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

The implementation of a model of person-centred practice in older person settings
surprised that older people experienced a reluctance to be open and honest about
their views on care and the place they were living in.
I thought that we knew best what was good for the residents. Now I know that we
don’t and even if we do, it’s not always what the older person wants. This
programme has shown me that what I know is important but how I talk to and value
what they [older people] want and do not want is more important
(participants reflection year 2)
Participants experienced and came to learn that their professional views about what
mattered to older people was not necessarily what the older people said. Further, as
has already been discussed in the previous chapter, at the beginning of the
programme it was discovered that care plans generally did not represent the needs
and priorities of older people. Whilst participants recognised that it was often the little
things that mattered, they also learnt that the bigger things also matter. Birthdays,
Christmas and dying/death (amongst other events) were all used as ways to promote
learning and often as a way to promote unlearning of the rituals that had been set up
and that generally did not include the choices and preferences of older people.
In many of the sites resident committees were set up to provide structures whereby
older people could have a voice in how their home operated and how services were
provided. It is well documented that these forums can take a long time to become
effective and that they require skilled facilitation in order that the residents are
genuinely voicing their views and that these views are representative of all residents.
As a result of the committees that have been set up advocacy has become a higher
concern and two areas undertook some work with an advocacy project. Across the
sites residents committees have been consulted on a range of issues such as name
badges, mealtimes and menu choices, special events (parties) décor and furnishings
and pets. The Mental Health Service has been working on how to involve older
people with dementia and learning from their experiences can be transferred to other
services. This will of course become a growing need within older people services in
the future.
The least successful aspect has been learning alongside older people within the
programme within the programme days. A few sites were beginning to introduce this
towards the end of year two so there is only a small amount of data relating to this.
This is a new level of challenge for many staff to face for the future.
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