ers
- Promote change in current cultures and philosophies of care, focusing on person centred care and upholding personhood
- Creating enriching environments that reduce triggers to stress related responses and stimulate the senses
- Catering for individual specific needs, choices and preferences
- Validation of the reality of people living with dementia
- Preservation of respect and dignity with a belief that all people are of value, and are unique
- Placing importance on the continuation of life
- Prevention or minimising obvious risk
- Keeping active in body, mind and soul
- Maintenance of current strengths and independence, self-esteem and self-worth
- Conversion of ill-being to well-being with holistic care – spiritual, religious, sexual, physical, social, cultural and emotional
- Focus on building and retaining relationships and effective interaction/communication
- Promotion of continuity of community
- Preserving the individual’s privacy and confidentiality
The 4 pillars of Person Centred Care
- Uniqueness – Regardless of any medical condition, all people are unique, and this must be acknowledged
- Complexity – Humans are complex beings and a myriad of factors influence the way we see and respond to the world around us. Always consider the level/type of dementia, personality, life history, physical health status, social life etc.
- Enabling - It is all too easy for us to focus on the disability and loss associated with cognitive decline and age. We need to recognise the strengths and abilities of all people and ensure opportunities exist for them to be utilised.
- Value – Person centred care is not just about the way we interact with a person but also recognises the personhood of all people
The Person Centred Care Model
- Consistency in caregiver approach and expectations
- Continuity of past life patterns and preferences
- Respect for personal values, beliefs and worth
- Involvement in decision making
- Support in decreasing or eliminating areas that impede quality of life – maximising autonomy, independence and participation
- Relate to the person rather than the illness
The Care Environment
- Provision of an environment and experience that is enriching and meaningful
- Recognise the importance of working in partnership with family and friends of the person
- Commitment to personalised care
- Leadership by senior carers that promotes ownership of the core principles of person centred care
- Knowledgeable and consistent carers who are encouraged to be positive, creative and flexible
- Well-designed/homelike environment – avoid clutter – do not change
Creating ill being from well-being
- Rule out and resolve immediately depression/delirium
- Concise and accurate assessment/interview and specific individualised care planning
- Management of other comorbidities – eg. Pain, breathlessness, blood ppressure
- Reduce chemical restraint/use of sedatives/polypharmacy
- Abolish physical restraint
- Homelike safe environment
- Establish relationships/rapport/communication based on the person’s abilities
- Treat with respect, and dignity
- Sensory stimulation whilst ensuring over/under stimulation does not occur
- Provide praise to boost self-esteem and remove unfair expectations based on capability
- Create positive situations to experience success and feel needed, valuable and worthwhile
- Include in day to day living, but simplify activity towards need
- Rest periods/recuperation time – especially as progression of dementia occurs
- Use validation, reminiscence, memory aids
- Maintain a sense of humour – laughter is truly the best medicine – SMILE!
- Affection and touch – massage, hold hands, a cuddle, a kiss on the cheek
- Physical activity and exercise catered to needs
Examples of daily activities that are meaningful or purposeful, and not just a diversion, so as to continue life as the person knows it:
- Domestic life: baking, preparing morning tea, setting tables, wiping tables, washing dishes, folding washing.
- Outdoor life: walking, raking leaves, sweeping, gardening, feeding pets, small repair jobs, outdoor men’s