Sadie woke up slowly as the sun filtered into the room through her curtains. She had slept a little later than usual, but she felt good. She took her time getting dressed and went down to the dining room for breakfast. She poured herself a cup of coffee and chatted with the regulars while her eggs were cooking, just as she had ordered. She took some fruit with her when she left to enjoy later in her room. She had scheduled a busy day. She was getting her hair and nails done this morning. Then she was going on a trip to the local museum. She wasn't sure what she would do after that. She could attend the book club meeting or the exercise class, or she could just go back to her room to watch a little television and take a nap if she felt like it. After dinner - the pot roast she ordered was wonderful - she called her daughter on the phone in her room. Around 7:30, Sadie was delighted when some old friends surprised her with a visit. She took them to the visitors lounge, offered them refreshments, and they talked until late. After her guests left, Sadie asked Alice to help her take a warm bubble bath and Sadie went to bed, looking forward to another busy day tomorrow.
Is Sadie at a ritzy spa? Is she staying at a fine hotel? No. Sadie lives in a nursing home that provides person-centered care. Consumers are entitled to feel at home wherever they live, in both long- or short-term living environments, whether in nursing homes or community-based settings. Person-centered care is an approach to care that honors and respects the voice of elders and those working closest with them. It's about relationships and is based on the values of choice, dignity, respect, self-determination and purposeful living. Delivery of medications, meal times and activities are scheduled according to the needs and desires of residents, rather than strict adherence to programmed timetables. Flexible plans allow for choice and spontaneity.
For nursing homes, this approach builds on the residents' rights guaranteed in the 1987 Nursing Home Reform Law. A resident of any facility has the right to be informed of all available services, charges and regulations in a language the person understands. Residents have the right to complain, without fear of reprisal and with prompt efforts by the facility to resolve those grievances. They have the right to actively participate in their own care, receive visits and make personal choices. Residents have the same rights as all of us to expect privacy, confidentiality, dignity, respect and freedom. Person-centered care creates communities where elders want to live and employees choose to work.
Nursing home staff also benefit from a person-centered philosophy. Care becomes less about forms, lists, and reporting and more about a common-sense approach to bringing "care" back into caregiving and enriching the lives of those that live and work in long-term care. Person-centered environments develop and support a workforce of direct caregivers who know residents intimately and care for them like family. Flexibility can enhance a staff's ability to provide optimal care. Consistent staffing allows staff members to really get to know their residents, to take ownership of the residents' care plans, and to work as a team. Organizational changes and practices lead to better outcomes for consumers and direct care workers in a cost-effective way. It involves a continuing process of listening, trying new things, seeing how they work, and changing things in an effort to individualize care and de-institutionalize the nursing home environment.
Ohio is developing quality incentives for nursing homes that adopt certain person-centered practices. The goal: Soon all Ohio nursing home residents can live every day like Sadie. Go to the Person-Centered Care Coalition website for more information.
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