Person-Centered Care: Analysis and Recommendations for Geriatric Care

This report delves into the concept of person-centered care within the context of a geriatric department, analyzing its philosophical approach and practical implementation. The assignment begins with an overview of the author's area of practice, highlighting the challenges of providing individualized care to a large influx of elderly patients with chronic conditions. It then explores the person-centered practice framework, emphasizing the importance of patient beliefs, engagement, shared decision-making, empathetic presence, and holistic care. The report examines the pre-requisites of person-centered care, such as maintaining dignity, respect, and compassion, and their impact on future nursing practices. It also considers the care environment, including skill mix, shared decision-making, staff relationships, power dynamics, and the physical environment. The analysis extends to the organizational level, emphasizing supportive systems, risk-taking, and innovation. The report concludes with an analysis of the author's current practice setting, identifying challenges and opportunities for improvement, and offering recommendations to enhance the person-centered culture within the geriatric ward.

Running head: PERSON CENTERED CARE
PERSON CENTERED CARE
Name of the student:
Name of the university:
Author note:

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Introduction:
Person centered care is a philosophical approach towards service development and
service delivery in healthcare sectors (Willems et al., 2015). This approach mainly promotes
providing of services in ways that are respectful of and responsive to the needs, values as well as
preferences of service users and their caregivers (Vikstorm et al., 2015). This assignment would
mainly be discussing the aspects of person-centered care and how healthcare wads can be
managed to develop person centered environment.
Overview my area of practice:
Presently, I am working in the geriatric department in one of the teams allocated for
rehabilitation care for old patients. Huge number of old patients mainly with chronic disorder
sympstoms is admitted on a daily basis. With the advancement of technology and medical
advancements, life expectancy had increased but quality of life could not be assured among older
patients. A marked increase in the number of older patients with chronic ailments had been
observed but the ward does not have sufficient staffs to handle the huge inflow successfully.
Therefore, providing individualized care had become difficult and time consuming.
Overview of the person-centered practice framework:
The healthcare professionals need to ensure following of five important care processes so
that they can successfully provide person centered care to patients. Working with the beliefs and
values of patients, engaging the patients in developing care plans, participating in shared
decision making, having sympathetic presence for the patients and providing them with holistic
care are the five important aspects (Willems et al., 2015). Nurses need to make sure that
particular person centered care they provide would have positive outcomes on patients. These

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outcomes would be satisfaction with care, involvement with care, feelings of well being and
develop a therapeutic relationship with professionals (McCance, McCormack & Dewing, 2017).
High levels of satisfaction and involvement in their own care ensures that their dignity and
autonomy is respected, their values and traditions are cared and these enhance their adherence
with the treatment plan (Vikstorm et al., 2015).
Pre-requisites of the person-centered practice and its impact on future practice:
Each of the prerequisites have been followed by a specific example by which nurses can
develop their future practices.
One of the most important components of the person-centered care is maintaining people
dignity, respect as well as compassion. When patients see that their human rights are maintained
and that their wishes and needs were given the first preferences, it results in higher patient
satisfaction. This helps nursing professionals to develop strong bonds with patients that in turn
ensure mutual trust and adherence of the patients with the medications (Kogan et al., 2016).
Every nursing professionals need to ensure certain important aspects in their healthcare practices
so that high quality patient centered care can be given to patients in their future. They need to be
fully committed towards their jobs to ensure high level of emotional intelligence and dedication,
sympathy and compassion towards patient and provide high quality and safe care to patients
(Vikstorm et al., 2015).
Firstly, they need to respect values of every service users and put them at the centre of
care. Secondly, they need to take into account the preferences, expressed needs of the patients,
and accordingly develop their care plans that align with their preferences (Kogan et al., 2016).
Often different patients come from various backgrounds and cultures with their respective

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cultural traditions, inhibitions, preferences and customs (Brummel‐Smith et al., 2016). Nurses
need to provide care that is culturally competent and aligns with their cultural needs. This
ensures patient satisfaction as well. They need to clarify the beliefs and values of not only the
patients and family members. They also need to be aware of their “self” that is their own
perceptions, biasness, cultural competency, their sensitivity towards others cultures and all. This
would help to develop cultural awareness and knowledge among nurses and pave their ways for
further development in future. They need to be aware of both their pharmacological and non-
pharmacological skills sp that they become experts in the future (Kim & Park, 2017)..
Third, the nursing professionals need to provide coordinating and integrating care and
need to work together with other members of the healthcare teams and the patients and his
families for making sure that there is smooth flow of communication, education and information
(Chaudhury et al., 2017). Nurses need to develop interpersonal skills to achieve this aspect of
patient centered care. Researchers are of the opinion that every professionals need to gain
informed consent from patients (Kolanowski et al., 2015). Patients need to be given information
about their health condition in details along with the different interventions that would be
provided to them. All the benefits and disadvantaged of the treatment procedures all need to be
discussed in details. Following this, consent needs to be taken from the patient (Kim & Park,
2017). This not only helps in making the patient feel involved in his own care but also helps in
reduction of anxiety among the patients and his family members about the treatment procedures
and health conditions. Therefore, this aspect of person-centered care would be included in the
future nursing practices as well .
Fourth, individualized care plan needs to be provided to patients which are unique to
their specific needs and at the same time assure making patients feel physically comfortable and

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safe. Therefore, nurses need to be professionally competent to achieve this aspect of person-
centered care. Two different patients suffering from similar disorders might have different needs
and requirements to be met from healthcare professionals. Therefore, providing same traditional
healthcare services can never be a part of person centered care (Chaudhury et al., 2017). Nurses
during their practice needs to make sure that the care plan is developed with interventions that
are in accordance with specific needs of patients making patients the centre of decision-making.
Therefore, nurses in their future nursing practices need to provide individualized unique care to
patients that align with their requirements to ensure their satisfaction (Kolanowski et al., 2015).
The care environment of the person-centered practice framework and its impacts on
implementation of the person-centered care processes:
A number of important aspects need to be considered by the healthcare manager in order
to develop a care environment that would influence the implementation of person-centered
framework. Firstly, the manager needs to make sure that there exists an appropriate skill mix in
each and every of the ward. The healthcare manager needs to ensure that the ratio of the
registered nurses and the non registered nurses in the nursing teams is such that they can provide
high quality and safe care to the patients (Chaudhury et al., 2017). In multidisciplinary teams,
there should be perfect mix of nursing professionals with requisite amount of knowledge thereby
enabling safest and holistic care for all (Coyne et al., 2018). Another important aspect for
developing a care environment so that the nursing professionals can provide person centered care
is to ensure that they participate in shared decision-making systems. The organization should
encourage the healthcare members of the team to participate and commit to the development of
an environment where they will collaborate with others and engage in inclusive and participative
methods of decision making within and between teams. This would help all the members to

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shared close bonds with each other, avoid miscommunication, engage in constructive feedbacks
and develop mutual trust for each other’s. This would help the members to provide safest quality
person centered care towards patients (Coyne et al., 2018).
Another important aspect that the healthcare managers need to be careful about is the
development of effective staff relationships. When staff has strong bonding and effective
teamwork skills between them, they develop mutual trust for each other and hence develop close
relationships. This helps in sharing of work burden and hence reduction of any omissions, errors
and betterment of communication (Taylor et al., 2015). Therefore, professionals can effectively
care for patients with proper teamwork and coordination ensuring patient safety. Managers also
need to care about the important aspects of power sharing which has the capability of affecting
the development of therapeutic relationships between patients and healthcare professionals. Care
needs to be taken that the professionals do not exhibit power but rather focuses on reading a
mutually agreed goal, desires and wishes. This helps in ensuring dignity and autonomy in the
patients making them feel respected provide (Roberts et al., 2015)..
Another important aspect that the managers need to be especially careful about for
development of person centered care environment is the development of the physical
environment. By this, the healthcare manager needs to ensure making the healthcare
environment such that it can balance the aesthetics of the décor and the different functions of the
wards by effectively focusing on several important aspects of the infrastructure and physical
space where the patients rest (Lines et al., 2015). Design, privacy, safety, choice control, dignity
and sanctuary are the specific aspects that nurse mangers need to incorporate efficiently in the
physical environment. This would help in the improvement of not only patient mental and
physical conditions but also manage conditions of family properly. The development of care

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environment should also take place at the organization level by developing supportive
organizational systems. The mangers need to allocate funds and incorporate plans and systems
that would help in developing a governance framework that emphasizes on development of
organizational culture that would be based on the foundations of values, relationships,
communication, accountability, professional autonomy and many others (Taylor et al., 2015).
When person-centered organizational climate and systems are developed, it can help in the
promotion and initiation of creativity, freedom and safety of persons helping to provide quality
healthcare services. Such organizational culture helps to develop job satisfaction among the
professionals that ultimately reflects in the care that they provide (Roberts et al., 2015). This
helps in not only providing safe care but also quality care ensuring high level of patient
satisfaction.
One another aspect that the nursing manager needs to incorporate among the
professionals is their potential for risk taking and innovation. The professionals need to
exercise professional accountability by which they can take correct decisions and balance their
professional judgments, patient–family preferences, best available evidences and local
information successfully (Yasuda & Sakakibara, 2017). The professionals need to be accountable
with their own work, decisions, risks and other aspects and thereby ensure development of an
environment of safe and quality care provide (Roberts et al., 2015).
An analysis of where your practice setting is in regard to the outcomes within the person-
centered practice framework:
The aged care department where I work comprises of experienced and novice nursing
professionals. Most of the patients who are admitted here are sufferers from chronic ailments.

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Therefore, their treatment continues for prolonged period and often each of the professionals
need to remain in association with each of the patients for quite a longer period of time. Certain
aspects are always seen to remain associated in the geriatric ward that nursing managers need to
be very careful about. The aging population is greater sufferers of depression and anxiety and
the intensity of the symptoms increases with age. This might be due to lessening of freedom
and independence in daily activities of life (Zoffman et al., 2016). Secondly, difficulty in
keeping up with the modern changes in the generations also creates mental and emotional
pressures on the older population. Third, in many cases, loneliness and lack of care and
affection from family members and society are also found to be common among the older
patients. Negligence from family members, social exclusion due to physical, mental and
financial turmoil also makes them aloof from the world. Such conditions are often seen to
worsen when chronic ailments affect them as it acts an additional burden on their health and
abilities. They fail to manage the conditions successfully and suffer from poor quality life.
Hence, due to above mentioned issues, managing and caring for older patients are more
challenging than other cohort of people is (Bangertan et al., 2015). They require not only
physical care interventions but they also need mental and emotional support from professionals
that helps boosting their physical health.
One of the important aspect that I noticed that the nurses working in the ward became
easily fatigued and burned out while caring for patients. This might be because there was lesser
number of staffs than required and the present staffs did not share good rapport with each other’s
(Coulourides Koganet al., 2016). Hence, work burden was not shared among team members and
this created stress on individual members (Zoffman et al., 2016). Communication was poor.
Power struggles among the experienced and novice nurses were high. All these made them

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emotionally drained out and burned out. In such situation, engaging authentically with patients
becomes much difficult for the professionals in the geriatric ward (McGilton et al., 2016). The
professionals cannot develop effective therapeutic relationship with patients and their family
members that disrupt the person-centered caring process. The care environment in the geriatric
ward also lacks effective staff relationships. Poor communication among the team members,
blame games, power struggles and similar other aspects exist in the healthcare teams allocated
for rehabilitation of different disorders for older patients. This also affects the person-centered
care as such issues lead to omissions of services, delay in providing care interventions,
medication errors and many others (Bangertan et al., 2015). The patients do not get the scope for
good care experiences that affect them in negative ways. Moreover, as the professionals remain
fatigued and tired and face short of time for attending to huge number of patients in the geriatric
ward, they cannot allocate separate timing for being sympathetically present for the patients
(Coulourides Koganet al., 2016). Nursing duties not only ensure providing care interventions, but
also need them to be sympathetically present where they need to engage with patients and family
and thereby recognize the uniqueness and values of the individual. They can do so by
appropriately responding to the cues that helps in maximization of the coping resources by
successful recognition of the different important agendas of life. The members of the geriatric
department do not follow this. Appropriate skill mix was absent and hence a professional had to
complete all care responsibilities of patients irrespective of his expertise and weakness. This
often resulted in poor quality care and unsafe outcomes (Hermer et al., 2018).
Survey questionnaires for the patients revealed that they were not satisfied with the care
of the nurses. The main reasons were that the old patient felt that their dignity and autonomy
was not maintained and that they were not made a part of the decision making process. Many

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of the patients even did not know what treatments were applied on them. These were breaches
in the principle of the person centered care services and hence all these needed to be addressed.
The patients also felt powerless in front of the professionals as they were not given the scope of
expressing their wishes, values and desired goals and in place, the care plan was introduced to
them without any scope of feedback from patients.
Conclusion and Recommendations that could improve the person-centered culture in the
geriatric word:
Some important aspects need to be taken care by the nurse manager to develop a person
centered environment so that the care that the patients receive are individualized, unique and
aligns with their values and wishes. It has been found that the geriatric department and lower
number of staffs than required to handle the pressure of handling huge amount of patients .
Moreover, the team formation is also incorrect as it does not have proper skill mix and hence the
cares provided to students are not only of poorer quality but is also unsafe. Therefore, the
healthcare manager needs to discuss the issues with the human resource departments. More
allocation of funds and recruitment of professionals with varieties of skills and expertise in the
ward is important (Coulourides Koganet al., 2016). The healthcare managers also need to
develop supportive organizational systems that help professionals to align with the duties and
responsibilities needed to provide person-centered care (Young & Siegel, 2016). The healthcare
managers need to focus on development of organizational culture that promotes shared decision-
making systems, frequent team-meetings and feedback sessions, following of principles of
person-centered care and many others. The managers can introduce policies, which would help

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the professionals with person-centered guidelines and ways to develop the organizational
culture where professionals are encouraged to involve in shared decision making with team
members, work with beliefs and values of patents, and allocate time for therapeutic
communication and relationship development and many others.
Effective training sessions are extremely important where nurses need to be made
knowledgeable about the benefits and advantages of person-centered care and the negative
impacts when such care principles are not followed (Hung et al., 2016). The professionals should
be taught about the importance of effective teamwork and staff relationship development and
hence build team working skills so that person-centered care can be assured. Moreover, they
should be also introduced to communication workshops as communication is considered an
important aspect for taking of informed consent, developing knowledge about values and
wishes of patients, developing therapeutic relationship with them, show empathy and
compassion and many others (Flagg, 2015).
Besides, the management should undertake extra initiatives and allocate funds for better
wellbeing of professionals so that they enjoy their profession and experience job satisfaction.
This has direct impact on the quality of person-centered care for patients (Hung et al., 2016).
Arranging for fun sessions, informal outings, scope for career growth, arrange motivation
development sessions; allocate counseling sessions for nurses and many others are some of the
ways (Flagg, 2015). When nurses see that their employer is concerned about their well-being,
they would feel supported and this satisfaction would have direct positive impact on the quality
of person-centered care to patients. In this way, person centered care can be assured to patients.

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