ReviewResident outcomes of person-centered care in long-term care: A narrative review of interventional research
Section snippets
Background
The demand for long-term care (LTC) services has risen with the growing aged population. However, residents’ lives in LTC have been characterized by loneliness, helplessness, and boredom (Thomas, 1996). LTC includes skilled nursing homes, assisted living, and other types of residential or care homes where residents live on the premises. LTC residents are reported to have lower quality of life and poorer outcomes than community dwelling elders, including increased depressive symptoms, rapid
Search strategy
Two search strategies were used to identify relevant articles for this narrative review. First, multiple databases were searched and relevant articles were selected. Second, reference lists of all articles selected were reviewed to identify additional relevant articles.
Searches were conducted on CINAHL, MEDLINE, PsychoINFO, Evidence Based Medicine Reviews, Cochrane Review, and ProQuest Dissertations and Theses using the following keywords individually and in multiple combinations:
Results
The studies were categorized into two groups based on the type of PCC intervention. The first group includes studies for LTC residents in general (Table 1). All 15 studies in this group were guided by culture change models and conducted in the US. The second group, conducted in the UK, Australia, and US, includes studies specifically for residents with dementia; most studies (8 out of 9) in this group reflected Kitwood's PCDC model (Table 2).
Discussion
Person-centered care, which is viewed as a high quality approach in residential care settings, requires a significant shift in philosophy from custodial, physical task-oriented care to care that redirects the control to residents with the goal of facilitating autonomy, independence, and QoL. It is a care model that upholds the older adults’ humanity and works on the unique needs of the individual rather than institutional and biomedical goals (Brooker, 2007, Gladman et al., 2007, Powers, 2005).
Conclusion
There are several ongoing efforts to improve the quality of life and care in LTC settings across the world, as alluded to in our introduction. None have the kind of strong empirical evidence base that we need or would like, but all have at their heart the desire to make things better. It is unlikely that any of these models, in isolation can have a lasting impact and there is a need to conduct further synthesis and investigate the accumulative impact of combining approaches and models. The
Conflict of interest
None declared.
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