Person centred care has been promoted as best practice in dementia care, but the concept is still poorly defined. Four core themes, with the acronym (VIPS), have been described by Brooker (2006):
- V –Valuing people with dementia and those who care for them
- I – Treating people as individuals
- P –Looking at the world from the perspective of the person with dementia
- S – A positive social environment in which the person living with dementia can experience relative wellbeing.
The gold standard to aim for, but difficult to achieve? The important aspect for the hospital system to consider, is the interface where the chronic and acute care sections meet. Does the acute care sector meet the needs of chronic patients and provide opportunity for maintaining their independence and personal locus of control, or are admission/discharge targets the focus of ‘quality’ care? Individuals with dementia are likely to have higher risk for complications such as delirium, pressure sores, frailty, incontinence and risk of falls. Are extra specialist resources available to support such a high risk group within an acute care admission? Can acute care be delivered outside the hospital utilising an alternative healthcare model? Is it time to reconsider how health care is and will be delivered in the future? So many important questions for the acute care sector to consider in the drive for personalised healthcare.
The acute hospital setting is reliant on standardisation and checklists, but where do they fit in with person centred care? Do they provide a minimum standard or are too generalised and miss out marginal patient populations, such as elderly with dementia? So many questions, but hopefully the below resources will assist in answering person-centred care issues for delivering focused care for dementia populations.
Free Online Understanding Dementia Course
Brooker D. (2006) Person-centred dementia care: making services better. London: Jessica Kingsley Publishers.
Nilsson, A., Rasmussen, B. H. and Edvardsson, D. (2013), Falling behind: a substantive theory of care for older people with cognitive impairment in acute settings. Journal of Clinical Nursing, 22: 1682–1691.
McCormack, B., Dewing, J., & McCance, T. (2011). Developing person-centred care: addressing contextual challenges through practice development. OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 2, Manuscript 3.
McCormack, B., Henderson, E., Wilson, V., & Wright, J. (2009). Making practice visible: the workplace culture critical analysis tool (WCCAT). Practice Development in Health Care, 8(1), 28-43.
McCormack, B., Manley, K., Kitson, A., Titchen, A., & Harvey, G. (1999). Towards practice development–a vision in reality or a reality without vision?. Journal of Nursing Management, 7(5), 255-264.
Harvey, G., Loftus‐Hills, A., Rycroft‐Malone, J., Titchen, A., Kitson, A., McCormack, B., & Seers, K. (2002). Getting evidence into practice: the role and function of facilitation. Journal of advanced nursing, 37(6), 577-588.
McCance, T., McCormack, B., Dewing, J., (May 31, 2011) “An Exploration of Person-Centredness in Practice” OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 2, Manuscript 1.
Nursing Education Network. (2017). Developing person-centred care: addressing contextual challenges through practice development.
Nursing Education Network. (2017). Practice Development in Nursing.