Beyond Health and Safety, Person Centered Care is Your Right
Image from the American Assn of Coleges of Nursing
As discussed in previous blogs I’ve written, if you live in long term care, there are several Residents Rights mandated by the Centers for Medicare and Medicaid Services - (CMS).
Such rights were implemented in Nursing Home Reform Law in the mid 1980s and have undergone updates and refinements to the current day.
One of the most important rights, which may seem difficult to define, is the right to person centered care.
In practical terms, rather than solely being responsible for the traditional nursing- medical model of health and safety, person centered care and thinking is all about the social, emotional, cultural needs, of one’s identity and well being. Bottom line - It is about offering choices.
None of us exist in a vacuum, or a safe cocoon. Our life takes on meaning and richness with the comfort of routine and enjoyable rituals, cultural practices and activities which become part of one’s identity.
If a resident has difficulty verbalizing needs, as possibly with a CVA (stroke) or dementia, it is important to note the specific behavior, which is truly their way of communicating to ensure that their rights are being recognized.
Definition from the Kansas Office of the State Long Term Care Ombudsman Program-
A nursing home is a place residents call "home." A place where someone lives and calls home should nurture the human spirit as well as meet medical needs. Culture change is a movement that seeks to create an environment for residents, which follows the residents' routines rather than those imposed by the facility; encourages appropriate assignments of staff with a team focus to make deep culture change possible; allows residents to make their own decisions; allows spontaneous activity opportunities; and encourages and allows residents to be treated as individuals. Deep culture change is an important component of the right of residents to “care and services to attain or maintain the highest practicable physical, mental and psychosocial well being;” as promised in the 1987 Nursing Home Reform Law.
In a few words… ‘paying attention to the little things’ which may be important to a resident, can either make or break their experience, their quality of life, their ‘sense of home’. It is this self-directedness, this feeling of being in charge of your own destiny (provided it maintains health and safety), that is the key to a fulfilling community experience.
Allowing a person to describe ‘a good day or best day would include…. ‘ as well as ‘describing a bad day’, will serve to enlighten nursing staff, other direct care staff, family members and long term care ombudspersons as to their choices.
What are some common examples of potential requests?
Respecting a resident’s right to sleep longer than the ‘community wake up time’;
Requesting that a medication be stopped or given at a different time;
Asking that foods reflective of one’s culture be brought in to the community ‘X times per month’ versus the usual dietary fare or incorporated in the menu if possible;
Requesting to bath/shower at night versus in the morning;
Embracing a resident’s talents if they wish to instruct others in an activity such as crocheting, painting etc,
Requesting extra time be given for certain tasks, not to ‘feel rushed.’
Requesting transportation- visits to a favorite place when time, resources allow.
LISTEN TO A LIVELY, INFORMATIVE PODCAST WITH MAIREAD PAINTER (CT LONG TERM CARE OMBUDSMAN & FORMER KANSAS LONG TERM CARE OMBUDSMAN CAMILLE RUSSELL -
(Available on Apple and other formats). This Podcast Series is called -
YOUR CARE, YOUR RIGHTS, YOUR VOICE
Example of A Plan of Care focusing on Person Centered Care
(Template from the New York State Department of Health)Link - https://www.health.ny.gov/health_care/medicaid/redesign/hcbs/docs/pcp_template.pdf
****If you have a long term care question or issue, I may be able to assist with (fee for service) please contact me on my contact page. Fees may be negotiable.
Long term care is one of my passions in memory of all those residents I served professionally in the past, as well as in memory of my mother, Patricia V. Gore.
Comments are encouraged! Let me know what you found to be most helpful.