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

The implementation of a model of person-centred practice in older person settings
Five significant themes are identified here from this programme day:
(1) Justification of the programme: participants had to explain the programme to
others and found this challenging as they felt they had to justify the time they
spent on the programme during times when cut backs were being made in the
health service. “The more things are discussed, the better understanding of
person-centred care”. The participants found it difficult when met with
resistance but with the continued support of the program days, they were both
developing resilience to this and staying focused to overcome this resistance.
The participants reported that having a good knowledge base and being
confident with the processes used on the program helped them with this. “It is
starting to make more sense, I feel more confident”. This highlights that cultural
change needs time and spaces for discussion. Inherent in this, the discussion
need to be championed by team members. The traditional way of simply
handing down or informing staff at a meeting will not suffice.
(2) Reflective Practice: as already highlighted, initially it was difficult for participants
to engage in structured written reflection as many had not written in a structured
way previously. In particular they found it hard to write about emotional
aspects of their work, which demonstrates the emotional disconnection with
work experienced by many. On day six there was an intentional focus on
reflection and structured reflection using a variety of models. Encouraging
participants to reflect on things that were not practice-based “helped to
overcome the initial fear of writing” and participants were able to transfer this
new skill to practice. They became “more in tune with their feelings” and
“perceptions of what was happening”. “Reflection is central to understanding
the way care affects the resident and is a valuable tool in helping me learn”. As
already noted, acquiring the discipline to systematically write reflection was an
ongoing challenge. Some sites and facilitators took this challenge on board
whilst others were less systematic about it. Those that engaged in a systematic
and structured way tended to see more progress.
(3) Interview techniques with older people: initially, participants found it difficult to
‘stop’, sit down and ask residents personal questions about themselves or their
lives. By this point, participants had learned how to approach the resident, how
to frame questions and listen to what is being said or not being said.
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