Person-Centered Care in Residential Dementia Care: Evidence into Practice

Thursday, July 14, 2011: 10:55 AM

Jane Stein-Parbury, RN, BSN, MEd, PhD1
Lynn Chenoweth, RN, BA, MA(Hons), MAdult, Ed, Grad, Cert, PhD1
Yun-Hee Jeon, RN, BHSc, (Nursing), MN, (Research), PhD2
(1)Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Lindfield, NSW, Australia
(2)Sydney Nursing School, The University of Sydney, Camperdown NSW, Australia

Learning Objective 1: The learner will be able to understand how the principles and processes of person-centered care for people with dementia can be introduced into residential settings.

Learning Objective 2: The learner will be able to appreciate that person-centered care for people with dementia requires a whole of system approach when implemented in residential settings.

The global increase in the number of people with dementia will continue to place burdens on care providers. While efforts to prevent, cure or slow the progression of dementia are underway the challenge of providing quality care remains. One method of providing quality care to people with dementia is person-centered care (PCC). Developed by Kitwood (1997), PCC challenges conventional constructions of dementia which focus on neurodegenerative changes that eventually result in the loss of ‘self’ (Davis, 2004). PCC is aimed at the preservation of the personhood of people with dementia. Grounded in a social-psychological theory of personhood PCC offsets the disabling effects of dementia through enriching the social and relational world of the person (Dewing, 2008). In residential care settings the implementation of PCC can prove challenging as it requires a whole of system approach, not just how individual carers interact with the person. In this paper we will provide a detailed description of the PCC intervention arm of a cluster-randomised study that demonstrated a reduction of agitation in persons with dementia in residential care settings (Chenoweth, et al 2009). The intervention included both training of care staff and ongoing care planning support in the settings. We credit this two-pronged approach with the success of the PCC in promoting well-being in people with dementia.

Chenoweth, L., King., Jeon, Y., Brodaty, H., Stein-Parbury, J., Norman, R., Haas, M., Luscombe, G. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurology, 8, 317-325.

Dewing, J. (2008). Personhood and dementia. Revisiting Tom Kitwood’s ideas. International Journal of Older People Nursing, 3, 3-13.

Kitwood, T. (1997). Dementia reconsidered. The person comes first. Buckingham: Open University Press.

Davis, D.H.J. (2004). Dementia: sociological and philosophical constructions. Social Science and Medicine, 58, 369-378.