Person-centred care helps make long-term care homes a better place to live: A look at our Culture Change Initiative

PC P.E.A.R.L.S™While most Canadians with dementia prefer to remain in their own homes for as long as possible, the reality is that 57 per cent of seniors living in a residential care home have a diagnosis of dementia,  and 70 per cent of all individuals diagnosed with dementia will die in a long-term care home.  

For people living with dementia and their caregivers, this reality means making good decisions about long-term care all the more important.

Changing the culture of care

In 2008, the Alzheimer Society of Canada decided it was time to start changing the conversation about long-term care. Instead of talking about the number of beds and their cost, we asked:

  • How can we work with others to make the experience of long-term care better for people with dementia?
  • How can we make the transition to long-term care easier and less frightening for their families?
  • And, how can we support staff to provide care that is centred on the needs of people with dementia and their families rather than those of the home? 

With these questions in mind, we set out on a “culture change initiative” to advance person-centred care in the way people with dementia, their families and long-term care staff work together and support each other.

In 2011, we developed Guidelines for Care: Person-centred care of people with dementia living in care homes, which helped us understand what we know theoretically about person-centred care, but not necessarily how to put this approach into practice. 

In order to address this gap, we assembled a committee of long-term care representatives and experts in person-centred care to help us select six homes that are known to be practicing a person-centred approach to care, representing the diversity of the long-term care sector in Canada.

The good news is that these represent just a sample of homes embracing person-centred care in Canada. More and more homes are learning about a “person-centred” approach to care, and staff are using this approach to find creative solutions to better meet the complex and unique needs of their residents. They’re continually trying different methods, seeing what works and changing their practices. In the homes we visited we found there were seven common key elements underpinning person-centred care, known as the PC P.E.A.R.L.STM and ways that these elements can be implemented in long-term care.

Understanding the lifelong values, wishes and personality of each individual opens the door to innovative approaches that can make each day the best day possible for people with dementia, no matter the stage of their disease.   

Homes practicing person-centred care recognize that family members are integral members of the care team because they provide important information to help guide the care of the person with dementia. For example, perhaps a resident is resisting staff when they try to give him a shower early in the day. The family can point out that their father or husband was never a morning person.

By changing the time of the day for showering, the resident might be more comfortable, calm and happier. Staff may have an easier time if he doesn’t push them away. Families feel reassured that their father or husband is more content while he gets the physical care he needs. Even though it means accommodating many different schedules, this change in care can benefit everyone.

A step in the right direction

At the core of culture change is shifting our way of thinking. A diagnosis of dementia doesn’t automatically mean life is over for people with the disease. They can still live meaningfully in an environment that respects them as whole individuals, emphasizes autonomy, dignity and choice, while promoting their strengths and abilities through tailored activities.  

Switching from a “one-size-fits-all” to an individualized approach is a giant leap forward. We know it won’t solve all of the challenges that come with our changing demographics. But it’s a much-needed step in the right direction.

To learn more about culture change, visit

Last Updated: 11/08/2017