Is person centered care really being used in assisted living and memory care facilities? Or is it just another empty "buzzword"?
Alzheimer's Reading Room
The death of 8 residents in a Florida rehabilitation center; and, a lawsuit against the largest assisted living center in the United States is calling into question how our elders are being cared for in assisted living, nursing care homes, and memory care facilities.
Most of these facilities are touting "person centered care" as a technique they use to care for the elderly. Is this just an empty buzzword; or, is it really being put into practice?
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I thought my days of writing articles were over, but apparently not. I have written so many over the years, and I really, really hate to repeat myself. Besides, things live forever on the internet, don’t they?
Several days ago, I read my friend Pamela Kelly’s article, “Alive Inside - Find your Song”. It is a great article and well worth reading.
I thought about the article for several days, and really couldn’t get her article out of my head. Along with reading the article published today about the pending lawsuits in Florida and California against Brookdale Senior Living, (the largest corporation running Assisted Living Communities in the United States today), essentially compelled me to write this article.
Here is the link to the article about Brookdale - Largest Assisted Living Chain In U.S. Sued For Poor Care of Elderly
Pamela, in her article, is referring to the “Alive Inside” movie that shows evidence based proof of the effect of “personalized music’s” miraculous effect on persons with Alzheimer’s and other dementia.
Pamela did the same magic with her own mother that they did in the movie by singing her mother’s 4 favorite songs with and for her mother daily when she visited her, no MP3 or earphones needed!
What Pamela (and the creators of “Alive Inside”) did IS the perfect example of real “Person Centered Care”.
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In the industry relating to care of older adults, “Person Centered Care” is the current most popular buzzword, especially in the senor residences sector. Everyone is touting their “Person Centered Care” in their marketing materials, and when they talk to families visiting their community looking to possibly place a spouse, mother or father in that community.
What I’m saying here is: BUYER BEWARE! I think that you would want to question their definition of the “Person Centered Care”.
Ask them to name 2 examples of the “Person Related Care” that they give. They should be giving examples about specific actions with specific residents in their community, not things like we have singers (or entertainers) come in every week for our residents.
Not that the residents don’t enjoy that; I’m sure that they do, but it’s a group activity, not a one on one activity that is especially slated to that individual tastes, preferences or previous talents.
For example, creating specially made MP3’s with music for a specific individual using artists that THAT person is a fan of, or singing particular songs that are favorites of a particular person with that person (like Pamela did with her mom) are the REAL “Person Centered Care”.
There is only one memory care out of all the memory cares and assisted livings in Dallas (where I’m from) that I know of that uses the “Alive Inside” methodology of MP3’s and personalized play lists, (and there are a lot of memory cares and assisted living communities here).
A couple of other examples could be all aides knowing that you give Mrs. “X” only chocolate ice cream every time for dessert and Mr.” Y” only vanilla ice cream for dessert, without having to ask either of them, because the staff knows their preferences.
Or, painting with Mr. “Z” every week, because you know that he used to be a painter, not having a painting activity every week for a group of residents. That activity may be enjoyable for them, but it is a group activity, not an activity slated specifically for a particular individual because it is something that he personally liked to do in his past.
Get the drift of where I’m going here?
There is nothing wrong with group activities, mind you, but group activities are done for the convenience of the community/facility, to keep a number of people “busy”.
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Person centered care is really about recognizing and validating the worth of a particular individual. Showing them that they personally have value as a human being, pumping up their ego and self esteem, if you will. That takes time and effort on part of the staff.
So, when you are talking with the community’s marketer, or any other staff member for that matter, ask them to explain “Person Centered Care” to you, and listen critically to their answer.
If their answer revolves around group activities, you know that they don’t “get it”. And if they don’t “get it” what are the chances that any other staff member “gets it” as well?
Take that into consideration when evaluating how well your family member is going to be treated if they live there.
Also, you might want to consider asking what is the ratio of staff to residents, on ALL the shifts, day or night. The higher the ratio of residents to staff (caregivers) the less time they would have available to devote any sort of “Person Centered Care” to any one individual at any one time.
Does it not make sense that an aide that is responsible for care of 15 people would have less time to spend with a single person, than say, an aide responsible for 8 people? You might also want to ask what other duties does the aide have aside from the personal care of the resident.
Is the aide responsible for the general housekeeping of the place, responsible for cooking the food, for doing laundry, for doing activities with the residents?
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Each of those things cuts down on the amount of time the aide has with the individual resident, thus giving less opportunity to give “Person Centered Care” to your loved one.
Factor that in to your assessment of how life will go for your family member. (This relates to the Brookdale article mentioned earlier in this article.) You want the best care possible for your loved one, don’t you?
Carole Larkin is a private Dementia Care Consultant with over 10 years of experience in Dallas Texas. Carole earned the Alzheimer's Reading Room seal of approval for her great work and the ability to understand how dementia patients think and feel.
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Person Centered Care Structured Programming
1. Has individually tailored activities scheduled seven days a week (minimum 6 per day except Sunday for assisted living; and, a minimum 4 per day for residential care homes).
2. Activities are focused on resident's strengths and preferences (thing they can and like to do).
3. Active and passive programs from life skills to exercise, music, art, current events, and social activities.
4. Offers short, flexible and success-oriented activities.
5. Offers large group, small group and one-on-one activities.
Person Centered Care Staffing
1. Has a full-time program director for memory care in assisted livings.
2. Staff (including care aides) well educated in Alzheimer’s disease process and care techniques.
3. Requires ongoing specialized staff training and education.
4. Has high staff-to-resident ratios on all three shifts (preferred: under 8:1 under the day shift in assisted livings; and, under 4:1 in residential care homes).
5. Seems attentive to the residents while you are visiting (not ignoring them)
6. Has a consulting medical director, and other specialties as needed for the residents.
7. Uses an nterdisciplinary team approach.
8. Has A licensed nurse on the premises a minimum of 8 hours a day for assisted livings and on call for residential care homes.
Personhood in relation to dementia is recognizing the person with the disease as always being a person no matter what the disease has done to their minds. To no longer think of them as a person makes them out to be an object in the other person’s mind. Now that they have become just like an object (non human), their thoughts, words, needs, and in short their whole reason for existence loses all importance.
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