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 has been paid to improving the environment in many of the participating sites and this has been viewed positively. • Meaningful relationships: The attention paid to such issues (which are overt demonstrations of being more person-centred) as language, team-work, reducing ritual and routine, facilitating more choice, intentionality and the development of meaningful relationships have had a positive impact on resident experience. In the Year 1 observation data there were as many poor practice examples as there were good practice, in the year 2 data set there were significantly less examples of poor practice, demonstrating a change in culture and supporting the findings of the PCNI and PCCI. The table below shows examples of the way in which the ‘residents’ narratives were more positive at the end of the programme compared with Year 1 data, again reinforcing the change in the overall findings: Year 1 End of Programme • “It is communal living and I accept it” • “I hate not being independent and having to stay here. I’d like to leave here but I can’t” • If I have a problem? – I just stay quiet – “a shut mouth catches no flies”. • “Do you think they would let Bella (dog) come in here? I don’t know if Bella is still alive, ah, just leave it” • “I miss the smell of silage – was part of my life for so long” • “Its great here as long as she’s not around (meaning a particular nurse)” • “Can’t remember the last time I had a Guinness – now that would be a treat” • “The staff are friendly and they would do anything for you, even back a horse”. • “I love to get up at six. When I was at home I would go to bed at midnight and get up at 6 a.m. I would hate it if someone told me I couldn’t get up till 10 a.m. - I like my routine”. • “Feels like a hotel here, you have everything you want. It is the staff really, they leave their troubles behind and focus on you, have a laugh and a joke and attend to your questions, you can ask them anything and they are very attentive”. • “We made cream slices and were barely hot out of the oven before they were eaten”. • “I like my own room and love watching the telly. I am a real telly addict”. • “I like the company in here, you always have someone to talk to when you want. The nurses are brilliant, especially the wee blonde Sister” 19
The implementation of a model of person-centred practice in older person settings An evaluation framework has been introduced that could be continued at a local regional or national level. We believe this framework can support HIQA and other quality initiatives nationally across older peoples’ services Further test a model of person-centred practice in long-term care/rehabilitation settings and develop it as a multi-professional model. The model has been tested and will be reported elsewhere in more detail. The testing in this programme demonstrated the need for the physical care environment to be included. Utilise a participant generated data-set to inform the development and outcomes of person-centred practice. The programme has enabled local NMPDU facilitators to work with shared principles, models, methods and processes in practice development work across older people services in Ireland. A range of learning and evaluation tools have been introduced through this programme that can be continued. The data set informed the development of local action plans in the programme and has been used to demonstrate outcomes in person-centred practice across the sites over three time periods. RECOMMENDATIONS For future practice development programmes and for the development of residential care for older people in Ireland a number of issues need to be addressed and these are set out below under 6 themes. Theme 1: Role of NMPDU and NMPDU facilitators • Establish leadership role of NMPDUs in taking forward emancipatory/ transformational approaches to practice development work • Review of the effectiveness and value for money in staff input into training and short term training and practice development initiatives • Review/map the skills sets of NMPDU staff working in practice development • Plan for the ongoing development of facilitators who can enable emancipatory practice development processes to be realised in practice in line with the National practice development strategic framework 20
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