The Implementation of a Model of Person-Centred Practice In Older ...

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The implementation of a model of person-centred practice in older person settings “What’s your story” led to the development of residents’ life story books, in order to provide engagement, discussion and connection with residents and their families. As a result of the actions outlined above, increased awareness of person-centred processes grew. Participants became more empowered, and became aware of the process of achieving change and utilising it. Residents’ choice and voice were heard regarding ward processes. For example the establishment of residents’ support groups was of great benefit to the residents in order to improve their overall quality of life and their environment. Increased interaction with residents and their families was developed through ‘life stories’. The social and aesthetic aspects of mealtimes were improved by including the use of table cloths, jugs, serviettes and glasses on tables; television is turned off during mealtimes; all clutter/equipment is removed from dining room areas; liquidised diets are presented in a more appetising manner; and as a result of residents’ meetings in one site, fruit is now on offer in the afternoons. Phase 3 (final) data collection findings (June 2009) As a result of phase three data collection in June 2009, the final evaluation findings were as follows. Environmental issues continue to be a problem with most wards needing painting and decorating. Lack of privacy is very evident where some wards do not have doors at the entrances to their 6 bedded bays. A number of residents appeared to have no particular purpose to their day or a lack of appropriate activities for them was evident. Although it is difficult to transform culture and break away from routine, sometimes little changes are as significant as major modifications. However the ongoing moratorium on staff recruitment within the HSE makes it more difficult to maintain the momentum of implementing change. It takes time and energy to eliminate comments like “this is the way things are done around here” and to sustain change. Nevertheless the biomedical model is less evident in favour of the person-centred model of care. 101
The implementation of a model of person-centred practice in older person settings Achievements Positive interaction and engagement is obvious between residents and staff and this two way communication helps to support the change process, which has been described as “a definite process of getting things done”. Residents are encouraged to voice concerns and to take part in ward decisions. Correspondingly, staff are more aware of choice for residents and are more actively listening to them. Personal growth and development of staff involved in the programme has been of benefit not only to residents but to other staff on site as well. Participants feel more empowered to get things changed. There has been a major shift towards using person-centred language. Signage has improved. Team work is more encouraged and enhanced. Meal times have become a social/interaction time and are more aesthetically pleasing. Environmental issues, while not perfect, are being noted and addressed in a person-centred manner. Involvement in the person-centred programme is assisting with fulfilling obligations under the HIQA Standards (2007) and the Health Act (2009). A residents’ forum was piloted on one ward and then extended to all wards on that site. Advocacy services are now available on all three sites. A relatives’ support group has been established on one unit, which brings the residents, relatives and staff together to work on improving life and the environment for present and future residents of that unit. An information booklet for residents and relatives is designed and is available. Also, a ‘Help to get to know you’ booklet has been developed for residents and their carers to complete prior to admission. Into the future, full day or half day program days will be delivered on person-centred care on a regular basis in order: to involve more staff by recruiting new members from all wards; to up-skill current participants to develop and deliver program days; and to continue to transform attitudes towards person-centred care. Residents will be encouraged to become more involved in the planning of their care. They will be asked about their preferences/issues rather than their wishes being assumed. Current action plans will continue and new action plans will be implemented to further progress person-centred care. Progress evaluation will be ongoing with the continued use of WCCATs, Narratives and Context Assessment Index (CAI). 102
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