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Chapter 2: Literature Review
In summary, the literature relating to person-centred care identified knowing the
person as key to the success of this approach to care.
2.3.6 Life Plans
Many researchers state that life plans are essential for knowing the person and
subsequent realisation of autonomy for older people in residential care (Tutton,
2005; Lidz, Fischer and Arnold, 1992; Agich, 1990; Meyers, 1989). Meyers (1989)
stated that in order to live a harmonious existence and acquire autonomy one must
possess a life plan, and in order to do this one must possess certain skills to make
decisions and thus realise that life plan. Agich (1990) also recognised the importance
of life plans if older people with reduced capacity wish to remain autonomous.
Focusing his work on older people in residential care he called for a refurbished,
concrete concept of autonomy that systematically attends to the history and
development of persons and takes account of experiences of daily living. He also
recognised that the “individual” is always in a state of change and development
across the life cycle.
“Thus, to speak of individuals as autonomous requires that we pay
attention to the kinds of things with which they properly identify in
their lives….we need to learn how to acknowledge their habits and
identifications”
(Agich, 1990, pp.12)
Agich (1990) added that to be dependent on something is not a loss of autonomy if
one truly identifies with what one is dependent on. He reflected on the concept of
autonomy as it relates to residential care and questioned if the choices actually
afforded to residents were indeed meaningful or worth making, and stated that being
able to identify with one’s own choices is a prerequisite for true autonomy. In other
words, whether or not a resident has a shower at 06.00am or 12noon may be
irrelevant to them, but what they may wish to be autonomous about is their love for
documentaries about animals and being enabled to watch them on TV. Knowing the
resident through gathering life plans enables staff to provide meaningful choices.
Similarly, Lidz, Fischer and Arnold (1992) explained that autonomous acts are
accomplished by individuals with a past, present and future. Autonomy is consistent
with an individual’s life history and subsequent life plans. Therefore, assessing