scholarly journals Person-centred care in dementia: Philosophy and challenges in implementation

2021 ◽  
Vol 8 (1) ◽  
pp. 3-6
Author(s):  
Priya T Nandimath

Health care concept is increasingly moving away from medical, task oriented and professional driven model towards a holistic model of health care which values the needs of the persons and centred on the needs of the patients. This shift is described as person centred care. Despite the wide availability of literature, philosophy and evidence on the outcomes of the person centred care, barely it is an ideal in reality. This present article throws light on the philosophy and challenges of person centred care and tries to raise the awareness and understanding about person centred care for people with dementia and explores on the challenges underpinning person-centred care in dementia.Person centred care means, being “respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”. Each individual has unique history, personality, values, right to dignity, respect and right to participation. PCC framework emphasises on the assumptions made about the people with dementia, care givers attitude, models and care practices, factors at organisational level, cultural factors as well as structural elements such as lighting and flooring. It is a holistic philosophy across the continuum of services which takes into account the specific needs of each person. The philosophy of person centred care focuses on “the abilities and strength of the person than the losses” and on “the person than on the condition”.Lack of clarity in understanding person centred care in dementia, lack of research evidence, not valuing the views and needs of people with dementia, organisational culture, task centred care culture, lack of resources. : To improve quality of life of people with dementia and for the better functioning of the people with dementia there is a need for greater implementation of person centred care. However the challenges in the implementation of person centred care are masking the achievements and positive aspects of the person centred care approach. The challenge ahead for dementia experts is to advocate and raise the awareness and understanding and to provide evidence based solutions in practically implementing person centred care and making it more real in practice than keeping it ideal in literature.

2022 ◽  
Vol 9 (1) ◽  
pp. 56-57
Author(s):  
Jane Shulman ◽  
David Kenneth Wright

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.


2021 ◽  
pp. e1-e11
Author(s):  
Eana Meng

Failed by mainstream medical institutions, 1970s revolutionaries of color sought to take health care into their own hands. A lesser-known phenomenon was their use of acupuncture. In 1970, an alliance of Black, Latinx, and White members at Lincoln Detox, a drug treatment program in the South Bronx area of New York City, learned of acupuncture as an alternative to methadone. In Oakland, California, Tolbert Small, MD, used acupuncture for pain management following his exposure to the practice as part of a 1972 Black Panther Party delegation to China. Unaware of one another then, the Lincoln team and Small were similarly driven to “serve the people, body and soul.” They enacted “toolkit care,”—self-assembled, essential community care—in response to dire situations such as the intensifying drug crisis. These stories challenge the traditional American history of acupuncture and contribute innovations to and far beyond the addiction field by presenting a holistic model of prevention and care. They advance a nuanced definition of integrative medicine as one that combines medical and social practices, and their legacies are currently carried out by thousands of health care practitioners globally. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e11. https://doi.org/10.2105/AJPH.2020.306080 )


Liquidity ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 110-118
Author(s):  
Iwan Subandi ◽  
Fathurrahman Djamil

Health is the basic right for everybody, therefore every citizen is entitled to get the health care. In enforcing the regulation for Jaringan Kesehatan Nasional (National Health Supports), it is heavily influenced by the foreign interests. Economically, this program does not reduce the people’s burdens, on the contrary, it will increase them. This means the health supports in which should place the government as the guarantor of the public health, but the people themselves that should pay for the health care. In the realization of the health support the are elements against the Syariah principles. Indonesian Muslim Religious Leaders (MUI) only say that the BPJS Kesehatan (Sosial Support Institution for Health) does not conform with the syariah. The society is asked to register and continue the participation in the program of Social Supports Institution for Health. The best solution is to enforce the mechanism which is in accordance with the syariah principles. The establishment of BPJS based on syariah has to be carried out in cooperation from the elements of Social Supports Institution (BPJS), Indonesian Muslim Religious (MUI), Financial Institution Authorities, National Social Supports Council, Ministry of Health, and Ministry of Finance. Accordingly, the Social Supports Institution for Helath (BPJS Kesehatan) based on syariah principles could be obtained and could became the solution of the polemics in the society.


2014 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Nevin Altıntop

What is the perception of Turkish migrants in elderly care? The increasing number of elder migrants within the German and Austrian population is causing the challenge of including them in an adequate (culturally sensitive) way into the German/Austrian health care system. Here I introduce the perception of elder Turkish migrants within the predominant paradigm of intercultural opening of health care in Germany as well as within the concept of diversity management of health care in Vienna (Austria). The qualitative investigation follows a field research in different German and Austrian cities within the last four years and an analysis based on the Grounded Theory Methodology. The meaning of intercultural opening on the one hand, and diversity management on the other hand with respect to elderly care will be evaluated. Whereas the intercultural opening directly demands a reduction of barriers to access institutional elderly care the concept of diversity is hardly successful in the inclusion of migrants into elderly care assistance – concerning both, migrants as care-givers and migrants as care-receivers. Despite the similarities between the health care systems of Germany and Austria there are decisive differences in the perception and inclusion of migrants in elderly care that is largely based on an 'individual care' concept of the responsible institutions. Finally, this investigation demonstrates how elderly care in Germany and Austria prepares to encounter the demand of 'individual care' in a diverse society.


1999 ◽  
Vol 16 (2) ◽  
pp. 130-136 ◽  
Author(s):  
Sayonara Beatriz Ranciaro Fagundes

Clinical pharmacologists, neurologists, and all health care givers must consider the efficacy, safety, and side effect profile of a given antiepileptic drug when determining which drug is best for a given patient.The purpose of this study was to investigate valproic acid with a detailed analysis of the different reports.


SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983445
Author(s):  
Linda Rykkje ◽  
Oscar Tranvåg

More than 80,000 Norwegians live with dementia. Most caregivers for people with dementia are spouses, and women outnumber men. Due to an aging population, and women’s higher risk of dementia as well as men’s increased life expectancy, the number of male caregivers will rise. There are some differences in the caregiving roles of men and women. Research suggest that males report lower burden and depression than female caregivers, but some men struggle to adjust to the caregiver role, and men are less likely to access health care services. The aim of this study is to explore the experiences of husbands engaged in caregiving for their home-dwelling spouse with dementia. This knowledge will add to the growing body of research about men in the context of dementia care and may raise gender awareness. The method is qualitative interviews with hermeneutical interpretation. The participants are five husbands recruited from two Hospital Memory Clinics in Norway. The results portray how the husbands managed their everyday challenges, and how they adapted to changes, experiences of loss and bereavement, and how they redefined personal freedom and expanded their responsibilities. Acknowledging the rewards of caregiving, the husbands found their life meaningful and they were thriving in their caregiving role. Health care personnel should recognize and respect the challenging life situation caregiving husbands may experience, calling for personnel to learn from, care for, and collaborate with them, enabling the couple to live a meaningful life together at home as long as possible.


2021 ◽  
pp. 030802262110181
Author(s):  
Megan L Howes ◽  
Diane Ellison

Introduction There is recognition within the literature that the role of care-giving can have a negative impact on care-givers’ general well-being. Less is understood about the role of care-giving on an individual’s occupational participation and in turn occupational identity. Occupational therapists have a unique understanding of the interplay between occupational participation and health, though this is an area that has been under researched in relation to mental health care-givers. Therefore, the current research aims to understand how the role of care-giving for an individual with a mental illness impacts on occupational participation and identity. Method A qualitative semi-structured interview the Occupational Performance and History Interview–Version 2 was utilised to understand life experiences. Six mental health care-givers were interviewed, and these interviews were transcribed for thematic analysis. Findings Three main themes were identified: being me, roles and responsibilities associated with care-giving and services. Conclusion The findings suggest being a mental health care-giver does have a detrimental impact on occupational participation and therefore occupational identity. As care-givers gained more experience in their role, they used occupational adaption as a positive coping mechanism that helped them achieve occupational balance. Using their unique understanding of occupational participation and occupational identity, occupational therapists are well placed to utilise their knowledge and skills to work in a systemic way supporting both the person with mental illness and their care-giver.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaki Kobayashi ◽  
Mio Ito ◽  
Yasuyuki Iwasa ◽  
Yoshiko Motohashi ◽  
Ayako Edahiro ◽  
...  

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586


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