Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: “You Only Get Things Done When Working in Concert with Clients”

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.

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Last Place of Care and End-of-Life Quality of Life in the United States: Evidence From a National Representative Data Set

Innovation in Aging ◽

10.1093/geroni/igaa057.056 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 17-17

Author(s):

Yifan Lou ◽

Nan Jiang ◽

Katherine Ornstein

Keyword(s):

Quality Of Life ◽

Older Adults ◽

End Of Life ◽

End Of Life Care ◽

The United States ◽

Life Care ◽

Person Centered Care ◽

Centered Care ◽

The Relationship

Abstract Background: Quality of life (QoL) during last stage of life has raised expanded interests as an important aspect of person-centered care. Last place of care (LPC), refer to the last place decedents received their formal end-of-life care (EOLC), has been identified as a key indicator of older adults’ end-of-life QoL, but the relationship was understudied. This study explores the association between LPC and end-of-life QoL among American older adults. Methods: Data used seven waves of Last Month of Life data with a total sample of 3068 Medicare decedents in NHATS. Outcome is end-of-life QoL assessed by eleven measures on four domains: pain and symptoms management (SP), quality of healthcare encounter (HE), person-centered care (PC), and overall quality of care (QC). LPC was categorized into home, hospital, nursing home, and residential hospice. Multivariate logistic regression analyses were used to examine the relationship with covariates. Results: LPC varied by most demographic characteristics, except immigration status and education. Older adults whose LPC is hospital, compared to those who had home-care, were less likely to have great experiences on HE, PC, and QC. People dying at nursing homes are more likely to receive care meeting their dyspnea and spiritual needs. Residential hospice is negatively related to respected care, clear coordination, and keeping family informed, but are more likely to provide PS and spiritual care. Discussion: Home-based end-of-life care has certain advantages but still has room to improve on SP and religious concerns. Hospitals should keep reforming their service delivery structure to improve patients’ QoL.

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The COVID-19 Pandemic Reignites the Need for Person-Centered Gerontological Approach

Gerontology and Geriatric Medicine ◽

10.1177/23337214211041800 ◽

2021 ◽

Vol 7 ◽

pp. 233372142110418

Author(s):

Pamela A. Saunders ◽

Tara McMullen ◽

Sonya Barsness ◽

Andrew Carle ◽

Gay Powell Hanna

Keyword(s):

Older Adults ◽

Policy Development ◽

Geriatric Medicine ◽

Adverse Outcomes ◽

Call To Action ◽

Person Centered Care ◽

People With Dementia ◽

Care Partners ◽

National Response ◽

Centered Care

The national response to the COVID-19 pandemic pressed gerontologists to reflect, redesign, and reform services supporting older adults. Efforts to isolate a peer cohort to stabilize and maintain a standard of health had adverse outcomes and added pressure conflicting with autonomy and individual desires. In this, person-centered care emerges as a meaningful archetype to address dignity and independence. This article presents views from academics and practitioners across an interdisciplinary spectrum, arising from a webinar hosted by Georgetown University Program in Aging & Health. A description of personhood as an extension of the humanities is followed by a robust discussion of safety and autonomy for older adults during the COVID-19 pandemic. We examine the necessary commute between critical gerontological theory and the practice of humanistic gerontology. Further, this article disentangles humanism and person-centered care to balance autonomy and safety for older adults in congregate living situations and focuses on specific populations: people with dementia and their care partners. Discussion on the importance of person-centered policy development in a public health pandemic is also explored. The article concludes with a call to action for the adoption of a comprehensive person-centered care model across the fields of gerontology and geriatric medicine.

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‘Patient-Centered Care’ for Complex Patients with Type 2 Diabetes Mellitus–-Analysis of Two Cases

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s12231 ◽

2013 ◽

Vol 6 ◽

pp. CMED.S12231 ◽

Cited By ~ 4

Author(s):

Jennifer M. Hackel

Keyword(s):

Older Adults ◽

Diabetes Management ◽

Tight Control ◽

Patient Centered ◽

Treatment Approaches ◽

Person Centered Care ◽

Complex Patients ◽

Centered Care ◽

New Guidelines ◽

Primary Care Practitioners

Purpose This paper serves to apply and compare aspects of person centered care and recent consensus guidelines to two cases of older adults with poorly controlled diabetes in the context of relatively similar multimorbidity. Methods After review of the literature regarding the shift from guidelines promoting tight control in diabetes management to individualized person centered care, as well as newer treatment approaches emerging in diabetes care, the newer guidelines and potential treatment approaches are applied to the cases. Results By delving into the clinical, behavioral, social, cultural and economic aspects of the two cases in applying the new guidelines, divergent care goals are reached for the cases. Conclusions Primary care practitioners must be vigilant in providing individualized diabetes treatment where multiple chronic illnesses increase the complexity of care. While two older adults with multimorbidity may appear at first to have similar care goals, their unique preferences and support systems, as well as their risks and benefits from tight control, must be carefully weighed in formulating the best approach. Newer pharmaceutical agents hold promise for improving the possibilities for better glycemic control with less self-care burden and risk of hypoglycemia.

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