A person-centered road trip
Imagine the long-term care industry's shift toward person-centered care as a cross-country road trip.
Before you embark on any road trip, you have some important decisions to make. You need to choose where you're going, how you're going to get there, who you're inviting along for the journey.
The same goes for long-term care facilities refocusing their strategy to take residents' wishes and preferences into account. The industry has helped suggest a destination, with a recently released definition of person-centered care, and there are “roadmaps” out there for facilities looking to make the change.
But like any road trip, the journal to person-centered care has its roadblocks. A recent study published in Clinical Gerontologist outlines the barriers that are keeping long-term care facility staff from being able to fulfill resident preferences, ranging from the staff's own perceptions, facility characteristics, social environment and resident characteristics.
Staff member involvement is one of the biggest drivers behind making the person-centered care change, so it's no wonder that issues or hangups among staff can prevent those changes from taking place.
The study found negative perception of residents by staff, ability to accurately match a residents' stated preference, perceived lack of staff control and staff not being able to address resident's wishes in a timely manner as the top barriers to honoring residents' preferences. Residents who change their minds about previously stated preferences also threw a wrench into staff efforts to honor those preferences, researchers said.
The good news? While these roadblocks exist, the study's authors found that the majority of staff felt that understanding and honoring residents' preferences was “reasonable and the right thing to do,” even if honoring some preferences wasn't possible in certain facilities. As one worker interviewed for the study noted, “we try to satisfy preferences but we can't provide season tickets to the opera.”
The study's authors suggest communication as one of the most important tools for facilities who have hit one of these staff-centric roadblocks to person-centered care. When the the roadblock involves facility regulations or restrictions, facility staff should open up a dialogue between themselves and regulations. Facilities struggling with adopting person-centered care could also benefit from encouraging direct care staff to share the residents' preferences “across all shifts and disciplines,” researchers noted.
The road to person-centered care is a long one, paved with good intentions but filled with potential barriers and roadblocks. Staff perception can be one of the hardest to overcome, according to this latest study, but there are alternative routes and detours providers can take to get around them.
By thoughtfully planning for the road ahead, and involving all the passengers in that planning process, providers can ensure smooth sailing and a safe arrival to their ultimate destination of person-centered care.
Emily Mongan is the Staff Writer at McKnight's.