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The Growing Demand for Person-Centered Home Care

  • Aug 23, 2017
  • Karen Carney
  • 7-min Read

Quiz: How Do You Measure Up?

Denise Logeland found out first-hand that a lot needs to change in the US to create true person-centered care. Her blog “When Health Care Ignores Your Goals” for Next Avenue shared her 83 year-old mom’s experience being discharged from the hospital. “Nobody asked my mom what mattered to her as a patient, not at the hospital and not at the transitional care unit of the nursing home where she spent a week getting physical therapy. That’s not unusual,” she writes. “Not asking is still the norm.”

In fact, as Denise researched the term ‘person-centered care’ she found more marketing-speak than actual practice. Senior living providers said they provided ‘person-centered care’ by offering in-house coffee shops or movie theatres. But that’s not really person-centered care by most people’s definition.

And home care and other community-based providers may spend time learning a senior’s preferences, hobbies, and interests but do little to build those into becoming core elements of the care plan.

What is person-centered senior care?

According to the American Geriatrics Society expert panel that was convened in 2015 to draft a definition of ‘person-centered care’ the term means that ‘individuals’ values and preferences are elicited, and once expressed, guide all aspects of their health care, supporting their realistic health and life goals.”

Seniors want to be seen for who they are – not their diagnosis, their condition, or their limitations. And most older people want to live, not simply exist. While the American Geriatrics Society outlined the essential elements of person-centered care for older adults, Lifespark believes we need to take it even further and use a whole person approach.

“I tell my clients you are not defined by your diagnosis,” explains Mary Claire O’Brien, RN, Lifespark Life Care Manager (LCM). “That diagnosis only tells me one part of your health story, never mind your whole life story and what you want. We have to have that fuller picture to help people make good choices for themselves. Just looking at a person’s health alone sells them short – they are so much more than that.”

[Are you patient-centered enough? Take the quiz below.]

A growing shift in focus for senior care

The rise in the use of the term actually reflects a growing awareness that health and senior care options have been far too focused on a person’s diagnosis than on what is really important to the individual. And consumers of all ages are demanding a more personalized approach – in home care, senior living, transitional care, and hospitals, too. In fact, there is a push toward more focus on wellbeing than the traditional ‘sick care.’

At Lifespark, we believe that people deserve a whole person approach that starts from the moment they connect with Lifespark services, and the approach needs to be ingrained in all we do. We also consciously choose not to use the terms ‘patient-centered care’ or ‘patient’ because we understand the power of language and feel the word ‘patient’ lacks the sense of collaboration that should occur between the professionals and the client.

“By listening and communicating reflectively on what we have heard from the client and the family, we are then able to focus holistically on the client’s needs AND wishes,” says Julie Flanagan, RN, a Campus Director of Life Care for Lifespark. “Clients and families are reassured when they know their LCM understands the client’s wishes because they then know the LCM will focus on what is best for the client regardless of where the client lives or which services are involved.

“Using a proactive approach,” Julie adds, “ideally gives us a chance to develop a relationship,w enabling us to learn about and discover a client’s preferred lifestyle choices. By being able to understand their desires, abilities, ideals, preferences, values and capabilities, our LCMs – our nurses – can then easily relate and individualize each client’s plan based on what is realistic and attainable within a client’s lifestyle.”

It is easy to get caught up in the tasks that we as health care professionals are required to do with and for our clients. Much of that is defined by reimbursement and constrained by short timeframes and limited episodes of care.

However, as Mary Claire sees it, we need to break through those limitations and find ways to be person-centered in our practice. Seeing through the clients’ eyes is the first step. “There’s more a person wants for their life than just the diagnosis and our goal is always to work through those issues that are stumbling blocks, if we can, to allow time to focus on other aspects of who they are,” she admits.

When a person comes out of the hospital, that person feels defined by lab results and diagnoses, medications, etc. “To me,” Mary Claire continues, “it’s so important to dig deeper than that to learn who that person is and what they want, how they view this stage of their life, and trying to figure out how they achieve some of those goals. We’re not going to ignore health issues and pursue something tangential but it is important to figure out the balance of what’s most important to that person.”

Because the Lifespark model digs deeper into people’s goals and personal priorities, people become more engaged in the Life Plan implementation because they see it leading to goals they care about, which leads to better success. And Lifespark uses that discovery process with all Lifespark services regardless of whether it is short-term Medicare-certified home health or longer term private-pay.

“That feeds directly into people maintaining control over their life,” Mary Claire stresses. “A health crisis is a perfect example of how you can feel out of control of your own life, or even if you are a family member acting on behalf of a loved one, you can feel your life derailing your own priorities too.”

Person-centered goals and a plan developed to achieve those goals go a long way toward resetting the balance and control in life for seniors and their families.

Take the quiz:

So, are you person-centered enough? We all have room to improve, and you can use this quiz to screen referral partners as well.

1. Does your language reflect your desire to be person-centered? For example, how often are terms like ‘non-compliant’ used?That’s a provider-centric term, not person-centered. What about other words like ‘patient’ or ‘the diabetic’?

2.  Name 3 examples of person-centric actions you take every day.

3.  Name 3 examples of barriers to person-centric care at your organization. And what can you do about them?

4. How is a person-centric approach built into your company’s/department’s model of care:

a. Training and education for staff members emphasizes and demonstrates person-centric care. For example, written materials AND actual processes use a person-centric approach.

b. The care plan is based on the senior’s goals and preferences, and is continually reviewed and updated.For example, how does the care plan balance what is convenient for the senior vs. your team with respect to visit times and office hours? What happens when the care plan goals conflict with the person’s goals? How are issues of client autonomy and safety addressed?

c. A primary point of contact and coordination is established for the senior.For example, there is one go-to person whom the senior and family can contact and who coordinates all the senior’s care. How comprehensive is that person’s role?

d. Performance measurement and continuous improvement reflect and inspire person-centric philosophy. For example, how is senior and family feedback used to improve the person-centric approach? What person-centered criteria are uses to evaluate team member performance?

e. Decisions on preferred providers and community resources use person-centric criteria.For example, how does your company evaluate referral partners? How much is a person-centric approach weighted in those decisions?

We want to hear from you. What are you and your organization doing to become more person-centric?

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