Person Centred Care

Person Centred Care reflects the related concepts of dignity, worth and human rights. These ideas are enshrined in national and international documents that govern the way health care is provided. These include the:

  • International Declaration of Human Rights, professional ethics documents, The Aged Care Act (1997) and other related documents
  • ICN code of ethics for nurses says 'Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect' [1]
  • Australian Code of Ethics for Nurses states 'nurses recognise the vulnerability and powerlessness of people in their care' and must 'actively manage the power differential'. [2]

There is still debate about an exact definition of person centred care. An analysis of the concept identified common themes in the literature. Person centred care:

  • recognises and maintains person hood
  • recognises uniqueness and individuality, and acknowledges this in care plans and care pathways
  • is professional care that respects autonomy, dignity, privacy and the rights of the person
  • identifies strengths and positive aspects, rather than weaknesses and problems
  • acknowledges the person’s lived world. [3]

Person centred care has been promoted as best practice in dementia care, but the concept is still poorly defined and lacks an empirical base. [4] Four core themes, with the acronym (VIPS), have been described:

  • V  Valuing people with dementia and those who care for them
  • I  Treating people as individuals
  • P  Looking at the world from the perspective of the person with dementia
  • S  A positive social environment in which the person living with dementia can experience relative wellbeing.

Person centred care offers hope and support to the person living with dementia. It values the person’s experiences and makes him or her, the focus of care delivery not their disease. [5]

Therapies and approaches incorporating person centred care

Person centred approaches to care include:

  • reminiscence therapy
  • life history or biographical approaches
  • validation therapy.

Systematic reviews of reminiscence and validation therapy have not found conclusive evidence for their effectiveness. [6]

A small study from Ireland [7] used life review therapy to assist residents with dementia to compile a life story book. This study reported staff involved found the process enjoyable and families commented on the improved mood of the residents involved. A review of psychosocial treatments of behavioural symptoms in dementia concluded that music tailored to the individual preferences of residents was more effective in reducing agitation than generic relaxation music. [8]

Language and person centred care

Language and terminology are very important to the concept of person centred care. Addressing people by their preferred name and avoiding pet names or generic terms like 'love' or 'dear' is a dignity promoting strategy. It recognises the individual and reinforces his or her sense of self-worth and personhood and conveys respect. [9] The use of inappropriate language reduces resident choice and sense of personhood. It has been linked to an increase in resistiveness to care shown by residents with dementia. [10]

Alzheimer’s Australia has produced a preferred list of dementia friendly words and phrases. Using dementia friendly language promotes the dignity or self-esteem of people living with dementia. The term person centred may infer a greater recognition of care recipient autonomy than client centred or patient (resident) centred care. These terms imply a focus on illness or dependency and a power imbalance between care provider and care recipient. [3]

Person centred care and residential aged care staff

Person centred care is promoted as improving resident care and quality of life. Researchers have identified a relationship between the attitudes of staff, the ability of staff to rate the quality of life of residents that they care for, and staff satisfaction levels with their work. [11,12] Staff who have a person centred approach to residents rate resident's quality of life more realistically and express greater job satisfaction.

Implementing a person-centred approach to care in RAC is more likely to succeed when management demonstrates a person-centred approach to staff. A nurturing environment promotes excellence in care and higher levels of staff, resident and family satisfaction. [13]

These studies are mostly small and may not be representative of all aged care staff or facilities. Further studies are needed before firm recommendations can be made.

  1. International Council of Nurses (ICN). The ICN Code of Ethics for Nurses (215kb pdf). Geneva: ICN; 2012.
  2. Australian Nursing and Midwifery Council. Code of Ethics for Nurses in Australia [Internet]. Australian Nursing and Midwifery Council; 2008 August [cited 2012 September 11].
  3. Slater L. Person-centredness: a concept analysis. Contemp Nurse. 2006 Oct;23(1):135-44.
  4. Brooker D. Person-centred dementia care: making services better. London: Jessica Kingsley Publishers; 2006.
  5. Edvardsson D, Innes A. Measuring Person-centered Care: A Critical Comparative Review of Published Tools. Gerontologist. 2010 Dec;50(6):834-46. Epub 2010 Jun 21.
  6. Woods B, Spector A, Jones C, Orrell M, Davies S. Reminiscence therapy for dementia. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001120.
  7. Haight BK, Gibson F, Michel Y. The Northern Ireland life review/life storybook project for people with dementia. Alzheimers Dement. 2006 Jan;2(1):56-8.
  8. O'Connor DW, Ames D, Gardner B, King M. Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. Int Psychogeriatr. 2009 Apr;21(2):225-40. Epub 2008 Sep 25.
  9. Gallagher A, Li S, Wainwright P, Jones IR, Lee D. Dignity in the care of older people - a review of the theoretical and empirical literature. BMC Nurs. 2008 Jul 11;7:11.
  10. Herman RE, Williams KN. Elderspeak's influence on resistiveness to care: focus on behavioral events. Am J Alzheimers Dis Other Demen. 2009 Oct-Nov;24(5):417-23. Epub 2009 Aug 19.
  11. Winzelberg GS, Williams CS, Preisser JS, Zimmerman S, Sloane PD. Factors associated with nursing assistant quality-of-life ratings for residents with dementia in long-term care facilities. Gerontologist. 2005 Oct;45 Spec No 1(1):106-14.
  12. Moyle W, Murfield JE, Griffiths SG, Venturato L. Care staff attitudes and experiences of working with older people with dementia. Australas J Ageing. 2011 Dec;30(4):186-90. Epub 2010 Oct 8.
  13. Tellis-Nayak V. A person-centered workplace: the foundation for person-centered caregiving in long-term care. J Am Med Dir Assoc. 2007 Jan;8(1):46-54.
Last updated 20 October 2017