Person-Centered Care

Long-term care is not really something someone thinks about until they are faced with the challenge of finding a quality long-term care facility to care for their aging or ill family member. Most of us have probably known someone who is in a long-tern facility, and most of us would never want to be placed in one due to the impression that we have about them as being dreary, dirty, smelly, and where you go to die.We have seen a change lately in reforming how people think about nursing homes and the care that is provided in them. “The culture-change movement is a broad-based effort to transform nursing homes from impersonal health care institutions into true person-centered homes offering long-term care services” (Koren, 2010). In the article Person-Centered Care For Nursing Home Residents, by Mary Jane Koren, she talks about the importance of patient-centered care and what needs to be done to help make improvements.One of those points that she talks about is when the culture-change movement began and how we got there. The Institute of Medicine published an article called “Improving the Quality of Care in Nursing Homes”, and in this article they talked about what needed to be done and the changes in regulatory policies and procedures that were necessary to help ensure that residents in nursing homes are receiving quality care. (Koren, 2010). There was some reform that was implemented after this report that helped to give some regulatory guidelines that had to be followed. The newly enacted law required that each nursing home resident “be provided with services sufficient to attain and maintain his or her highest practicable physical, mental, and psychosocial well-being”” (Koren, 2010). In implementing this they were trying to help make sure that all residents were getting quality care. This can be easier said than done. It is important that the resident has a part in the care that they are receiving. There are ways in which we can improve the direction and encompass certain traits that an ideal facility would have.One would be to give the residents choices and allow them to decide what they would like; whether it is what they wear or what time they want to go to bed. Another would be to make it like home, and not like a medical facility. You want them to feel like they were living at home, and also give them the ability to have access to food and drink just like if they were at their own home. Build relationships between the resident, the family of the resident, the staff. In building a relationship between all of these helps the resident feel more comfortable. (Koren, 2010).Another point made in this article is the awareness of the change going on within person-centered care. States are starting to adopt these changes within their own systems to help improve the quality of care that is being given. “Efforts to “rebalance” the mix of longterm care services and supports offered in institutional and community settings, coupled with Medicaid coverage for assisted living, are giving consumers alternatives to nursing homes thereby forcing traditional nursing homes to reassess what they must offer to stay competitive” (Koren, 2010).It is tough to change what you have known for so long, even though it may no longer be working. In terms of long-term care and the way it was being run is no longer a feasible way to run that system. Changes have to be adapted, but it has been slow. There has been a lag on facilities adopting these changes. In 2007, the Commonwealth Fund’s Nation Survey of Nursing Homes showed that only 5 percent of homes had completely met the description of nursing home transformed through culture change, and only 10 percent reported to initiating at least seven or more of the culture change. (Koren, 2010).There are some barriers in being able to implement person-centered care in a nursing home. Workforce, regulations, and reimbursement play a key role in nursing homes being able to initiate these culture changing practices. There is a very high turnaround in nursing homes, so it is hard to keep good help, which makes it difficult to establish close relationships with the resident and their families. Reimbursement is not very high for Medicare patients, so that means there just is not the funds to upgrade and make all changes that are needed, and regulations also make it difficult on facilities in being able to make changes.Some other person-centered care facilities would be transitional care. “Transitional care-the planning of implementation of a move between care settings-is an opportunity to focus on person-and family-centered care” (Levine & & Feinberg, 2012). You may have a patient that is moving from living on their own to going into assisted living. This is a big change for both the resident and the family because they have to accept that they can no longer live on their own.In focusing on that patient, you are helping them to feel more comfortable and important even though they have many changes going on, and letting them know that they don’t have to give up all of their independence and they do still have choices in their meals, when they can leave and go on outings. Dementia care is another example of how person-centered care can be beneficial for a patient. “Persons with dementia are at risk of being stigmatized as less than fully human” (Thornton, 2011).In this care setting they are focusing on the needs of the dementia patient, and not caring for all of them the same way. The inclusion of family is a very important part in caring for a patient with dementia. “For the person with dementia, the family is the main source of information about the individual and their life history” (Thornton, 2011). This helps the nursing home get to know who that patient was, and they can focus the care they give based on that information. It is important that changes are made in the delivery of long term care and making it more person-focused.In conclusion, we have talked about how person-centered care is changing the way that care is given, and the industry can turn its image around and provide quality person-focused care that every resident needs in order to be healthy.

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