It’s time to take the pulse of person-centered care.
By Steve Moran
I started my career in senior living in the mid-1980s looking at supportive environments for people living with dementia. This pre-dated the days of “SCUs” (Special Care Units”), when there were just a handful of communities proactively addressing how to provide a good and supportive care setting for individuals who, back then, we referred to as “the demented.”
We believed they had “unique” needs that were different from the rest of the folks living in nursing homes or assisted living. There were a handful of researchers, academicians and providers who suggested a number of therapeutic goals for individuals living with dementia, including personalization, continuity of self, social contact, control, support for functional abilities, privacy, safety and security.
When I look back, what I see is how far we have come. We recognize that individuals living with dementia are individuals and they retain their personhood, just like everyone else. And, everyone wants and deserves those same “therapeutic goals” — these aren’t unique to dementia, but apply to everyone. So we moved from SCUs and DCUs (Dementia Care Units) to the concepts of Person-Centered Care (PCC), where every individual has a right to:
Express their preferences and have those preferences honored
Participate deeply in decision-making and planning, not only for care but daily life
Have staff consistently serve and support the same residents so meaningful relationships can develop
Live in a place that looks and feels more like a home than a hospital
Even hospitals have gotten on the bandwagon, and are focusing on “patient-centered care.”
When I look around today, I see some care communities that have completely reorganized, rebuilt and restructured to further the goals of person-centered care. And others that are deeply committed to adopting the principles and values of Person-Centered Care, but within the confines of an “Old School” building design.
There are some communities that are just dabbling around the corners, doing the bare minimum and still convinced that good clinical care and safety trump quality of life. I disagree, and more importantly, CMS disagrees. Anyone who read their proposed rule changes can clearly see that within a few years, the minimum standards are going to be even more person-centered. I applaud CMS for their continuing efforts.
Are We Really Making A Difference?
But how far have we—as an industry—come?
In 2007, the Commonwealth Fund sponsored a national survey to assess the culture changing practices of Person-Centered Care in nursing homes across the US. Their results showed that a majority of care communities were aware of the concepts embedded in PCC and that increasing numbers of care communities were adopting some PCC practices, but that deep adoption was still rare.
It’s been almost a decade, and many factors are contributing to increase the adoption of PCC Practices, including changes to the CMS Interpretive Guidelines and several of the Advancing Excellence goals. It is, once again, time to take the pulse of Person-Centered Care as well as explore newer concepts and practices that have gained traction within the senior residential and care industry.
To this end, and in the absence of a formal mechanism to measure the degree and trajectory of change, The Rothschild Foundation, in collaboration with Perkins Eastman, the IDEAS Institute, and The Beryl Institute, has developed the 2015 State of the Art of Person-Centered Care Survey based on the Commonwealth Fund Culture Change study a decade ago.
I urge all care community to go to www.IDEASInstitute.org/2015PCCSurvey and spend about 30-40 minutes letting us know where you are in relation to the practices associated with Person-Centered Care. The survey will only be available online for only a short time longer – so don’t delay. Please, just do it now.
You can expect to see some preliminary results from this survey in the first quarter of 2016.