Person-Centered, Skilled Services Using a Montessori Approach for Persons with Dementia

2018 ◽  
Vol 39 (03) ◽  
pp. 223-230 ◽  
Author(s):  
Jennifer Brush ◽  
Michelle Bourgeois ◽  
Natalie Douglas
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Health Outcomes ◽  
Health Care System ◽  
Advisory Board ◽  
Person Centered Care ◽  
Centered Care ◽  
Person Centered Approach ◽  
International Advisory ◽  
Skilled Person

AbstractThe current mandate for person-centered care throughout the health care system, and especially in the nursing home industry, requires that speech–language pathologists ensure that the services they provide to elders with dementia are skilled, person centered, and relevant to positive overall health outcomes. Guidelines developed by the Association Montessori International Advisory Board for Montessori for Aging and Dementia are one avenue toward such skilled and person-centered services. The purpose of this article is to provide clinicians with practical strategies for guiding their assessment, goal writing, and intervention plans to meet the expectations of a person-centered approach to services for elders with dementia, using the Montessori approach as a philosophical guide.

The Distinct Value of OT: Examination of Person-Centered Care in Practice

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510251p1-7512510251p1
Author(s):  
Elizabeth Jayne Braun ◽  
Erin Casey Phillips ◽  
Hannah Corner ◽  
Shayla Murphy ◽  
Alayna Pullara ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Capacity Building ◽  
Evidence Based ◽  
Person Centered Care ◽  
Centered Care ◽  
Person Centered Approach ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Health care is shifting from volume to value, and there is a need to define the distinct value of services. OT is founded on the principles of person-centered care, and the intentional use of these strategies must be part of evidence-based outcomes in order to solidify the value of OT services. This study examined the use of person-centered care in clinical practice, and results were used to develop capacity-building strategies for implementation of a person-centered approach. Primary Author and Speaker: Elizabeth Jayne Braun Additional Authors and Speakers: Erin Casey Phillips, Hannah Corner Contributing Authors: Shayla Murphy, Alayna Pullara, and Nathan Kies

scholarly journals From protocolized to person-centered chronic care in general practice: study protocol of an action-based research project (COPILOT)

2019 ◽  
Vol 20 ◽  
Author(s):  
Mieke J.L. Bogerd ◽  
Pauline Slottje ◽  
Francois G. Schellevis ◽  
Anneliet Giebels ◽  
Mieke Rijken ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Chronic Diseases ◽  
Person Centered Care ◽  
Care Approach ◽  
Centered Care ◽  
Person Centered Approach ◽  
The Impact ◽  
Multiple Chronic Diseases

AbstractAim:To develop a proactive person-centered care approach for persons with (multiple) chronic diseases in general practice, and to explore the impact on ‘Quadruple aims’: experiences of patients and professionals, patient outcomes and costs of resources use.Background:The management of people with multiple chronic diseases challenges health care systems designed around single disease. Patients with multimorbidity often receive highly fragmented care that may lead to inefficient, ineffective and potentially harmful treatments and neglect of essential health needs. A more comprehensive, person-centered approach is advocated for persons with multiple morbidities. However, examples on how to provide more person-centered care and evidence of its impact are scarce. A group of Dutch general practitioners (GPs) took the initiative to develop such a care approach.Methods/Design:Mixed methods with a development and pilot-testing phase. The proactive person-centered approach will be developed using an action-based research design consisting of multiple plan-act-observe-reflect-adjust cycles. In each cycle, experiences of patients and primary care professionals from 13 practices will be collected via interviews, observations and focus groups. Starting point for the first cycle is a ‘person-centered consultation’ of up to 1 h in which the GP discusses the health status and health care needs of the patient. Furthermore, shared decisions between GP and patient are made on treatment goals and follow-up. In the pilot-test phase, a nested case cohort study allows to explore the impact of the new approach on ‘Quadruple aim’ outcomes comparing persons with and without exposure to the new care approach.Discussion:This study will provide a proactive person-centered approach for persons with multimorbidity in primary care and estimate its potential impact on quadruple outcomes.

scholarly journals Health Care Preferences Among Nursing Home Residents: Perceived Barriers and Situational Dependencies to Person-Centered Care

2015 ◽  
Vol 42 (2) ◽  
pp. 11-16 ◽  
Author(s):  
Lauren R. Bangerter ◽  
Katherine Abbott ◽  
Allison R. Heid ◽  
Rachel E. Klumpp ◽  
Kimberly Van Haitsma
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Perceived Barriers ◽  
Person Centered Care ◽  
Centered Care ◽  
Health Care Preferences

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

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.

scholarly journals Using an Interactive App for Symptom Reporting and Management Following Pancreatic Cancer Surgery to Facilitate Person-Centered Care: Descriptive Study

10.2196/17855 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e17855 ◽  
Author(s):  
Tina Gustavell ◽  
Kay Sundberg ◽  
Ann Langius-Eklöf
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Self Care ◽  
Symptom Burden ◽  
Symptom Reporting ◽  
Activity Levels ◽  
Care Needs ◽  
Person Centered Care ◽  
Centered Care ◽  
Care Activity

Background Pancreatic and periampullary cancers are rare but have high mortality rates. The only hope for cure is surgical removal of the tumor. Following pancreatic surgery, the patients have a great deal of responsibility for managing their symptoms. Patients report a lack of sufficient knowledge of self-care and unmet supportive care needs. This necessitates a health care system responsive to these needs and health care professionals who pay close attention to symptoms. Person-centered care is widely encouraged and means a shift from a model in which the patient is the passive object of care to a model involving the patient as an active participant in their own care. To address the challenges in care following pancreatic cancer surgery, an interactive app (Interaktor) was developed in which patients regularly report symptoms and receive support for self-care. The app has been shown to reduce patients’ symptom burden and to increase their self-care activity levels following pancreaticoduodenectomy due to cancer. Objective The aim of the study was to describe how patients used the Interaktor app following pancreaticoduodenectomy due to cancer and their experience with doing so. Methods A total of 115 patients were invited to use Interaktor for 6 months following pancreaticoduodenectomy. Of those, 35 declined, 8 dropped out, and 46 did not meet the inclusion criteria after surgery, leaving 26 patients for inclusion in the analysis. The patients were instructed to report symptoms daily through the app for up to 6 months following surgery. In case of alerting symptoms, they were contacted by their nurse. Data on reported symptoms, alerts, and viewed self-care advice were logged and analyzed with descriptive statistics. Also, the patients were interviewed about their experiences, and the data were analyzed using thematic analysis. Results The patients’ median adherence to symptom reporting was 82%. Fatigue and pain were the most reported symptoms. Alerting symptoms were reported by 24 patients, and the most common alert was fever. There were variations in how many times the patients viewed the self-care advice (range 3-181 times). The most commonly viewed advice concerned pancreatic enzyme supplements. Through the interviews, the overarching theme was “Being seen as a person,” with the following 3 sub-themes: “Getting your voice heard,” “Having access to an extended arm of health care,” and “Learning about own health.” Conclusions Interaktor proved to be well accepted. It made patients feel reassured at home and offered support for self-care. The app facilitated person-centered care by its multiple features targeting individual supportive care needs and enabled participation in their own care. This supports our recent studies showing that patients using the app had less symptom burden and higher self-care activity levels than patients receiving only standard care.

scholarly journals Management strategy of healthcare organizations. PDRQ–9 method

2021 ◽  
pp. 243-248
Author(s):  
Ch. E. Karibdzhanov
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Research ◽  
New Paradigm ◽  
Healthcare Organizations ◽  
Patient Centered ◽  
Brief Assessment ◽  
Centered Care ◽  
Physician Relationship ◽  
Care System

The main source of success for a customer-centric organization is the ability to identify its customers, identify their needs, and use that information to develop a customer-centric strategy. In this regard, there is a widespread change in attitudes toward the construction of management in organizations. Whereas previously the competitiveness of an organization could be measured by its financial performance, now the intellectual potential of an organization is at the forefront. As the role of the patient in the health care system has intensified, the importance of patient participation has received increasing attention and has become central to health care research. In this regard, in today’s environment, the foundation of success in the treatment and delivery of professional care in medicine is primarily the degree of patient satisfaction. Patient-centered care acts as a new paradigm for the development of the health care system, which is characterized by a shift in the center of gravity to the patient. In this regard, in the field of health care, the relationship between the patient and the doctor, as perceived by the patient, is one of the main elements of the methodology of scientific research. The purpose of this article is to review and analyze the results of the PDRQ–9, which assesses the patient-physician relationship. The PDRQ–9 provides researchers with a brief assessment of the therapeutic aspects of the patient-physician relationship in the primary care setting. It is a valuable tool for research and practice purposes that includes monitoring the patient-doctor relationship.

The impact of person-centered care on residents' perceptions of care quality in nursing homes: an intervention study

2018 ◽  
Vol 7 (2) ◽  
pp. 118-124
Author(s):  
Vigdis Abrahamsen Grøndahl ◽  
Liv Berit Fagerli ◽  
Heidi Karlsen ◽  
Ellen Rosseland Hansen ◽  
Helena Johansson ◽  
...  
Keyword(s):  
Nursing Home ◽  
Intervention Study ◽  
Care Quality ◽  
Legal Rights ◽  
Nursing Home Administrators ◽  
Person Centered Care ◽  
Before And After ◽  
Centered Care ◽  
The Impact ◽  
Perceptions Of Care

Background: The quality of care offered to older people is still poor. Nursing home administrators often claim that they provide person-centered care, but research indicates that institutional goals take precedence. Aim: The aim was to explore the impact of person-centered care on residents’ perceptions of care quality.  Methods: An intervention study was conducted in one nursing home (41 residents). Person-centered care was operationalized into the interventions: greeting the resident on each shift, one-to-one contact (resident – carer) for 30 minutes twice a week, informing the residents continuously about changes in medication, and informing the residents about their legal rights at admission and three months after admission. The interventions were systematically conducted for 12 months. Face-to-face interviews using the Quality from Patient’s Perspective (QPP) questionnaire were conducted both prior to interventions and immediately after the 12-month period. Descriptive and comparative statistics were used to test for differences between care quality perceptions before and after intervention (p ≤ .05). Results: The residents rated all four quality dimensions (caregivers’ medical-technical competence and identity-oriented approach, care organization’s socio-cultural atmosphere, and physical-technical conditions) more highly after the 12-month period, and the socio-cultural atmosphere was rated significantly more highly. At item level, 44 items received higher scores, and, among them, significantly higher scores were given to 6 items. One item received a significantly lower score. Conclusions: Residents’ perceptions of care quality increase when person-centered care is operationalized and takes precedence over the ward’s routines or is part of the ward’s routines. The results indicate that it is possible to design a care system where the residents are at the centre of the health care offered.

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