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

The implementation of a model of person-centred practice in older person settings
effectiveness when sharing knowledge and skills from PD sessions and how they
strategically planned for changes in the systems in which they worked.
In the early to middle stages of the programme, many individuals looked outside their
group for external support to drive changes in their sites. Developing a belief that
they all had the capacity now to bring about cultural and practice change was a slow
process of realisation that they could do this. This was in marked contrast to the
perception when the programme started that many changes were beyond their scope
of authority and outside their circle of influence. In essence PD groups started to
become active learners where they looked beyond learning-by-doing, to learning
from theoretical constructs, PD methods and methodologies, and from practical
activities and critical reflection. With this significant development came an
appreciation of the need to structurally plan their PD work with colleagues. Project
work identified at the beginning of the programme and embraced enthusiastically,
became a chore very quickly because in some sense there was a disconnect
between what was envisioned and how that would happen. Obstacles within the
system disheartened groups quickly and a defeatist attitude made progressing with
some project plans very difficult. When the groups started to understand PD
methodology in its totality as it applied to them they started to understand that they
could not change their practice or system alone and had to start engaging in a real
level with each other and colleagues. This is best illustrated by the ‘tea-bags event’ –
based on resident feedback, the group identified the need to improve the quality of
the tea-bags used in the setting, but the manager refused to support the change:
“The issue with the quality of the tea bags floored us at first and we thought that we
couldn’t do anything about it because it was the system we had to work in. Now we
are not prepared to take no for an answer from anyone without questioning it. This is
just a system and systems can be changed”.
Practice development processes such as environmental walk-abouts and
observations of practice helped staff to start to appreciate what life may be like for
residents/guests 1 when living in an environment that has no frame of reference for
them to their life before entering residential care.
For one group member the
profoundness of the experience following an observation of care exercise in a
residents lounge area for 20 minutes was deeply meaningful. She commented that,
1
In one of the participating sites an activity was undertaken to establish how the older people residing
there wished to be referred to. They chose the term ‘guest’.
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