Person-Centeredness in Care is an Intimate Process

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Its not a new term.  It gets tossed around quite a bit from training manuals for direct care staff in care settings to outlines used for  in-service sessions for care providing, coordinating and monitoring professionals.

I, like others, tend to wonder if many are not quite grasping the reality of the concept or practice, at least not enough to initiate processes that ensure it is a large part of their daily operation.  This matters in home care, adult day health, group or assisted living and other care environments.  In order for the process to be truly intimate we must blend the clinical with the personal.  We need to know the fears, prejudices, phobias and concerns of those we serve.

Knowing this helps us to shape an environment that will assist in not allowing someone we serve to feel disconnected from what they know to be home.  The late Mr. Eugene Sanders might be a good example.  I first admitted him into our adult day care program in the fall of 1995.  From there he received overnight respite services and by the beginning of 1996 he was admitted into The Friendly Villa, my assisted living program.  He was a lonely man.


He responded to his loneliness by making a concerted effort to annoy everyone else, including deliberately wandering into the private rooms of female residents. As the administrator I knew I had to dig into his soul and find out how to create a calmer, fulfilling spirit which would hopefully lead to some behavioral modifications.  I knew I had to make him number 1 on my ladder of daily priorities.

In conversation I learned that his only son was killed in the line of duty as a police officer.  The presence of his granddaughter who was also a police officer painfully reminded him of what happened to his son. He had spent the last couple of years in his home alone, fading into mild dementia with only a neighbor to look after his needs consistently.  In his mind he was all alone.

I quickly instituted a series of hugs and modified his Plan of Care with an addendum for staff to add to the attention we showed him and the time we donated to listen to him daily.  I also added it as an agenda item during our team meetings and I would like to think we made life better for him.

PIC - FRIENDLY VILLA DINING RM SANDERSI can recall contacting a family friend of his who was also a pastor and arranging for him to pick up Mr. Sanders on Sunday for church.

Of course every care program, regardless of the environment type has its own dynamics.  We all may serve food at different times, in home care we may arrange supervisory visits on different schedules, in adult day care have certain days for showers, etc.

However, regardless of our operational critiques, person-centeredness must never be viewed as an optional or negotiable item.  When staff begins to take a cookie cutter approach to the care of everyone we serve, due to what they perceive to be the approach of their supervision, everyone can smell it and those being served will suffer in a void of anonymity.

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This is what I was seeking to avoid when I wrote the course on Person Centered Planning for all care venues. Its a guide for staff, supervision, ownership, care coordinators and families.  It is full of stories about how real person-centeredness impacts lives for the good.

When the right coordination of all that our client is and wishes to be – from the clinical, to the personality to the personal care needs to their dietary preferences  – dominates the day, success will come and it will remain.

When the opposite occurs so will disaster including for our reputation.  And who wants that?

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