The term ‘person-centred care’ appears in many policy documents, healthcare websites and advertisements. This approach to services’ delivery and care has been adopted across the Irish Health Care. But what is it? As an educator in care of the older person I often ask nursing and care staff this question in the training room. “Putting the person at the centre of what we do” and “treating the client as an individual” are common answers. This is correct, and in order to put the person at the centre of things, it is vital that their wishes and preferences are taken into account and that they are always treated with dignity, compassion and respect.
Person-centred care is about identifying and helping meet client needs, whether physical, social or psychological. The overarching aim in person-centred care is to help the client maintain (or sometimes regain) a sense of well-being, and it is important that staff are aware of this key goal.
I recall a time early in my nursing career when decisions were frequently made for people, sometimes without proper consultation or consent – on the assumption that those decisions were in the person’s “best interest”. Thankfully, we have long moved away from that kind of paternalistic approach.
Health and social care continues to evolve, and the notion of “best interest” has now been dropped in favour of a Human Rights approach.
In 2019, the Health Information and Quality Authority (HIQA) and Safeguarding Ireland published guidance to health and social care services on the Human Rights-based Approach ¹. The guidance is based on five ‘FREDA’ principles: Fairness, Respect, Equality, Dignity and Autonomy.
In 35 years of nursing, I have seen some wonderful examples of person-centred care. The care worker who takes time to get to know the client living with dementia, making a playlist of favourite music from the past: a powerful way to connect the person again – even for a brief moment, with their own personhood and life story. The ‘noticers’, as I call them: care professionals who pick up on non-verbal cues indicating the client is worried or upset, acknowledging the difficult feelings and not merely trying to ‘jolly the worries away’, or thinking a quick cup of tea will fix things.
I strongly believe that staff too must be treated in a person-centred way in order to maintain wellbeing. They must be heard, noticed and validated. Too often, care staff in the training room express their disappointment at a lack of recognition from the employer. Where this occurs, motivation is likely to decrease, staff retention suffers and care quality and continuity will be adversely impacted.
I remind my trainees that managers are people too, and are human beings worthy of dignity and respect and needing to be acknowledged too.
In the light of all this, I believe it is vital that care providers and professionals familiarise themselves and their staff with the FREDA principles and freely use them when interacting with one another, as well as when caring for clients.
Reference:
¹Health Information and Quality Authority and Safeguarding Ireland (2019). Guidance on a Human Rights-based Approach in Health and Social Care Services. Dublin: Health Information and Quality Authority and Safeguarding Ireland.
