Person-Centered Care: At the Core of Assisted Living

2010 ◽  
Vol 31 (5) ◽  
pp. 391-392 ◽  
Author(s):  
Josh Allen
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 676-677
Author(s):  
Debra Dobbs ◽  
Sheryl Zimmerman ◽  
Stephanie Miller ◽  
Paula Carder ◽  
Anna Beeber ◽  
...  

Abstract For those who provide care to the more than 40% of persons with dementia in assisted living (AL) communities, behavioral expressions (BEs) can be challenging. The objective of this mixed-methods study was to understand how AL staff conceive of BEs and what strategies they use to address them. Staff from 250 AL communities in seven states were asked to describe one successful and unsuccessful case of care. A conceptual model related to antecedents, behaviors, and consequences was developed and expanded to include staff strategies and outcomes of care; organizational characteristics associated with care practices were examined. Anxiety/restlessness, combativeness and resistance to care were the most prevalent BEs. Medical interventions (e.g., inpatient psychiatric assessment, medication management) were used in two-thirds of cases. Person-centered care was used more often in successful cases. Respondents in dementia-only communities identified antecedents to BEs more often than those in other communities.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 269-270
Author(s):  
Katherine Abbott ◽  
Kirsten Corazzini

Abstract Person-centered care (PCC) is an approach to care that both nursing homes (NH) and assisted living (AL) communities strive to provide. PCC is a philosophy that recognizes knowing the person and honoring individual preferences. However, when COVID-19 emerged, the NH and AL environments were ground zero for infection spread and disproportionate numbers of deaths among residents. As a result, many practices changed dramatically in efforts to reduce the transmission of COVID-19 in these communities. The purpose of this symposium is to discuss several projects that can speak to the impact of the pandemic on stakeholder efforts to provide PCC. First, Dr. Roberts presents feedback from residents and family members on the challenges COVID-19 created for family involvement in care conferences. In the second study, Dr. Behrens examines focus group data from direct-care nurses on their perceptions of delivering PCC related to risk of harm to staff and residents. The third study presents the voices of activities professionals who were implementing a PCC quality improvement project to communicate resident preferences, which illustrates both the importance of PCC during the pandemic, but also the challenges implementing during the pandemic. Fourth, the Kansas PEAK 2.0 program used provider feedback to direct and inform program responses through components such as consistent staffing. Finally, Dr. Zimmerman presents qualitative data from over 100 AL administrators, medical, and mental health care providers on their experiences pivoting during COVID-19. Our discussant will explore the implications of these studies in terms of the future of PCC in residential settings.


2013 ◽  
Vol 3 (2) ◽  
pp. 123-126
Author(s):  
James Appleyard

From earliest times listening to a person’s story has been the essence of the patient-physician consultation. Evidence from the literature suggests that it is the core clinical skills of communication through questioning, delineating, interpreting, explaining and discerning meaning that provide a way of bringing together the very different perspectives of patients and health professionals.These narrative skills facilitate an awareness of both health and disease and take into consideration the biological, social psychological, spiritual and pathophysiological dimensions. In this context the science of objective measurements can be successfully integrated with the art of clinical experience and judgment.


2019 ◽  
pp. 118-136
Author(s):  
Ulrik Kihlbom ◽  
Christian Munthe

The aim of this chapter is to outline how different relational aspects of families may ground obligations on the part of healthcare professionals toward patients and their families in the decision-making process. The exploration starts from the core idea within person-centered care of having patients’ general life situation, experiences, wants, and values to be a substantial topic of concern in a process of shared decision making. If relational decision-making paradigms are to be minimally functional, healthcare professionals’ stances need to involve complex schemes of including people closely related to patients, who will have to be recognized as legitimate stakeholders and partners in, as well as resources for, clinical care.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 668-668
Author(s):  
Howard Degenholtz ◽  
Candace Kemp ◽  
Doug Pace

Abstract Understanding the needs of persons living with dementia is critical to promoting quality of life and care. Co-sponsored by the Assisted Living (AL) and Research in Quality Care Interest Groups, this symposium includes four papers that present new ways to use claims data, qualitative data, benchmarking data, and intervention data to promote well-being for persons living with dementia. First, Degenholtz and Van Cleve use Pennsylvania Medicaid data from 2014-2016 to examine the provision of personal care to persons with and without dementia. They find that those living with dementia received more personal care per day across levels of physical disability and discuss implications for home and community based services policy. Next, Kemp et al. investigate meaningful engagement among assisted living residents with dementia using qualitative data collected over a one-year period in four diverse care communities. Findings show a range of engagement experiences and point to the influence of key resident, care partner, and care community influences. Third, Morgan et al. use data from a statewide probability sample of nursing home staff (n=438) to identify barriers and facilitators to person-centered care. Findings show key barriers to delivering person-centered care, including a lack of staff empowerment practices and low use of consistent assignment. Last, Zimmerman et al. present an evidence-based program, “Mouth Care Without a Battle” developed in nursing homes. Using data from over 2,000 assisted living stakeholders, they situate their findings within implementation science and the NIH Stage Model and make their findings transferable regardless of focus or setting.


Author(s):  
Yvette M. McCoy

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.


Sign in / Sign up

Export Citation Format

Share Document