Person-Centered Care: Overview, Strategies, and Standards
Introduction
The person-centered care (PCC) approach has been gradually receiving more attention both in the academic and clinical fields of medicine. In general, this concept refers to the treatment that focuses on the patient as an individual with unique needs, wishes, and beliefs (Santana et al., 2017). The conceptual framework has demonstrated immense results in improving patient satisfaction, the quality of the provided services, and creating a supportive environment (Santana et al., 2017). From these considerations, many healthcare organizations are shifting toward the PCC approach, emphasizing the patients’ needs and values (Güney et al., 2021). The current paper examines the underlying principles of the PCC treatment, analyzes three prominent PCC strategies, and provides reflection thoughts on the framework.
Person-Centered Care Overview
As derived from the name, the most fundamental element of the PCC approach is an emphasis on the values and needs of the individual. While it was first titled ‘Patient-Centered Care,’ the new term better represents the core components of the framework and focuses on the unique personality of each individual (Moody et al., 2018). Canadian healthcare, in particular, has been focusing on the PCC approach over the last twenty years and is currently ranking PCC as the highest priority in treatment (Moody et al., 2018). Consequently, experts emphasize four primary process domains that are necessary for the PCC framework: cultivating communication, respectful care, engaging patients in treatment, and integration of care (Santana et al., 2017). These factors facilitate the nurse-patient relationship, improve the satisfaction of all stakeholders, and create a supportive environment in long-term care facilities (Santana et al., 2017). Ultimately, the PCC framework is a highly effective healthcare approach that is gradually becoming more prominent in Canada.
Person-Centered Care Strategies
Nevertheless, many patients are dissatisfied with PCC treatment primarily due to the nurses’ lack of understanding and specific competencies needed for the framework. From these considerations, it is essential to discuss the practical implications and strategies that clinical nurses can implement in their work following the PCC approach. The first idea concerns the establishment of respectful communication with the patients. The people in residential homes need to feel nurses’ attention and caring treatment to mitigate their feelings of loneliness and discomfort (Santana et al., 2017). As seen from the article by Donnelly and MacEntee (2016), elderly patients underline the lack of a caring environment as the primary concern of treatment in long-term care (LTC) facilities. The respondents also highlight the fact that some nurses seem to heavily dislike their jobs and the concept of service to people (Donnelly & MacEntee, 2016). From these considerations, the first strategy in the PCC approach is to focus on respectful communication and the perception of patients as unique individuals with diverse needs.
The second recommendation concerns cooperation between nurses and patients in care management. Engaging patients in the recovery process, co-designing of care plans, and shared-decision making can significantly facilitate the relationship between clients and healthcare providers (Santana et al., 2017). Furthermore, the nurses should consult patients to better understand the goals of the treatment and select the most appropriate therapy methods (Santana et al., 2017). As a result, cooperation facilitates the four process domains of the PCC framework, leading to increased productivity and efficiency of the treatment (Santana et al., 2017). As mentioned briefly before, the core concept of PCC is an emphasis on the person’s needs and values, and engaging with patients helps them feel a sense of belonging and a caring environment. Thus, when the resident feels involved in the treatment process, it improves the quality of PCC.
Lastly, nurses should be adequately prepared to work in long-term care facilities and be knowledgeable about various diseases and health complications of elderly people. Ultimately, in Canada, approximately 93% of people in residential homes are older adults, and many of them are diagnosed with age-related dementia (Thompson et al., 2018). Consequently, it implies that nurses should be patient, compassionate, and prepared to provide services to elderly people despite the possible difficulties associated with their medical conditions (Thompson et al., 2018). The respondents in the article by Donnelly and MacEntee (2016) transparently convey their concerns that some nurses are reluctant to communicate due to their discontent with the job. Therefore, the last recommendation to the nurses would be to thoroughly assess their objectives and decide whether they are ready to work in a residential home following the PCC treatment. Ultimately, reflection on one’s own strengths and weaknesses is an effective strategy that would help nurses become better professionals in the PCC framework.
Standards of Practice
The regulated standards of practice governed by the Canadian Gerontological Nursing Association are essential to comprehensive PCC treatment. The two most notable recommendations include relational and ethical care (CGNA, 2020). The former underlines the importance of the nurse-patient social relationship, which is central to PCC (CGNA, 2020). The guidelines emphasize, “Gerontological nursing is a humanistic enterprise in which reciprocal communication and respectful interactions <…> are foundational to the provision of high-quality care” (CGNA, 2020, p. 12). In other words, the first standard of practice corresponds to the primary process domains of the PCC treatment and implies the establishment of respectful communication between the nurse and the individual.
The second standard is ethical care, which is an underlying foundation of medicine and governs all processes in healthcare services. It implies that nurses should always be aware of ethical concerns, be respectful of older adults’ rights and needs, and understand the moral context of provided services (CGNA, 2020). This standard is essential to healthcare in general; however, working with older adults would require even more patience and empathy from the nurses. As mentioned before, a large number of residents in long-term care facilities have associated medical conditions, such as age-related dementia. From these considerations, ethical care is highly significant to maintaining the dignity and sufficient quality of life of the patients.
Reflection and Conclusion
As seen from the article, many responses from elderly patients include negative remarks about the lack of a caring environment and the prevalence of inappropriate treatment. Personally, I was disturbed by the terrible conditions in the long-term care facilities described in the article. Specifically, the loss of human dignities, such as being dragged half-naked in front of other patients, seems like a concept opposite to the PCC values. I would never want my close people or myself to experience similar treatment regardless of the medical condition. Personally, I agree with the values of the PCC treatment and plan to adjust my practice according to the framework. After learning about the unacceptable therapy in the article, I am even more convinced that the PCC values are necessary for contemporary healthcare and allow people to maintain dignity and high quality of life. Ultimately, I will adjust my practice according to the PCC framework and make sure that the patients get relational and ethical care.
References
Canadian Gerontological Nursing Association. Gerontological nursing standards of practice and competencies (4th edition, 2020). Web.
Donnelly, S., & MacEntee, M. I. (2016). Care perceptions among residents of LTC facilities purporting to offer person-centred care. Canadian Journal on Aging, 35(2), 149-160.
Güney, S., Karadağ, A., & El-Masri, M. (2021). Perceptions and experiences of person-centered care among nurses and nurse aides in long term residential care facilities: A systematic review of qualitative studies. Geriatric Nursing, 42(4), 816-824.
Moody, L., Nicholls, B., Shamji, H., Bridge, E., Dhanju, S., & Singh, S. (2018). The person-centred care guideline: From principle to practice. Journal of Patient Experience, 5(4), 282-288.
Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person‐centred care: A conceptual framework. Health Expectations, 21(2), 429-440.
Thompson, G., Shindruk, C. L., Adekoya, A. A., Demczuk, L., & McClement, S. (2018). Meanings of ‘centredness’ in long-term care facilities: a scoping review protocol. BMJ Open, 8(8), e022498.