Koren, 2010)","plainCitation":"(Koren, 2010)","noteIndex":0},"citationItems":[{"id":148,"uris":["http://zotero.org/users/local/YjWHJPzk/items/PKGTC3IQ"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/PKGTC3IQ"],"itemData":{"id":148,"type":"article-journal","title":"Person-centered care for nursing home residents: The culture-change movement","container-title":"Health Affairs","page":"312–317","volume":"29","issue":"2","source":"Google Scholar","title-short":"Person-centered care for nursing home residents","author":[{"family":"Koren","given":"Mary Jane"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Koren, 2010).
Person-Centred Care Provided to Fiona
Including the person or patient in the decision making, has been getting popular lately. The movie ‘Away from her’, portrays the practical example of person-centered care provided to the character Fiona Anderson who has been married to Grant Anderson for about forty years and chooses to live in long-term care after being diagnosed with Alzheimer’s disease ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"123pmGst","properties":{"formattedCitation":"(\\uc0\\u8220{}CBC Gem\\uc0\\u8212{}Away from Her,\\uc0\\u8221{} n.d.)","plainCitation":"(“CBC Gem—Away from Her,” n.d.)","noteIndex":0},"citationItems":[{"id":144,"uris":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"itemData":{"id":144,"type":"webpage","title":"CBC Gem - Away from Her","URL":"https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d","accessed":{"date-parts":[["2019",10,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“CBC Gem—Away from Her,” n.d.). Fiona decides to go the nursing home, ‘Meadowlake’ which does not have a good reputation in the town regarding cure and treatment of the patients as none of the patients returned to their homes recovered. Instead, all were kept in the care home with worsening symptoms and not even able to recognize their family or friends ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"123pmGst","properties":{"formattedCitation":"(\\uc0\\u8220{}CBC Gem\\uc0\\u8212{}Away from Her,\\uc0\\u8221{} n.d.)","plainCitation":"(“CBC Gem—Away from Her,” n.d.)","noteIndex":0},"citationItems":[{"id":144,"uris":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"itemData":{"id":144,"type":"webpage","title":"CBC Gem - Away from Her","URL":"https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d","accessed":{"date-parts":[["2019",10,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“CBC Gem—Away from Her,” n.d.). This section provides an insight into the type of person-centered care which was offered to Fiona in Meadowlake ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jfGOHs5j","properties":{"formattedCitation":"(Edvardsson & Innes, 2010)","plainCitation":"(Edvardsson & Innes, 2010)","noteIndex":0},"citationItems":[{"id":147,"uris":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"itemData":{"id":147,"type":"article-journal","title":"Measuring person-centered care: a critical comparative review of published tools","container-title":"The Gerontologist","page":"834–846","volume":"50","issue":"6","source":"Google Scholar","title-short":"Measuring person-centered care","author":[{"family":"Edvardsson","given":"David"},{"family":"Innes","given":"Anthea"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Edvardsson & Innes, 2010). There are some basic elements of person-centered care which should be considered while performing an analysis of care provided to Fiona. The first and most important is using relationship-based care to support a sense of self and personhood in the patient. Second is the provision of individualized activities with impactful engagement ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fN3NstaE","properties":{"formattedCitation":"(Crandall, White, Schuldheis, & Talerico, 2007)","plainCitation":"(Crandall, White, Schuldheis, & Talerico, 2007)","noteIndex":0},"citationItems":[{"id":154,"uris":["http://zotero.org/users/local/YjWHJPzk/items/5LI9M8UC"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/5LI9M8UC"],"itemData":{"id":154,"type":"article-journal","title":"Initiating person-centered care practices in long-term care facilities","container-title":"Journal of Gerontological Nursing","page":"47–56","volume":"33","issue":"11","source":"Google Scholar","author":[{"family":"Crandall","given":"Lynda G."},{"family":"White","given":"Diana L."},{"family":"Schuldheis","given":"Sherrie"},{"family":"Talerico","given":"Karen Amann"}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Crandall, White, Schuldheis, & Talerico, 2007). The third element to be considered is offering guidance to those who care for the patient. Fiona receives her own separate room for the opportunity to interact with other members. She was given the full authority of choice including medicine decision, health plan, and seeing her husband when he first left her in the nursing home. All these changes were made to provide relationship-based care.
The main components of person-centered care given by (Crandall, White, Schuldheis, & Talerico, 2007) include holistic care, choice, dignity, respect, value, determination and purposefulness. Most of these have been observed in Fiona’s case; she is determined in her decision and is respected for that ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"123pmGst","properties":{"formattedCitation":"(\\uc0\\u8220{}CBC Gem\\uc0\\u8212{}Away from Her,\\uc0\\u8221{} n.d.)","plainCitation":"(“CBC Gem—Away from Her,” n.d.)","noteIndex":0},"citationItems":[{"id":144,"uris":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"itemData":{"id":144,"type":"webpage","title":"CBC Gem - Away from Her","URL":"https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d","accessed":{"date-parts":[["2019",10,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“CBC Gem—Away from Her,” n.d.). She takes her own life and medical decision. Throughout the movie, nothing has been witnessed happening against Fiona’s will and decisions, which is a true reflection of the concept ‘person-centered care’ in long term care homes ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"123pmGst","properties":{"formattedCitation":"(\\uc0\\u8220{}CBC Gem\\uc0\\u8212{}Away from Her,\\uc0\\u8221{} n.d.)","plainCitation":"(“CBC Gem—Away from Her,” n.d.)","noteIndex":0},"citationItems":[{"id":144,"uris":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"itemData":{"id":144,"type":"webpage","title":"CBC Gem - Away from Her","URL":"https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d","accessed":{"date-parts":[["2019",10,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“CBC Gem—Away from Her,” n.d.). Letting the patient decide what he or she wants and how they want it, is the basic idea of a person-centered care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fN3NstaE","properties":{"formattedCitation":"(Crandall, White, Schuldheis, & Talerico, 2007)","plainCitation":"(Crandall, White, Schuldheis, & Talerico, 2007)","noteIndex":0},"citationItems":[{"id":154,"uris":["http://zotero.org/users/local/YjWHJPzk/items/5LI9M8UC"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/5LI9M8UC"],"itemData":{"id":154,"type":"article-journal","title":"Initiating person-centered care practices in long-term care facilities","container-title":"Journal of Gerontological Nursing","page":"47–56","volume":"33","issue":"11","source":"Google Scholar","author":[{"family":"Crandall","given":"Lynda G."},{"family":"White","given":"Diana L."},{"family":"Schuldheis","given":"Sherrie"},{"family":"Talerico","given":"Karen Amann"}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Crandall, White, Schuldheis, & Talerico, 2007). When she started to develop affection for Aubrey, her husband let her live with the man she is happy with. Therefore, Grant has been a strong component of providing person-centered care to Fiona. Instead of forcing her to part from Aubrey, he asked Aubrey’s wife to send him back to care home. He did all of this only because he wanted to see his wife happy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"123pmGst","properties":{"formattedCitation":"(\\uc0\\u8220{}CBC Gem\\uc0\\u8212{}Away from Her,\\uc0\\u8221{} n.d.)","plainCitation":"(“CBC Gem—Away from Her,” n.d.)","noteIndex":0},"citationItems":[{"id":144,"uris":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"itemData":{"id":144,"type":"webpage","title":"CBC Gem - Away from Her","URL":"https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d","accessed":{"date-parts":[["2019",10,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“CBC Gem—Away from Her,” n.d.).
Advantages
Many researchers have looked at the significance of person-centered care in long-term care homes. It has been proven helpful to people with aging conditions and dementia. It has significantly assisted in keeping people active and motivated towards the treatment and taking care of themselves ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jfGOHs5j","properties":{"formattedCitation":"(Edvardsson & Innes, 2010)","plainCitation":"(Edvardsson & Innes, 2010)","noteIndex":0},"citationItems":[{"id":147,"uris":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"itemData":{"id":147,"type":"article-journal","title":"Measuring person-centered care: a critical comparative review of published tools","container-title":"The Gerontologist","page":"834–846","volume":"50","issue":"6","source":"Google Scholar","title-short":"Measuring person-centered care","author":[{"family":"Edvardsson","given":"David"},{"family":"Innes","given":"Anthea"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Edvardsson & Innes, 2010). The patients get excitedly involved in the treatment plans when they get to choose the method of treatment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"7lmFzs9B","properties":{"formattedCitation":"(Stein-Parbury et al., 2012)","plainCitation":"(Stein-Parbury et al., 2012)","noteIndex":0},"citationItems":[{"id":155,"uris":["http://zotero.org/users/local/YjWHJPzk/items/F39N9LBW"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/F39N9LBW"],"itemData":{"id":155,"type":"article-journal","title":"Implementing person-centered care in residential dementia care","container-title":"Clinical gerontologist","page":"404–424","volume":"35","issue":"5","source":"Google Scholar","author":[{"family":"Stein-Parbury","given":"Jane"},{"family":"Chenoweth","given":"Lynn"},{"family":"Jeon","given":"Yun Hee"},{"family":"Brodaty","given":"Henry"},{"family":"Haas","given":"Marion"},{"family":"Norman","given":"Richard"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Stein-Parbury et al., 2012). Person-centered methods have also reduced the burden on health and social services. Moreover, it helps to improve people’s experience, generate positive outcomes and improves the confidence and satisfaction of the staff ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jfGOHs5j","properties":{"formattedCitation":"(Edvardsson & Innes, 2010)","plainCitation":"(Edvardsson & Innes, 2010)","noteIndex":0},"citationItems":[{"id":147,"uris":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"itemData":{"id":147,"type":"article-journal","title":"Measuring person-centered care: a critical comparative review of published tools","container-title":"The Gerontologist","page":"834–846","volume":"50","issue":"6","source":"Google Scholar","title-short":"Measuring person-centered care","author":[{"family":"Edvardsson","given":"David"},{"family":"Innes","given":"Anthea"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Edvardsson & Innes, 2010).
Disadvantages/Limitations
In contrast to above advantages of person-centered care, like any other healthcare strategy, it is also accompanied by some disadvantages. The approach is not beneficial for several types of anxiety and depression. Moreover, it is based entirely on hypothetical approaches rather than scientific knowledge which limits its credibility ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jfGOHs5j","properties":{"formattedCitation":"(Edvardsson & Innes, 2010)","plainCitation":"(Edvardsson & Innes, 2010)","noteIndex":0},"citationItems":[{"id":147,"uris":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"itemData":{"id":147,"type":"article-journal","title":"Measuring person-centered care: a critical comparative review of published tools","container-title":"The Gerontologist","page":"834–846","volume":"50","issue":"6","source":"Google Scholar","title-short":"Measuring person-centered care","author":[{"family":"Edvardsson","given":"David"},{"family":"Innes","given":"Anthea"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Edvardsson & Innes, 2010).
Suggested Improvements
The limitations highlighted above can be addressed by supporting theoretical knowledge with scientific evidence. Particularly considering Fiona, she was too young to be developing dementia or Alzheimer’s symptoms ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"7lmFzs9B","properties":{"formattedCitation":"(Stein-Parbury et al., 2012)","plainCitation":"(Stein-Parbury et al., 2012)","noteIndex":0},"citationItems":[{"id":155,"uris":["http://zotero.org/users/local/YjWHJPzk/items/F39N9LBW"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/F39N9LBW"],"itemData":{"id":155,"type":"article-journal","title":"Implementing person-centered care in residential dementia care","container-title":"Clinical gerontologist","page":"404–424","volume":"35","issue":"5","source":"Google Scholar","author":[{"family":"Stein-Parbury","given":"Jane"},{"family":"Chenoweth","given":"Lynn"},{"family":"Jeon","given":"Yun Hee"},{"family":"Brodaty","given":"Henry"},{"family":"Haas","given":"Marion"},{"family":"Norman","given":"Richard"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Stein-Parbury et al., 2012). Additionally, persons with dementia need oral health assistance. So, maintaining oral health is critical but this was not observed in the movie. Moreover, care should have been improved by stressing on the need of walking. Walking with ensured safety in a safe environment is a healthy outlet and helps to make connections for people with Alzheimer’s disease ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jfGOHs5j","properties":{"formattedCitation":"(Edvardsson & Innes, 2010)","plainCitation":"(Edvardsson & Innes, 2010)","noteIndex":0},"citationItems":[{"id":147,"uris":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/PDRUG7QX"],"itemData":{"id":147,"type":"article-journal","title":"Measuring person-centered care: a critical comparative review of published tools","container-title":"The Gerontologist","page":"834–846","volume":"50","issue":"6","source":"Google Scholar","title-short":"Measuring person-centered care","author":[{"family":"Edvardsson","given":"David"},{"family":"Innes","given":"Anthea"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Edvardsson & Innes, 2010)
All the patients at Meadowlake have been found to be kept in isolation without any social interactions. However, maintenance of social networks is crucial to promote and adopt creative measures ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fN3NstaE","properties":{"formattedCitation":"(Crandall, White, Schuldheis, & Talerico, 2007)","plainCitation":"(Crandall, White, Schuldheis, & Talerico, 2007)","noteIndex":0},"citationItems":[{"id":154,"uris":["http://zotero.org/users/local/YjWHJPzk/items/5LI9M8UC"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/5LI9M8UC"],"itemData":{"id":154,"type":"article-journal","title":"Initiating person-centered care practices in long-term care facilities","container-title":"Journal of Gerontological Nursing","page":"47–56","volume":"33","issue":"11","source":"Google Scholar","author":[{"family":"Crandall","given":"Lynda G."},{"family":"White","given":"Diana L."},{"family":"Schuldheis","given":"Sherrie"},{"family":"Talerico","given":"Karen Amann"}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Crandall, White, Schuldheis, & Talerico, 2007).
Person-centered care at Meadowlake could be improved by adding a few more activities where there are more chances of interaction with their families. A close analysis of the movie shows that Fiona had limited access to social and health services which caused an increase in her depression and anxiety ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"123pmGst","properties":{"formattedCitation":"(\\uc0\\u8220{}CBC Gem\\uc0\\u8212{}Away from Her,\\uc0\\u8221{} n.d.)","plainCitation":"(“CBC Gem—Away from Her,” n.d.)","noteIndex":0},"citationItems":[{"id":144,"uris":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/I2TZCERR"],"itemData":{"id":144,"type":"webpage","title":"CBC Gem - Away from Her","URL":"https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d","accessed":{"date-parts":[["2019",10,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“CBC Gem—Away from Her,” n.d.). One way to deal with the early disease symptoms in early ages is preventive strategies. An adequate access to social services can help to decrease the issue of dementia and Alzheimer’s in older populations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"7lmFzs9B","properties":{"formattedCitation":"(Stein-Parbury et al., 2012)","plainCitation":"(Stein-Parbury et al., 2012)","noteIndex":0},"citationItems":[{"id":155,"uris":["http://zotero.org/users/local/YjWHJPzk/items/F39N9LBW"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/F39N9LBW"],"itemData":{"id":155,"type":"article-journal","title":"Implementing person-centered care in residential dementia care","container-title":"Clinical gerontologist","page":"404–424","volume":"35","issue":"5","source":"Google Scholar","author":[{"family":"Stein-Parbury","given":"Jane"},{"family":"Chenoweth","given":"Lynn"},{"family":"Jeon","given":"Yun Hee"},{"family":"Brodaty","given":"Henry"},{"family":"Haas","given":"Marion"},{"family":"Norman","given":"Richard"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Stein-Parbury et al., 2012).
Conclusion
To conclude, it can be said that person-centred care has brought several benefits to people with older ages. It has helped to improve the quality of care for dementia patients. Including the patients in care plan, is getting increasingly popular because of its effectiveness. When people are kept involved in decision making for their treatment strategies, they follow the plan with enthusiasm which leads to favourable outcomes. The care provided to Fiona by the long-term care home is person-centred. Person-centred care has not only brought advantages to the patients but also to the healthcare systems. It has reduced the burden of care homes by giving the patient a choice. However, person-centred treatment plans are not scientifically proven and are entirely based on hypothesis. The benefits are also doubtful for the care of people with stress and anxiety. This type of care can be improved by including walk, social activities and lessening social isolation.
References
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY CBC Gem—Away from Her. (n.d.). Retrieved October 19, 2019, from https://gem.cbc.ca/media/media/films/away-from-her/38e815a-010bce5160d
Crandall, L. G., White, D. L., Schuldheis, S., & Talerico, K. A. (2007). Initiating person-centered care practices in long-term care facilities. Journal of Gerontological Nursing, 33(11), 47–56.
Edvardsson, D., & Innes, A. (2010). Measuring person-centered care: A critical comparative review of published tools. The Gerontologist, 50(6), 834–846.
Koren, M. J. (2010). Person-centered care for nursing home residents: The culture-change movement. Health Affairs, 29(2), 312–317.
Stein-Parbury, J., Chenoweth, L., Jeon, Y. H., Brodaty, H., Haas, M., & Norman, R. (2012). Implementing person-centered care in residential dementia care. Clinical Gerontologist, 35(5), 404–424.
