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A Book Chapter Review: Nay Et. Al (2009) Person-Centred Care
Nay et al (2009) article discusses in great detail the person-centred care (PCC) approach but narrows their scope on the applicability of this approach to people with dementia (PWD). The authors use the Lund trial in Sweden as well as the Australian replication in discussing the importance of culture and environment in enhancing quick healing through PCC. The authors also offer a set of recommendations on how PCC can best be applied by organisations in treating PWD. Overall, the authors suggest that the most important thing is not what is done but how it is done that counts towards PCC.
PCC from Nay et al Perspective
Nay et al gives a brief but comprehensive analysis of the historical perspective of the health care. They argue that the health professional was historically an expert with immense power over the client. The organisation of the health care facilities only reflected health professionals’ convenience and older patients were generally neglected. Treatment was task-oriented too. The authors therefore want their audience to believe that PCC replaced a rigid and biased task-oriented health care system that neglected the plight of older PWD. PCC is packaged as the best method to treat PWD. Essentially, the authors believe that PCC entails the “recognition of and connection with the person, a focus on the person’s strengths and goals, an interdisciplinary approach, and recognition of the centrality of relationships” (p.109). Using an experience of a health professional that underwent a PCC at the hands of highly professional and motivated health workers, the authors want their audience to believe that the environment and the quality of care a patient gets goes a long way in helping them to not only recover from illness but to also experience the healing process.
Nay et al offers a well thought-out analysis of the scope and practice of PCC on older PWD. They achieve this by drawing on past relevant studies. For instance, while acknowledging that past studies might not be exhaustive, the authors list the following indicators as the core characteristics of an ideal PCC:
Acknowledging an individual as an experiencing person despite the disease, offering and respecting client choices, using the person’s history and biography in care, focusing on abilities rather than disabilities, supporting individual rights, values, and beliefs, providing unconditional positive regard, interpreting all behaviour as meaningful, maximising potential and providing shared decision making (pp.109-110).
They posit that PCC takes place through two core stages, the “doing” stage and the “being” stage. While the “doing” stage covers the normal tasks performed in aid of PWD such as showing or feeding the “being” stage involves the quality of relationship developed between the carer and the client, for example, a careful and loving feeding experience. Overall, both “doing” and “being” stages are determined by the surrounding environment which the authors believe is responsible for sending caring or uncaring messages.
While using the Lund trial in Sweden and the Australia trial, Nay et al show that PCC is entirely about how care services are provided among the older PWD. They show that quality of staff-client relationships is critical for the cusses of PCC simply because staff and clients lives are shared by being together and doing together. This is true since the lack of communication between the staff and the client’s exacerbates dementia condition – clients feel a ‘sense of personal accomplishment … with more posit.............
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