Person-centred care

Keys to person-centred care

Person with dementia

• The person’s behaviour is understood in terms of unmet needs.
• Care involves the whole person and their social, cultural and individual identity, not physical care alone.
• Each person has unique interests and life stories.
• Care includes a person’s abilities, preferences, interests, values and spirituality.

Staff providing care

• Staff–resident relationship is key.
• Staff have good information and useful ideas about individuals in their care and share them with management to develop appropriate strategies.
• Staff are in touch with their own concerns and feelings.
• All staff members can become experts in dementia care.

On-the-job person-centred care

• Non-verbal interactions: use non-verbal behaviour to show respect for a person’s individuality. Do not act as if a person with dementia cannot hear or is not present.
• Assistance with independence-oriented tasks: use verbal and non-verbal communication to begin tasks for people to complete independently.
• Conversation: make sure verbal statements support feelings of belonging and self-worth. Do not use statements that dehumanise, threaten or show disrespect.
• Personal and social interaction: use a person’s preferred name and refer to the unique details of their lives.
• Lifestyle experiences: organise life activities that refer to people’s past social roles and meet their individual needs.
• Responses to unmet need: use verbal and non-verbal strategies for people to see their immediate needs or requests will be met.
• Interaction with families: request family members’ inputs about their relative’s care, restate family members’ feelings to convey understanding, and communicate with them as valued participants (Boettcher et al., 2004).

Attitudes

• Adopting and learning appropriate attitudes are basic for people involved in dementia care.
• Value people you care for regardless of the way they act, their ability to communicate by normal means or their social skills.
• Improve quality of life for the people you care for no matter what challenges.
• Be willing to try and try again. Good dementia care is about informed trial and error and having confidence to try different approaches if needed.Learn to tolerate repetitive, apparently meaningless, irritating or even sometimes hurtful approaches from people with dementia.
• Understand that hurtful and sometimes violent behaviours are not meant. Understand when, as a carer, you have had enough and need to let someone else take over care for a while (Herbert, 1997).

Staff development role play

Role plays where a facilitator plays the part of a person with dementia can help staff learn to individualise their approaches to care around specific tasks. In the following example, staff members experience how having more information about people improves communication.

• Two participants act out their roles: a person with dementia and a staff member bathing the person.
• The staff member attempts to bathe a person without information about their unique needs and preferences.
• The staff member then describes to other participants the process and problems encountered. Guided discussion follows.
• Before attempting to bath the person again, the staff member is given an information sheet listing the person’s unique preferences and important life events.
• Now the staff member attempts to bath the person using personal information to engage and calm them.
• De-briefing allows participants to describe the ways they might use information about individuals to better interact with them.
• This leads to staff reflecting on other changes needed to improve care (Adapted from Boettcher et al., 2004).