Person Centered Care . . .maybe sort of . . . not quite hitting the mark

I wish I could remember who said this and at what conference, but recently I came across it in my notes, but couldn’t figure out where it came from. If it is your thing please let me know so I can give credit . . . . An update, thanks to John Rimbach of West Living.  This idea came from Bryan Williams who did a presentation this spring at the California Assisted Living Association Annual Northern California Meeting)

You cannot go to a senior living conference without hearing multiple speakers talking about serving residents, but perhaps that is not really quite right.  Perhaps rather than, or more accurately in addition to, serving we ought to be thinking about our residents in the context of “How do we have more engagement?” 

Person-Centered Care . . . maybe sort of . . . not quite hitting the mark

I have this very ambivalent view of “person-centered care,” “person-directed care,” “culture change,” all sort of pointing to the idea that in most senior living care settings the management and staff of the community, in effect end up telling the residents what to do and how to live their lives.

Traditionally residents have to get up within a scheduled window; they have to eat at scheduled times; they have to attended a certain number of scheduled activities; they have to make their physician appointments fit within the transportation schedule of the community; they have to take a bath on the right days; and do their laundry (or have it done) on certain days and at certain times. I get it, if everything was “on demand” there could be an explosion of costs for the community, but here is the problem . . . it just does not look so much like their old life at home.

So this person-centered care thing is all about, under ideal circumstances, giving residents complete 100% control over these things and the senior community figuring out how to make that happen. 

Sounds great and yet . . . .

It ultimately still kind of looks like a parent-child role. Sure a very permissive and indulgent relationship where the indulgent parent (the senior community management) “LETS” the resident have control over all these things.

Too harsh? . . . maybe . . . just thinking here

I would like to suggest a really radical extension to person-centered care and that is that somehow we need to find time to have real meaningful engagement in three areas:

  • Staff and residents need to be friends; they need to be engaged in each other’s lives. Sure staff needs to be trained to use discretion in what they disclose about their lives but that is how we already do our social interactions. They need to know each other’s stories.
  • Staff and family members need to be friends; they need to engage in each other’s lives. They need to share their stories, their challenges, and their victories.
  • Team members need to be friends; they need to engage in each other’s lives beyond the contact they have at work. If there are no friendships that go beyond work there is likely no real friendship, no bond, in the workplace.

Why This is The Big Win

I won’t argue there are no downsides to this idea, but they are vastly outweighed by the wins. Here are a few of them:

  • Residents will be happier and they will tell their friends and family members how great you are.
  • Residents will be happier and the will be and feel healthier. This means they will require less staff time and they will live longer in your community.
  • Family members will see their loved seniors happier and healthier than ever.  They will tell their friends. When things go wrong and, from time to time they always do, family members will give you the benefit of the doubt. Solving problems will be immensely improved and the chance of being sued if things go way south will drop to just above zero.
  • Staff will love coming to work. They will stay longer, be happier and recruit new, high-quality staff for you.

How much engagement is going on in your community?