Appreciating the 'person' in long-term care.

Director and Head of Person-Centred Practice Research Centre, Institute of Nursing Research, School of Nursing, University of Ulster, Newtownabbey, Northern Ireland, Professor II, Buskerud University College, Drammen, Norway, Adjunct Professor of Nursing, Monash University, Melbourne, Vic., Australia, Adjunct Professor of Nursing, University of Technology, Sydney, NSW, Australia and Honorary Professor of Nursing, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK John A. Hartford BAGNC Scholar, School of Nursing, University of Wisconsin, Madison, WI, USA Professor of Nursing, Care for Older People and Executive Director, My Home Life Programme, School of Health Sciences, City University London, London, UK, Adjunct Professor of Nursing, Care for Older People, Research Centre for Clinical and Community Practice Innovation, School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia and Visiting Professor of Nursing, Care for Older People, Institute on Aging, School of Nursing, University of Wisconsin, Madison, WI, USA Canadian Institutes of Health Research/Saskatchewan Health Research Foundation Applied Chair in Health Services and Policy Research, Professor, Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada Research Fellow, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
International Journal of Older People Nursing 12/2012; 7(4):284-294. DOI: 10.1111/j.1748-3743.2012.00342.x
Source: PubMed

ABSTRACT Background.  Internationally, approaches to the long-term care of older people are changing. New models are being developed that aim to de-institutionalise care settings, maximise opportunities for older people to participate in decision-making and move from a predominant medical model of care to one that is community orientated. Aims.  The aim of this study is to highlight similarities and differences between the different models that exist and explore the implications of these for the role of the registered nurse in long-term care. Methods.  We chose three models for review as these represent a range of views of person centredness, each having distinct roots and focus. The models chosen were as follows: (i) culture change, (ii) person-centred practice and (iii) relationship-centred care. Results.  The review highlights two key issues - (i) the distinctiveness of different models and frameworks and (ii) different interpretations of 'person'. Firstly, we identify a disconnection between espoused differences between models and frameworks and the reality of these differences. The evidence also identifies how some models and frameworks adopt a more inclusive conceptualisation of person and personhood and do not define personhood in relation to role (resident, nurse and family member). Conclusions.  There is merit in the development of models and frameworks that try to make explicit the different dimensions of person centredness in long-term care. However, the focus on the development of these, without sufficient attention being paid to evidence of best practices grounded in the concept of personhood, person-centred care is in danger of losing its original humanistic emphasis. Further, models and frameworks need to take account of the personhood of all persons. Implications for practice.  Registered nurses need to have an understanding of the concept of personhood to make sense of the various person-centred practice frameworks that exist. Without this understanding, there is a danger that the essence of personhood may be lost in the zeal to implement particular models and frameworks.

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