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

The implementation of a model of person-centred practice in older person settings
Participants in the programme recognised the difficulties inherent in addressing these
issues as they are often at the core of older persons’ life experiences. However,
activities that enabled greater participation in the daily life of wards/units, activities to
enable social connection and activities that enabled connection with past lives (see
Findings Chapter 1 for examples of these) were implemented and were successful in
addressing issues of loss for many residents.
The implementation of these activities has an added benefit of dealing with issues of
hopelessness. The first and 2 nd round of observations of practice identified how
‘hopeless’ some residential care settings are, often reflected by a lack of meaningful
activity, a lack of meaningful social engagement and a lack of attention to maximising
the older person’s ability to do things for themselves (no matter how small). A has
been illustrated in category 1 and 2, much effort went into addressing these issues by
programme participants.
However, hopelessness continued to be seen in resident’s narratives through their
worries, sadness and depression and a feeling of being ignored. Older people
seemed to accept their lot and make the most of their loss of independence and were
content with where they were at. The voicelessness was underpinned by fear – fear
of the future, fear of dying, fear of function and fears of not being included or fitting in:
“Time is long, boredom sometimes. I’d love to get home but there would be no one
there. Just to get out would be great – great to get away from it. I will go out in the
weather when the weather is good. I go down in the lift but my husband used to
come down four times a week before he died. He is a terrible loss. The girls are
working and live off away from here. I’d like to get out while I’m able …No, I don’t
feel I have a say in how things are done here – No say, no, just get on with it …”
(Resident story)
“There is no pressure on you to do anything. I like that because I find it hard to
decide and they are very kind, the nurses, and I am not just saying that, they are very
caring and very kind. The only big choices I have to make is if I will get up or if I will
stay in bed. Most of the time I get up but some of the time I prefer to stay in bed.
Sometimes I choose my clothes, well they ask me what will I put on and would I like
this or that on, and sure I don’t care … I don’t talk to the others much , don’t know
why that is, sometimes it is not easy because you are inclined to close up at least I
am anyway and it isn’t easy to talk to people” (Resident’s story).
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