Person Centered Thinking & Culture Change
in Long-Term Care Facilities in NC
What is Person Centered Thinking?
"In a wide variety of settings people find themselves receiving acute or long term services and need to take positive control over what is happening with their life. Everyone seeks to have a balance in their lives between what is “important to” them and what is “important for” them (e.g., issues of health). When we find someone needs extensive care because of a disabling condition or serious illness, what is important for them often takes priority over what is important to them. Where the services are extensive and frequently intrusive, such as in nursing homes and other congregate living facilities, what is important to people can be lost."
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So often in the past, human services agencies and staff arrange for and provide services within a framework that is workable, affordable, and measurable for the agency. The person needing care was then placed within that framework instead of the framework being built around the person.
What does that mean? Consider the example of a nursing home resident needing personal hygiene care. Historically, arrangements would be made for "x" number of aide hours per day to provide hygiene care. However, in person centered thinking, those same number of aide hours would be identified and structured to provide Mr. Smith with a shower at 8 a.m. with a soap that lathers profusely with hair washed on Tuesdays and Fridays and nails clipped on Wednesdays, if needed. It's finding out that Mr. Smith has family visitors on the weekend and he likes to be clean. It's finding out that he doesn't feel that he really gets clean without a good lathering of the soap. It's asking if he prefers a sponge versus a wash cloth. It's the honoring, to the extent possible, the preferences and values of the long-term care resident. It's adjusting the mindset of human services workers to focus on the "human" versus solely the provision of a "service". It's asking; it's understanding; it's respecting; it's valuing preferences. That's what person-centered culture change is - changing the culture of provision to the culture of care.
| It doesn't have to be expensive. It doesn't have to be hard. All that is required is a willingness to ask, listen, and be flexible enough to honor personal preferences and wishes to the extent feasible within the long-term care setting. It is having all staff on board and focused on the residents as people - people deserving respect and honor as well as services. |  |
North Carolina is making strides across all avenues of services to seniors and family caregivers to ensure that services and support systems promote independence, choice, dignity, and flexibility for individuals. It's the concept of not only addressing the needs of the service providers (health, safety, measurability, liability, etc.) but also identifying and satisfying the needs of the individual receiving care (choice, personal preferences, values, respect, etc.). The goal is to improve the quality of life, on every level, for the person needing care. The expectation is that both parties will benefit. The providers will benefit from clients who are much happier and relaxed and the care recipient will benefit by retaining some level of choice and dignity and respect in a situation that, historically, has not paid attention to that aspect of quality care.
"Whether you are the person seeking services, the service provider, or manager of a helping organization, Mick Jagger’s observation, “You can’t always get what you want,” is still true. Person-centered thinking strategies don’t guarantee that everyone gets everything they want all the time. " Instead, the focus is on creating the best possible balance between what is important to individuals and what is important for their continued health and well-being. |
What is Culture Change?
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To respond to the national and state call to evolve the way services and supports are viewed and provided within long-term care facilities, training has been developed to teach facility staff how easy changing the culture of a facility can be. The expanded way of treating and responding to the needs of residents is called “Culture Change” since, it does indeed change the culture within which they live. As a part of the person-centered thinking initiatives taking place across the country, the aim is to transform nursing homes and adult care homes from institutional settings to places where residents come first and the safety and comfort of “home” is evident. The intent is to make long-term care facilities and services responsive to individual residents’ needs in environments where they can thrive instead of exist. |
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To find out more about training or to arrange for training for either Culture Change or person centered care, contact your local Ombudsman or CARES at UNC.
