Culture change towards person centred care
Person centred care of people with dementia living in care homes: Executive summaryCurrently, over 500,000 people are living with dementia in Canada. More than 60% of them have Alzheimer’s disease. The 2010 Alzheimer Canada report Rising Tide: The Impact of Dementia on Canadian Society predicts that as baby boomers age, the number of people with dementia in Canada will rise steeply, so that by 2038 over a million Canadians will have dementia. This will have a profound impact on many aspects of Canadian society.
Dementia is a syndrome consisting of a number of symptoms that include a reduced ability to perform familiar tasks, impairment of memory, judgment and reasoning, and changes in mood and behaviour.
Some dementias are caused by treatable conditions such as depression, thyroid disease, infections or drug interactions. However, treatments to cure the disease are not yet available for the progressive, irreversible, dementias in which nerve cells in the brain become sick and eventually die. Because there is no cure, the focus of care for people with dementias like Alzheimer’s disease has been on supporting individuals and their caregivers throughout the course of the disease.
The Alzheimer Society believes that people with dementia have the right to enjoy the highest possible quality of life and quality of care. The Society believes that each person with dementia is an individual, regardless of the stage of the disease, and that care should be individually tailored to their unique needs, interests, habits and desires. To achieve this goal, the Alzheimer Society of Canada looked for evidence-based research that shows how to successfully implement person-centred programs and practices in long-term care homes. The result of this research is the Guidelines for Care: Person centred care of people with dementia living in care homes framework, which includes the input of people with dementia, family caregivers, researchers, educators, long-term care home staff, and various stakeholders.
We have developed the Guidelines for Care framework to ensure that people with dementia are engaged in meaningful relationships, based on equality, understanding, sharing, participation, collaboration, dignity, trust and respect.
The Alzheimer Society hopes that this framework will influence the culture of care homes and encourage care home staff to recognize the individuality of people with dementia in the following ways:
- Ensure that people who work in care homes understand what a person-centred philosophy of care means and are able to practice it.
- Make sure that relationships and interactions with people with dementia are respectful.
- Focus on maintaining, supporting, and/or restoring the independence of the person living with dementia.
- Develop strong bonds with family members of people with dementia and engage them in activities whenever possible.
- Provide quality care to all residents with dementia regardless of their cultural background, age or mental ability.
- Anticipate the needs and reactions of people with dementia and adjust individual, social and environmental factors to reduce negative behaviours.
- Encourage and support persons with dementia to make choices in keeping with the person’s lifelong values, preferences and interests.
The Alzheimer Society believes that the Guidelines for Care framework will provide two pathways to change the way care is experienced by people with dementia living in long-term care homes:
- advocacy to influence the policies, standards, and funding for person-centred care practices
- practical tools to support long-term care home staff in delivering person-centred care.
The Guidelines for Care framework consists of the following sections:
- What does a person centred philosophy mean?
- What does person centred care look like in a care home?
- Ensuring family inclusiveness
It is critical for staff to receive training around working collaboratively with families and recognizing what a move to a long-term care home represents for families.
- Extending a person centred philosophy through end of life
The Alzheimer Society believes that the practice guidelines contained in the Guidelines for Care framework can improve the quality, appropriateness and cost-effectiveness of care for people with dementia and their caregivers. Fostering a person centred approach to care will improve the quality of life of people with dementia and their families in long-term care homes in Canada.