Person-centred Care in Dementia – Are we doing enough?

May 24, 2018

Hi, I’m very pleased to be doing my first Expert Insight for QCS about Person-centred Care. I have worked as an Occupational Therapist for 20 years in the field of dementia care and I am passionate about promoting and delivering care in a way that I would be happy to receive it if I received a diagnosis of Dementia.

Dementia care is very much in the news recently with the lovely Barbara Windsor sharing her diagnosis and of course it is Dementia Awareness week beginning 21st May. Person-centred care is at the very heart of dementia care but what does that mean and are we really doing it?

I was lucky enough to meet the author Wendy Mitchell (diagnosed with early onset dementia at the age of 58) this week. She gave a talk to health and social care workers about what dementia meant to her, what support she required and how this should be delivered. She was the most inspiring lady I have ever met with her honesty and sense of humour about living with dementia. She was however quite scathing about the care she received from health and social care workers which at times was most definitely not person -centred. She said I’m sure this doesn’t apply to all of you, but we looked at each other sheepishly and had to admit that often person-centred care does not happen.

What is Person-centred care?

Person-centred care has been a buzzword for decades now. There are many different definitions that include things like “focusing on the needs of the person, not the service”, “reflecting a person’s needs wishes and preferences”, and “tailoring a person’s care to their interests, abilities, history and personality”.

People have their own views on what is best for them and how they would like to be treated. Wendy Mitchell certainly did. It can be small things that make a difference. What would you like people to know about your needs and wishes? I would like people to know that around 6:00pm I might not want a cup of tea, but a gin and tonic would really hit the spot!

It is a way of thinking and doing. Putting yourself in someone else’s shoes.

Barriers to Person-centred care
  • It takes time to find out a person’s views, especially if they have difficulty communicating.
  • We already provide it… but evidence suggests otherwise.
  • Service users can’t always make choices.
  • Don’t know how to start
  • The culture and processes of organisations.

Training and resources can certainly help us to provide person-centred care by giving us food for thought and ideas to try, but we can all make small changes to the way we provide care today… now. It can be as simple as spending an extra five minutes with someone, putting yourself in their shoes or trying something new.

Person-centred care for someone with dementia is just as important as it is for any other service user. As dementia progresses and the person becomes more vulnerable it may become harder to elicit their needs and wishes. But with the right skills and patience we can overcome this.

We can improve the way we communicate with someone living with dementia. Pay more attention to their facial expressions and body language. Offer them choices (not too many) and take time to gauge the response. Look at my face when you offer me tea or gin and see if you can tell which one I would prefer!

Take time to find out about the person’s past and offer meaningful activities. If somebody used to be a keen gardener, maybe they would like to go outside for a walk in the garden, plant some seeds or water the pot plants.

Promote independence wherever possible even if this means taking a little extra time.

Wendy Mitchell stated that the thing that helped the most was the kindness of people who took a little extra time to try and understand what she was going through, waiting for her to find the right words or allowing her to make mistakes to maintain her independence. She said that a healthcare worker once said to her “How would you like me to speak to you?”, to which she replied, “How would you like me to speak to you?”. Good point.

Rewards of Person-centred care

The benefits of person-centred care for our clients include improved quality of life, higher self-esteem, reduced agitation and aggression and improved sleep patterns. This has the added benefit of improving staff well-being, boosting morale and increasing staff confidence to try new things.

Person-centred care focuses on providing a culture of care that improves the happiness and well-being of everyone concerned. What’s not to like.

Wendy Mitchell’s book “Somebody I used to Know” was published in February 2018 and is a truly inspiring read for anyone who has been touched by Dementia.

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Katie Farrar

Occupational Therapist

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