By now, healthcare and medical professionals know that person-centered care is the gold standard in the planning, delivery and quality of care for people young and old. It has received a great amount of attention, for instance in skilled nursing facilities across the country. As our population ages in the United States, more attention is being paid to how person-centered care can be applied to the care of older adults and seniors who have multiple chronic illnesses.
Common Chronic Illnesses Among Older Adults and Seniors
To better understand how person-centered care can lead the way to the best care for older adults, it’s good to know what the most common chronic health conditions are affecting them.
They include:
- Hypertension or high blood pressure
- High cholesterol
- Arthritis
- Ischemic or coronary heart disease
- Diabetes
- Chronic kidney disease
- Heart failure
- Depression
- Alzheimer’s disease and dementia
- Chronic obstructive pulmonary disease (COPD)
Each chronic illness is as unique as the older adult living with it, and requires detailed attention to not only the clinical aspects, but to the older adult’s choices about care, their lifestyle, life goals, diet, functional abilities and decisions about how they wish to be treated.
Elements of Person-Centered Care
At the core of person-centered care are improving safety, quality and coordination of care and enhancing quality of life, all driven by the care team and older adults. The two become partners in care. While comprehensive medical care is provided, the team embraces personal choice and autonomy for the person receiving care and services.
Values and Preferences
The older adult expresses his or her values and preferences, and once they are known, all aspects of their care, be it for heart disease, stroke, diabetes or Alzheimer’s disease, support their realistic goals for health and their life. Values and preferences are drivers of a dynamic relationship developed between the older adult and the care team, others who are important to them, and all other providers of care and services.
Other elements to providing person-centered care to older adults with one or more chronic health condition include:
- Developing an individualized and goal-oriented plan of care based on the individual’s preferences
- Routine and ongoing review of the individual’s goals and plan of care as they disease progresses
- Care and services provided by an interdisciplinary team that makes the individual the center of the care process
- Ongoing education and communication about the disease process and personal choices or decisions made related to progression of the condition
- Obtaining constant feedback from the older adult to measure care goals, outcomes, and improvement
Barriers to Providing Person-Centered Care
While most care providers strive to deliver the highest quality of care and services, there are obstacles in doing so. In general, true person-centered care requires a significant shift from traditional biomedical-driven care, where the disease is the center of the care plan, not the person. Other potential barriers include:
- Inconsistent understanding of what person-centered care is, as well as the use of terms like values, preferences, and goals
- Concern for safety over preferences and taking medical control away from the individual
- Lack of communication from the care team and those involved in the person’s care
- Poor coordination of services where the older adults “gets lost” in the shuffle between multiple providers and agencies
Overcoming Barriers
In the grand scheme of things, person-centered care is still a relatively new concept in medical care and there are plenty of areas for improvement. Some habits are hard to break, particularly when medicine has been driven by one major paradigm for over 200 years in the United States, which is “doctor knows best”. Putting control of a person’s care in their own hands is a radical philosophical shift, but overcoming barriers can include the following:
- Recognition of the person as a whole – physically, socially, psychologically, emotionally and spiritually
- Understanding deep complexities associated with one’s culture, country of origin, beliefs and values
- Putting one’s self in their shoes, meaning going above and beyond to understand the individual’s life experiences and perspectives
- Providing a holistic approach to the person and their condition, including lifestyle, nutrition, exercise, meditation or prayer, and other alternative methods of treatment
- Understand and respect self-determination
Final Thoughts on Person-Centered Care for Older Adults with Chronic Illnesses
Medicine and healthcare have evolved from a once physician and care team driven model to a person-centered one, placing the person in the center of their care. This comes in an age where people are living much longer than before and developing more chronic health conditions as a result. Although there will be bumps in the road, person-centered care is the best approach to helping people live not only longer, but with quality, meaning and purpose in their lives.