Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-26T01:08:09.449Z Has data issue: false hasContentIssue false
  • English
  • Français

Person-centred Australian residential aged care services: how well do actions match the claims?

Published online by Cambridge University Press:  30 March 2021

Sylvia Sing Lynn Seah Open the ORCID record for Sylvia Sing Lynn Seah [Opens in a new window] ,
Lynn Chenoweth  and
Henry Brodaty
Sylvia Sing Lynn Seah
Affiliation:
School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
Lynn Chenoweth*
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
Henry Brodaty
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Recent inquiries into residential aged care services, including the 2018–2019 Australian Royal Commission into Aged Care Quality and Safety, have informed revisions to the 2019 Australian Aged Care Quality Standards. Reforms to the Standards include a greater focus on person-centred services, consumer-directed care and authentic participation in decision-making on service provision by residents and their family members. In respect of person-centred services, the revised Standards reflect the four elements of the ‘Valuing, Individualised Care, Personal Perspective, Social Environment’ (or VIPS) framework for quality aged (social) care services in the United Kingdom. This qualitative study investigated whether the quality of services in a convenience sample of seven Australian aged care homes, which claimed to be person-centred, aligned with the four elements and 24 indicators of the VIPS framework. Data were obtained via semi-structured interviews with a volunteer sample of people associated with these seven aged care homes: 12 residents, 15 family members and 18 staff members in various roles. Data were analysed deductively with a priori reference to the 24 VIPS framework indicators, achieving data saturation for four common themes which indicated more person-centredness and ten common themes indicating less person-centredness. Only two of seven homes adhered to the four elements and 24 indicators of the VIPS framework across most service offerings. The remaining five homes offered some aspects of a person-centred service. The study findings provide insight to the factors which support and hamper the implementation of the VIPS-informed indicators of a person-centred aged care service and, therefore, what is needed to help meet person-centred requirements as outlined in the 2019 Australian Aged Care Quality Standards.

Keywords

personalised careindividualised careperson-centrednessperson-centred carenursing homeaged care homesocial care
Type
Article
Information
Ageing & Society , Volume 42 , Issue 12 , December 2022 , pp. 2914 - 2939
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbott, KM, Klumpp, R, Leser, KA, Straker, JK, Gannod, GC and Van Haitsma, K (2018) Delivering person-centered care: important preferences for recipients of long-term services and supports. Journal of the American Medical Directors Association 19, 169–173.CrossRefGoogle ScholarPubMed
Aged Care Quality and Safety Commission (2019) Guidance and Resources for Providers to Support the Aged Care Quality Standards. Available at https://www.agedcarequality.gov.au/resources/guidance-and-resources-aged-care-quality-standards-providers.Google Scholar
Australian Bureau of Statistics (2016) Disability, Ageing and Carers Australia: Summary of Findings 2015. Canberra: Australian Bureau of Statistics. Available at https://www.abs.gov.au/ausstats/[email protected]/Lookup/4430.0main+features202015.Google Scholar
Australian Institute of Health and Welfare (AIHW) (2015) Use of Aged Care Services Before Death. Canberra: AIHW. Available at https://www.aihw.gov.au/reports/aged-care/use-of-aged-care-services-before-death/contents/table-of-contents.Google Scholar
Australian Institute of Health and Welfare (AIHW) (2018) Older Australia at a Glance. Canberra: AIHW. Available at https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/demographics-of-older-australians/australia-s-changing-age-gender-profile.Google Scholar
Australian Institute of Health and Welfare (AIHW) (2019 a) People Using Aged Care. Canberra: AIHW. Available at https://www.gen-agedcaredata.gov.au/Topics/People-using-aged-care.Google Scholar
Australian Institute of Health and Welfare (AIHW) (2019 b) Admissions into Aged Care. Canberra: AIHW. Available at https://www.gen-agedcaredata.gov.au/Topics/Admissions-into-aged-care.Google Scholar
Bangerter, LR, Heid, AR, Abbott, K and Van Haitsma, K (2017) Honoring the everyday preferences of nursing home residents: perceived choice and satisfaction with care. The Gerontologist 57, 479–486.Google ScholarPubMed
Bird, M, Anderson, K, MacPherson, S and Blair, A (2016) Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence. International Psychogeriatrics 28, 1937–1963.CrossRefGoogle ScholarPubMed
Boelsma, F, Baur, VE, Woelders, S and Abma, T (2014) ‘Small’ things matter: residents’ involvement in practice improvements in long-term care facilities. Journal of Aging Studies 31, 45–53.CrossRefGoogle ScholarPubMed
Brodaty, H, Aerts, L, Harrison, F, Jessop, T, Cations, M, Chenoweth, L, Shell, A, Popovic, GC, Heffernan, M, Hilmer, S and Sachdev, PS (2018) Antipsychotic deprescription for older adults in long-term care: the HALT study. Journal of the American Medical Directors Association 19, 592–600.CrossRefGoogle ScholarPubMed
Brooker, D (2007) Person-centred Dementia Care: Making Services Better with the VIPS Framework. London: Jessica Kingsley Publishers.Google Scholar
Brown, R and Miller, E (2003) Leading your leader: develop management skills in a patient centered care model. Nursing Management 34, 58–62.Google Scholar
Brownie, S and Nancarrow, S (2013) Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical Interventions in Aging 8, 1–10.CrossRefGoogle ScholarPubMed
Burack, OR, Reinhardt, JP and Weiner, AS (2012) Person-centered care and elder choice: a look at implementation and sustainability. Clinical Gerontologist 35, 390–403.CrossRefGoogle Scholar
Chenoweth, L, King, MT, Jeon, YH, Brodaty, H, Stein-Parbury, J, Norman, R, Haas, M and Luscombe, G (2009) Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. The Lancet Neurology 8, 317–325.CrossRefGoogle ScholarPubMed
Chenoweth, L, Forbes, I, Fleming, R, King, MT, Stein-Parbury, J, Luscombe, G, Kenny, P, Jeon, YH, Haas, M and Brodaty, H (2014) PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia. International Psychogeriatrics 26, 1147–1160.CrossRefGoogle ScholarPubMed
Chenoweth, L, Jeon, YH, Stein-Parbury, J, Forbes, I, Fleming, R, Cook, J, Cheah, S, Fletcher, S and Tinslay, L (2015) PerCEN trial participant perspectives on the implementation and outcomes of person-centered dementia care and environments. International Psychogeriatrics 27, 2045–2057.CrossRefGoogle ScholarPubMed
Chenoweth, L, Jessop, T, Harrison, F, Cations, M, Cook, J and Brodaty, H (2018) Critical contextual elements in facilitating and achieving success with a person-centred care intervention to support antipsychotic deprescribing for older people in long-term care. BioMed Research International 2018, Article 7148515. http://doi.org/10.1155/2018/7148515CrossRefGoogle Scholar
Chenoweth, L, Stein-Parbury, J, Lapkin, S, Wang, A, Liu, Z and Williams, A (2019) Effects of person-centered care at the organisational-level for people with dementia. A systematic review. PLOS ONE 14, Article e0212686. http://doi.org/10.1371/journal.pone.0212686CrossRefGoogle ScholarPubMed
Colomer, J and de Vries, J (2016) Person-centred dementia care: a reality check in two nursing homes in Ireland. Dementia 15, 1158–1170.CrossRefGoogle ScholarPubMed
Coughlan, R and Ward, L (2007) Experiences of recently relocated residents of a long-term care facility in Ontario: assessing quality qualitatively. International Journal of Nursing Studies 44, 47–57.CrossRefGoogle ScholarPubMed
Department of Health (2018) Single Quality Framework: Focus on Consumers. Canberra: Australian Government Publishing Services.Google Scholar
Department of Social Services (2014) DSS Annual Report 2013–14. Canberra: Australian Government Publishing Services.Google Scholar
Dewing, J (2004) Concerns relating to the application of frameworks to promote person-centredness in nursing with older people. Journal of Clinical Nursing 13, 39–44.CrossRefGoogle Scholar
Dewing, J (2008) Personhood and dementia: revisiting Tom Kitwood's ideas. International Journal of Older People Nursing 3, 3–13.CrossRefGoogle ScholarPubMed
Donnelly, L and MacEntee, MI (2016) Care perceptions among residents of LTC facilities purporting to offer person-centred care. Canadian Journal on Aging 35, 149–160.CrossRefGoogle ScholarPubMed
Doyle, PJ and Rubinstein, RL (2013) Person-centered dementia care and the cultural matrix of othering. The Gerontologist 54, 952–963.CrossRefGoogle ScholarPubMed
Edvardsson, D, Fetherstonhaugh, D and Nay, R (2010) Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff. Journal of Clinical Nursing 19, 2611–2618.CrossRefGoogle Scholar
Edvardsson, D, Petersson, L, Sjogren, K, Lindkvist, M and Sandman, PO (2014) Everyday activities for people with dementia in residential aged care: associations with person-centredness and quality of life. International Journal of Older People Nursing 9, 269–276.CrossRefGoogle Scholar
Gibbs, GR (2018) Analyzing Qualitative Data, 6th Edn. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Harrison, J and Frampton, S (2017) Resident-centered care in 10 U.S. nursing homes: residents’ perspectives. Journal of Nursing Scholarship 49, 6–14.CrossRefGoogle ScholarPubMed
House of Representatives Standing Committee on Health, Aged Care and Sport (2018) Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia. Canberra: Parliament of the Commonwealth of Australia.Google Scholar
Hunter, PV, Hadjistavropoulos, T and Kaasalainen, S (2016) A qualitative study of nursing assistants’ awareness of person-centred approaches to dementia care. Ageing & Society 36, 1211–1237.CrossRefGoogle Scholar
Jaye, C, Tordoff, J, Butler, M, Hale, B, McKechnie, R, Robertson, L and Simpson, J (2016) Quality in residential care: exploring residents’, family members’, managers’ and staff perspectives. Quality in Ageing & Older Adults 17, 253–262.CrossRefGoogle Scholar
Jeon, YH, Simpson, JM, Li, Z, Cunich, MM, Thomas, TH, Chenoweth, L and Kendig, HL (2015) Cluster randomized controlled trial of an aged care specific leadership and management program to improve work environment, staff turnover, and care quality. Journal of the American Medical Directors Association 16, e1–e10.CrossRefGoogle Scholar
Kalaitzidis, E and Harrington, A (2018) Resident decision-making in the context of residential aged care. Collegian 25, 509–515.CrossRefGoogle Scholar
Kane, RA (2003) Definition, measurement, and correlates of quality of life in nursing homes: toward a reasonable practice, research, and policy agenda. The Gerontologist 43, 28–36.CrossRefGoogle Scholar
King, D, Svenssen, S and Wei, Z (2017) Not always a quick fix: the impact of employing temporary agency workers on retention in the Australian aged care workforce. Journal of Industrial Relations 59, 85–103.CrossRefGoogle Scholar
Kitson, A, Marshall, A, Bassett, K and Zeitz, K (2013) What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of Advanced Nursing 69, 4–15.CrossRefGoogle Scholar
Kitwood, T (1997) Dementia Reconsidered: The Person Comes First. Buckingham, UK: Open University Press.Google Scholar
Kitwood, T and Bredin, K (1992) Towards a theory of dementia care: personhood and well-being. Ageing & Society 12, 269–287.CrossRefGoogle ScholarPubMed
Lawrence, V, Fossey, J, Ballard, C, Moniz-Cook, E and Murray, J (2012) Improving quality of life for people with dementia in care homes: making psychosocial interventions work. British Journal of Psychiatry 201, 344–351.CrossRefGoogle ScholarPubMed
Li, J and Porock, D (2014) Resident outcomes of person-centered care in long-term care: a narrative review of interventional research. International Journal of Nursing Studies 51, 1395–1415.CrossRefGoogle ScholarPubMed
Love, K and Pinkowitz, J (2013) Person-centered care for people with dementia: a theoretical and conceptual framework. Generations 37, 23–29.Google Scholar
Luff, R, Ellmers, T, Eyers, I, Young, E and Arber, S (2011) Time spent in bed at night by care-home residents: choice or compromise? Ageing & Society 31, 1229–1250.CrossRefGoogle Scholar
Mavromaras, K, Genevieve, K, Isherwood, I, Crettenden, J, Flavel, J, Karmel, T, Moskos, M, Smith, L, Walton, H and Wei, Z (2017) The Aged Care Workforce 2016. Canberra: Australian Government Publishing Services.Google Scholar
McCormack, B and McCance, T (2006) Development of a framework for person-centred nursing. Journal of Advanced Nursing 56, 472–479.CrossRefGoogle ScholarPubMed
Miles, MB and Huberman, AM (1994) Qualitative Data Analysis: An Expanded Sourcebook. Thousand Oaks, CA: Sage.Google Scholar
Milte, R, Ratcliffe, J, Chen, G and Crotty, M (2018) What characteristics of nursing homes are most valued by consumers? A discrete choice experiment with residents and family members. Value in Health 21, 843–849.CrossRefGoogle ScholarPubMed
Morgan, S and Yoder, LH (2012) A concept analysis of person-centered care. Journal of Holistic Nursing 30, 6–15.CrossRefGoogle ScholarPubMed
Porter-O'Grady, T (2003) Researching shared governance. Journal of Nursing Administration 33, 251–252.CrossRefGoogle ScholarPubMed
Prince, M, Prina, M and Guerchet, M (2013) World Alzheimer Report 2013. London: Alzheimer's Disease International. Available at https://www.alz.co.uk/research/WorldAlzheimerReport2013.pdf.Google Scholar
Productivity Commission (2019) Report on Government Services 2019. Canberra: Australian Government Publishing Services.Google Scholar
Røen, I, Kirkevold, Ø, Testad, I, Selbæk, G, Engedal, K and Bergh, S (2018) Person-centered care in Norwegian nursing homes and its relation to organizational factors and staff characteristics: a cross-sectional survey. International Psychogeriatrics 30, 1279–1290.CrossRefGoogle ScholarPubMed
Rokstad, AMM, Vatne, S, Engedal, K and Selbæk, G (2015) The role of leadership in the implementation of person-centred care using Dementia Care Mapping: a study in three nursing homes. Journal of Nursing Management 23, 15–26.CrossRefGoogle ScholarPubMed
Røsvik, J, Brooker, D, Mjorud, M and Kirkevold, Ø (2013) What is person-centred care in dementia? Clinical reviews into practice: the development of the VIPS practice model. Reviews in Clinical Gerontology 23, 155–163.CrossRefGoogle Scholar
Røsvik, J, Engedal, K and Kirkevold, Ø (2014) Factors to make the VIPS practice model more effective in the treatment of neuropsychiatric symptoms in nursing home residents with dementia. Dementia and Geriatric Cognitive Disorders 37, 335–346.CrossRefGoogle ScholarPubMed
Royal Commission into Aged Care Quality and Safety (2019) Royal Commission into Aged Care Quality and Safety. Available at https://agedcare.royalcommission.gov.au/Pages/default.aspx.Google Scholar
Sjögren, K, Lindkvist, M, Sandman, PO, Zingmark, K and Edvardsson, D (2015) To what extent is the work environment of staff related to person-centred care? A cross-sectional study of residential aged care. Journal of Clinical Nursing 24, 1310–1319.CrossRefGoogle Scholar
Stein-Parbury, J, Chenoweth, L and Jeon, YH (2012) Implementing person-centred care in residential dementia care. Clinical Gerontologist 35, 404–424.CrossRefGoogle Scholar
Talbot, R and Brewer, G (2016) Care assistant experiences of dementia care in long-term nursing and residential care environments. Dementia 15, 1737–1754.CrossRefGoogle ScholarPubMed
van den Pol-Grevelink, A, Jukema, JS and Smits, CHM (2012) Person-centred care and job satisfaction of caregivers in nursing homes: a systematic review of the impact of different forms of person-centred care on various dimensions of job satisfaction. International Journal of Geriatric Psychiatry 27, 219–229.CrossRefGoogle ScholarPubMed
Wyatt, K (2018) Quality of Care Amendment (Single Quality Framework) Principles 2018. Federal Register of Legislation. Available at https://www.legislation.gov.au/Details/F2018L01412.Google Scholar