Person-centered care is a revolutionary approach to long term and assisted living care that is being adopted by facilities and elder care communities across the nation. It places decision making with the elder or those that work closest to them, empowers the care partners who are involved in the daily care and flattens the traditional hierarchy of decision making, placing greater independence over each elder’s daily life.
Relationships are at the heart of this philosophy and as a result, strengthen ties with the care partners, family, friends and community. Person-centered care encourages the highest level of quality of life and seeks to celebrate the individual, helping he/she to grow and truly experience a life worth living regardless of their clinical condition(s).
Person-centered care is a philosophy that has been created by both providers and consumers to improve a facility’s performance and to respond to the nation’s growing elder population. Moreover, it is the way every human being deserves to be treated—with love, respect, dignity and autonomy. The goal is to de-institutionalize the delivery of care to our elders and create an environment that celebrates life, love and the pursuit of overall well-being.
Long term and assisted living care in most settings is currently delivered via a traditional medical model, much like a hospital. It is based largely on institutional schedules to which the individual must conform, not the other way around.
Person-centered care, on the other hand, is driven by the individual’s needs and preferences, meaning that the elder can decide what treatment is provided, when to rise, when and what to eat, what social activities are appealing or how his/her living environment should look. Decisions are made based on whether the endeavor creates growth for the individual or neighborhood, if it provides close and continuing contact, and by following the rule of thumb: Would we do it this way at home? The person-centered care approach seeks to provide an environment that the elder regards as home, not just homelike.
Person-centered care is also different because it entails a new approach to training and developing the caregiving staff. Instead of training that is solely based on medical knowledge or job descriptions that are limiting and create work silos, the staff are cross-trained and learn to care for the whole individual, who also has social, spiritual and other personal needs. It is a fundamental shift in the way a senior care provider functions, in terms of both staff and leadership.
According to a recent survey of Western New York providers, nearly 77 nursing home and assisted living facilities, more than half of the providers in those categories have expressed interest in person-centered care. Twenty-two of those facilities indicated they were in synch with some aspects of person-centered care and 11 are actively advancing the model within their organization.
These facilities are representative of not-for-profit, for-profit and municipal facilities in the region.
Facilities in other parts of the U.S. have created their own
person-centered care models or are using the Eden Alternative®
or The Green House® Project, two nursing home transformation
initiatives developed by Dr. William Thomas, a Harvard-educated
geriatrician who has spent his career advocating for change in
There is no question that senior care needs to change, not only in Western New York but also in the rest of the country. The current system meets the medical needs of residents but not the psychosocial needs that are key to providing quality of life. Research of facilities that have undergone personal, organizational and physical transformation has indicated:
• Reduced levels of depression among residents
• Decreased levels of agitation and other behaviors
• Decreased use of psychotropic and anti-depressant medications
• Fewer incidences of pressure sores and falls
• Reduced need for specialized diets, nourishments and incontinence products
• Reduction in unplanned weight loss
• Increased family satisfaction with services and care
• Increased family involvement with elders and care partners
• Increased staff satisfaction and lower turnover
• Improved community relationships and perceptions
State governments, including New York, and leaders at the federal Centers for Medicare and Medicaid Services (CMS) have praised the initiative as a way to improve nursing home and long term care performance across the board.
As more providers adopt person-centered care, there is hope that it will influence how elder care is provided in all types of settings, including care provided at home and in the community.
The elder care system in Western New York and elsewhere in the U.S. evolved based on medical model practices, similar to hospitals and other health care institutions. Today, consumers are demanding better outcomes for elder care, and greater control.
In addition, the Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission, has provided a forum to re-evaluate how elder care is provided in New York state.
The primary goals of the institute to benefit the community are to: