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

The implementation of a model of person-centred practice in older person settings
Handover appeared professional. Residents referred to by name, communication
appeared very person-centred and respectful. Meaningful conversations, e.g. ‘Mary
would you like to attend the exercise class?’ Staff called each other by their first
names and were respectful (observation notes)
This shift in power was also demonstrated in the PCNI/PCCI data.
The person-centred practice framework used in the programme places equal
emphasis on the development of meaningful relationships among team members as
it does between team members and residents. Indeed it is argued that the
development of person-centred relationships with residents is predicated on those
same relationships existing among staff. The data demonstrates that the two-year
programme resulted in more evidence of teamwork and this was also supported by
the PCNI/PCCI data.
However, issues of a dominant focus on tasks with a routinised approach to care,
challenges of planning time in a person-centred way, lack of autonomy over decisionmaking
and staff attitudes and behaviours all impacted on the extent to which the
positive benefits of teamwork were realised.
“9 am in the morning and the staff are very busy. There is one nurse and two carers
working in the 4 th cubicle. One carer takes out the ‘morning trolley’ and checks that
the trolley is set up. Another attendant wheels a patient into the shower and the
nurse pulls the curtain and then and then asks the attendant to aid her with the
resident … there is a resident sitting on her bed and she is saying her prayers, I can
see the rosary beads in her hand. The care attendant asks her if she is ready for a
shower and she replies ‘yes’ but does not want her hair washed as she is going out
in the afternoon and her family is taking her to her own hairdresser to get a colour in
her hair. The resident is sitting on the shower chair, she is wearing her nightdress
and has slippers on her feet, she is holding a towel, wash-bag and clean clothes.
She is now wheeled out and another resident is at the hand basin cleaning her
dentures …” (observation notes)
Three residents in lounge. Nurse doing documentation in lounge as well. Very noisy
in lounge. Staff member on mobile phone and noise from staff tearoom making it
difficult for residents to hear TV. No communication occurring between residents or
with staff. Several staff members in and out without asking residents if they want
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