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How to Raise Quality of Life in LTC

An elderly woman holding fresh lavender

“The personhood of individuals with dementia needs to be continually replenished, their selfhood continually evoked and reassured,” according to Kitwood and Bredin. This is a fundamental idea behind person-centered care for individuals with dementia. What’s more, person-centered care practices can raise quality of life for residents and staff alike.

Person-centered care is a mindset that acknowledges cognitive abilities do not make or define a person, that selfhood persists through illness. Values, beliefs, interests, joys, and a personal life narrative are all aspects of selfhood. Caregivers can help discover and support this self by being open, listening, observing, adapting, and truly engaging with each resident. It is a two-way street, as human connections offer fulfillment to everyone involved.

Impact of person-centered care

Take a look at this example of person-centered care for a woman in a late stage of dementia progression:

“Emily was an avid gardener. Her yard was perfectly kept with many varieties of plants, which she grew from seed. She loved fragrant bushes, especially lavender. One side of her yard was filled with beautiful bushes. Throughout the progression, she stayed involved in gardening. In the later stage of the Alzheimer’s disease, care providers looked through seed catalogues with her, and talked about different varieties. They kept fragrant cut flowers and plants in her room, especially lavender when available. They kept a small satchel of dried lavender under her pillow, and also used a nice lavender lotion to moisturize her hands and feet” (Fazio et al.).

How does person-centered care affect residents? A wealth of research suggests it can decrease agitation, improve sleep patterns, and help maintain self-esteem.

Some of the best-known models for successful long-term care communities exemplify principles of person-centered care and have led the way in the culture change movement (Fazio et al.). Examples are the Eden Alternative, Wellspring, and Greenhouse/Small House.

Pioneer Network defines culture change as “the common name given to the national movement for the transformation of older adult services, based on person-directed values and practices where the voices of elders and those working with them are considered and respected.” They define person-directed values as choice, dignity, respect, self-determination and purposeful living.

Impacts of culture change

Implementing a culture change model leads to a “significant decrease in the Global Depression Scale in both cognitively intact and cognitively impaired residents over time—and lower levels of helplessness, boredom, and loneliness,” explain Fazio et. al

Residents can maintain their highest possible level of functionality in person-centered care models, too, according to research evaluated by Fazio et al. Slower decline in ability to perform ADLs such as eating have been observed.

As indicated by some research (Fazio et al.), person-centered can also:

  • Lead to a more positive affect, while research is inconclusive on whether it reduces depression
  • Be associated with less use of physical restraint and a reduction in use of psychotropic drugs
  • Maintain self-esteem
  • Improve quality of life

Reduce stress on dementia care staff

Caregiving for those with dementia is demanding work, and now more than ever, long-term care administrators struggle to attract and retain capable staff. In addition to a lack of candidates for positions, administrators face concerns about stress, burnout, and low rates of job satisfaction that can lead to turnover.

The good news is that a deliberate, person-centered care approach can help. A review by Fazio et al. revealed that a variety of approaches, all under the umbrella of person-centered care, have proven effective in reducing measures of burnout and stress, while increasing measures of job satisfaction. Examples of these approaches include:

  • Dementia Care Mapping
  • recreational therapy (storytelling)
  • multisensory stimulation (Snoezelen)
  • emotion-oriented and behavioral-oriented approaches.

“As a group, these studies provide some of the strongest evidence available as the staff-related benefits of person-centered care models,” conclude Fazio et al. The Eden Alternative sums it up, “Empowered care professionals = Empowered elders.”

Person-centered care practices inform the GuideStar Eldercare model, and our clinical psychologists provide training for dementia care staff to empower them in person-centered techniques. Can you elevate care with person-centered dynamics? No matter where you are in the journey, we believe you can, and we're here to help.