Wednesday 1 May 2013

We are all individuals

Of all the buzz words and phrases around in health and social care at the moment, ‘person-centred care’ is arguably one of the most important. It might sound like a cross between trendy language and clich├ęd ideas, but there is a huge amount of value and importance in what person-centred care represents, and it is fast becoming an approach that cannot be ignored by anyone involved in health and social care.

The essence of person-centred care is to treat each person as just that, a person. Not as an illness, a collection of symptoms, a problem that needs solving or as someone who is seen as having no ability. Person-centred care is about understanding each person’s unique qualities, interests, aspirations, preferences, abilities and needs and acting on that understanding in everything that you help that person with.

It may sound obvious, like perfect common sense, but for a long time a one-size-fits-all model of ‘care’ has been the norm, to the detriment of those on the receiving end of it. For anyone living with any condition, illness or disease, the holistic approach offered by person-centred care is a hugely positive step, but for someone who is living with dementia I would go as far as to say that person-centred care is a vital form of therapeutic treatment that can alleviate symptoms and promote quality of life. It can also make a massive difference to the life of a carer, because true person-centred care for your loved one will provide you with greater support and peace of mind.

I would like to think that person-centred care is about as far from the dreaded tick box culture as we can get, even if delivery of it can still be turned into a hugely paperwork-heavy exercise. Finally moving away from the idea that we can all be herded like sheep, grouped and homogenised, and actually recognising our differences and uniqueness can only be welcomed, providing of course it is accompanied by open-minded acceptance rather than discrimination or segregation.

For me though, the real heart of person-centred care isn’t about what we write down or input into a computer about a person, it’s about our interaction with them. It is easy to record what makes someone who they are, but adjusting how we interact with them is much more difficult. I don’t believe we are naturally conditioned to celebrate individuality, making it far more difficult to begin that process in our professional careers.

From an early age, our education system groups and trains us to follow a curriculum and examination process that is about everyone thinking and acting along the same lines. Person-centred care challenges that and tells us to toss out the textbook because each person has their own rule book, and you won’t have read each one of those at college.

Person-centred care means losing the safety net of treating everyone the same and using your own initiative, instincts, empathy and understanding to connect with that person and appreciate who they really are. Within every professional those qualities will differ, making person-centred care the ultimate unknown quantity. This in turn explains why some professionals and organisations deliver it so well, while others struggle immensely.

From a professional’s point of view, person-centred care can mean supporting someone’s wishes even when you don’t agree with them, helping them to do and achieve things that you might not find interesting or even worthwhile, and working at their pace rather than at yours. It can, however, also provide the greatest satisfaction and fulfilment in your life. Knowing you have cared, supported and enabled someone to be who THEY really are is an achievement unlike any other. 

From the point of view of someone receiving care, it is about taking control, having the security of knowing that you matter, having the peace of mind that you can be supported to live how you want to, and experiencing dignity and respect at all times. Person-centred care should remove worry, promote independence, give hope and positivity, and make each individual feel like the special person that they are.

In essence, none of this involves a direct cost implication so it should be popular with health and social care providers, but in reality delivering person-centred care needs people. Only a dedicated, compassionate, understanding person can provide person-centred care. It can’t be done by a machine, and it requires that most precious commodity of time.

As a result, person-centred care hasn’t been widely implemented. In fact in relation to my father, I would say that from the professionals involved in his care it was sporadic at best. Where paid carers were concerned it was only consistently demonstrated by his keyworker, and overall what made dad’s care person-centred was his family. We put dad at the heart of everything, always caring for him with his wishes, preferences and interests enshrined in what we did. For people without families, however, the story is often very different.

So how do we persuade health and social care providers to abandon models of care that assume we are all the same, and actually recognise our individuality and uniqueness? I believe it comes down to public pressure and understanding of this subject, a sustained drive towards new ways of thinking and working, meaningful training programmes, and championing those who are already implementing person-centred care and seeing the benefits of it.

In a world that is obsessed with evidence-based working, sometimes you cannot quantify the real depth of appreciation and wellbeing that comes from person-centred care. The inner relief, happiness and comfort a person may be feeling cannot always be articulated or measured, but that doesn’t mean we should abandon person-centred care in favour of one-size-fits-all. If you ever doubt the wisdom of providing care that supports someone to be exactly who and what they want to be, ask yourself this: if the roles were reversed, what sort of care would you want?

Until next time...

Beth x

You can follow me on Twitter: @bethyb1886

1 comment:

  1. Many thanks for your brilliant blog. I have been a carer for my daughter (she has profoundly and multiple impairments) for the past 30 years, but more recently became the carer for my parents - my dad has dementia. (I am also new to the world of Twitter and blogs - so this is my 3rd attempt to comment on your blog!!!) I often feel that professionals just don't get person-centred - ness as they try to fit us into their little tick boxes and give us scores. Our lives and those we care for are just more complicated than that - and boxes lack humanity and belittle the diversity and complexity of our lives. Jeanne