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A DV E R T I S I N G F E AT U R E
Monday, September 29, 2014
C3
seniors week SEPTEMBER 29-OCTOBER 4, 2014 I N
S A S K A T C H E W A N
Tracking person-centred dementia care by Hilary Klassen of SP Creative Features Dementia care has reaped the benefits of a humanistic approach to treatment over the past decade or two. The late British psychologist Tom Kitwood’s application of Carl Roger’s person-centred psychology to aging populations with dementia in the UK has become a global movement. With increased aging populations, the incidence of dementia is rising. Pressure on health systems is anticipated to increase and solutions are needed. Person-centred dementia care is being applied in the majority of residences in Canada, according to Dr. Paulette Hunter, Assistant Professor of psychology at St. Thomas More College. Hunter conducts research on dementia care and became interested in the topic because her mom, a long term care nurse, sensitized her to look deeper for the causes of agitation among long term care residents with dementia. Roger’s approach to person-centredness emphasized empathy, transparency, and unconditional positive regard – in Hunter’s words, “having a really good understanding of, and respect for, the person you’re working with.” In adapting these ideas to residential dementia care, health professionals have focused on good relationships, residents’ unique personal identities, opportunities for meaningful roles, and a home-like environment of care. A special focus of Canadian programs has been in raising awareness that accommodating individual needs and preferences of residents improves wellbeing and prevents agitation in advanced dementia. But tracking the efficacy of personcentred dementia care is no easy feat. Hunter says there’s not a lot of science attached to the approach yet. “I think everybody resonates with the idea
Dr. Paulette Hunter, assistant professor of psychology at St. Thomas More College conducts research into person-centred dementia care. She presented at this Annual Knowledge Network in Rural and Remote Dementia Care Summit in Saskatoon last year. Photo: Debra Marshal Photography
of treating people respectfully, and acknowledging their personhood, their rights, their individuality, but we don’t know how to do this in the best possible way.” She believes research on personcentred care is important because little is known about the potential effects of numerous new programs on residents and staff alike. For example, if staff are asked to change the way they offer care, could this increase staff burnout? “There are a few studies now that say even though it’s a bit time-intensive to do this kind of problem solving or this extra level of programming or intervention with residents, it actually reduces staff burnout. I think that’s because they have a better grasp of residents’ individuality and are better able to meet their unique needs. So they there are seeing less of the troubling behaviour (such as frequent wandering or calling out) that can arise when residents with advanced dementia have unmet
needs,” says Hunter. Less is known about how it affects the residents, partly because person-centred care operates under many different names, like culture change, relationship-centred care, and individualized care. There are even a number of specific programs to promote person-centred care, such as the Gentle Persuasive Approach and P.I.E.C.E.S program, developed in Canada. Hunter is part of a team of researchers from the Universities of Regina and Saskatchewan that are working on understanding quality of life for seniors in Saskatchewan from a number of angles. Hunter’s research has explored whether and how beliefs about personhood might impact dementia care and the effects of programs that promote person-centred care, as well as the contexts in which the programs are delivered. Her research suggests organizational factors (e.g. management support) are some of the
biggest contributors to person-centred care, and personal factors, including staff burnout and beliefs about personhood in dementia, also make a difference. The research team has just received a renewal of grant funding ($717,881) from the Saskatchewan Health Research Foundation for their work, and is beginning a series of 10 new studies. Hunter’s upcoming work will focus on the effects of Montessori-Based Interventions on long-term care residents’ mood and level of engagement, and whether these interventions can be successfully delivered by volunteer visitors. “There’s a big emphasis in the Montessori approach on the roles that residents have in their homes. For example, rather than having the staff deliver lunch, maybe a resident can have a role in setting the table.” Meaningful activities, environmental supports, physical environmental cues and maintaining mobility are also emphasized. More community support for people with dementia is needed too. In Bruges, Belgium, storefronts have decals in the window when staff have received education about dementia and are prepared to support shoppers with dementia. A taxi firm in Tavistock in the UK has been trained to recognize signs of dementia. Drivers also support regular customers with dementia by making sure they are paying the correct fare, checking on them if they seem to have forgotten an appointment, and so on. According to the Alzheimer’s Society, one in three seniors will die with some form of dementia. Dementia is still very much a mystery, but through person-centred care, we are moving away from a model of long-term care that made efficiency paramount toward a model that recognizes residents as community members who want to have meaningful roles and relationships.
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