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Chapter 2: Literature Review
The “My Home Life” project (Help the Aged, 2006), also in the UK, was developed
from a partnership between Help the Aged, the National Care Forum and the
National Care Homes Research and Development Forum, in collaboration with older
people and representatives from the care home sector. Amongst its main aims is to
promote “shared decision-making”, which should be realised by helping staff to
encourage residents to be active participants in their care. It was stated that an
approach to care which recognises the importance of decision-making is key to
partnership, sharing power and ultimately experiencing autonomy and quality of life.
It recognises that the wish to be involved in decision-making is likely to vary from
one individual to another and that severe cognitive impairment does not mean that
those residents’ views should not be sought, even if it is more difficult to do so. It
suggests that creative methods be employed in order to involve residents with
cognitive impairment in decision-making and thus in realising their autonomy and
quality of life. While both the “CARE” and the “My Home Life” projects highlight
how different approaches to care can impact upon older people’s autonomy and
quality of life in residential care by moving from task-based routine care to
partnership, participation and involvement in decision-making, they are ongoing
projects and therefore no final conclusions about their effectiveness have been
reported.
2.3.5 Person-Centred Care
The theory of person-centred care evolved from a desire to create an approach to
care that is non-paternalistic and non-task orientated and promotes autonomy. There
has been an extensive amount of debate and discussion in the literature advocating
for organisations to adopt a person-centred approach to care in residential homes for
older people (Manley and McCormack, 2008; McCormack, 2004, 2001).Most
importantly, policy documents (Department of Health, 2008; HSE Corporate Plan
2005-2008,The Health and Wellbeing for Older People, Western area, 2001-2006
have recognised that autonomy is a central ingredient in realising person-centred
care and subsequently quality of life for older people in residential care. Therefore
without the core ingredient “autonomy” there is a lack of person-centred care and
ultimately a good quality of life.