Taking a person centred approach to care
What does this mean?
You might hear this phrase referred to in relation to the dementia patient’s care, so what does it mean in practise for the patient? Person centred care involves a lot of getting to know the person who has dementia. Because so much of dementia is about memories and at times their care may involve tapping into past events, using photos or music to try and identify ways in which their memories can be stirred or evoked.
The person centred approach to dementia care considers the patient at the heart of the care plan. It uses information known about the patient such as their interests, their history and it ensures that the care remains centred around them, supporting their needs with compassion and focussing on the patient and not around the disease. This helps to ensure that the care received by the dementia patient is tailored to their needs and that the person is treated with respect, with dignity as their condition progresses. The care that they will receive takes into account them, their enjoyment and has a broader reach. Although we talk about dementia and its causes and effects, the range of symptoms felt by a patient can vary at different times and no two patients are the same. The effects of the illness as it progresses can have a big impact on the person involved and can be a frightening time for them as the illness takes hold.
By embarking on a person centred care approach, the patient’s care will centre on care that supports their own likes, dislikes and activities that they enjoy taking part in. It also helps care professionals and their care team to get to know them as a person. They can identify ways in which to engage with the patient and to talk to them about their history. They may be able to identify activities that they can enjoy taking part in. It might be the information that they need to help them to support the dementia patient on a particularly difficult day. It could hold the answers to calm them if they are having a particularly anxious day, or they are starting to react at particular times of the day.
Person centred care approaches require gathering a lot of information and asking questions about the patient but this information will be used to form the basis of their care. By adopting this approach it makes the care programme for the patient, all about the patient and less about the illness. Given that dementia impacts people in different ways it makes more sense to focus on what can be done to give that individual person enjoyment, and help them to feel better, than focussing solely on their dementia diagnosis, which has a place but less so.
Why take a patient centred approach?
By creating a care plan for a dementia patient that takes a person centred approach, the dementia patient feels involved in the decisions that are being made about their care. They feel like they can rightly so, make a decision as to where they receive their care when they are capable of having an input to those decisions. It also considers those who may be providing the care such as family members who operate as carers.
The idea of a patient centred approach is to focus on the element of compassion, understanding that the care plan is based around a person, their family and carers, not, on the illness, with clinical steps. Therefore the care plan takes into account alternative therapies that can support the dementia patient, such as music therapy, or wellbeing activities like yoga.
By understanding as much information as possible about the patient, the care plan is able to focus on the patient with an understanding of them, their life, history and to support them to enjoy a good care structure, whether that is within the home, or later on, in a cared for environment.
What are the benefits of a patient focussed care in dementia
Primarily this is about supporting the patient and making them feel like they are involved in their care plan. It acknowledges their needs, their requirements and their likes and dislikes. It’s the opposite of square peg, round hole. Because of the complexities that surround dementia and the nature of the disease, understanding the patient and their past, as well as their likes can help with delivering all round care. Say for example, a dementia patient is becoming distressed, knowing the types of music that the patient likes, will enable the care team to identify music to play which may help calm the anxious patient. By knowing their history, family members or having access to pictures, then the carer has the ability to talk through photos with the dementia patient and create a calm environment for the patient, which focuses on happy memories. This again helps to keep the dementia patient settled and calm and providers and different perspective for care through the complexities of dementia.
Summary
In order to support the dementia patient and to reduce their level of anxiety and other associated complexities from the disease, taking a patient centred approach enables a more personalised care plan which resonates with the individual. The benefits include a happier patient, and the care team will have access to more tools to support them should the patient become distressed and it helps the patient not to feel isolated. For the dementia patient, as the disease takes hold, they start to lose their independence and can endure some frightening moments. Being supported with a care plan that has focussed on them, the care team can use the knowledge of that patient to aid in their patient care.
