Person Centered Care in Long Term Facilities

Placing a loved one in a long-term care facility is often a last resort for families. Though it would be a difficult decision under any circumstances, the decision could made a little easier if the facility promoted person centered care. Nursing homes are moving toward a more home like environment. Ideally, they would like to have residents live in smaller spaces and give the resident more care options. Though nursing home officials would like to implement these changes immediately, there are regulations and laws that are slowing the process.

The cultural change movement represents a fundamental shift in thinking about nursing homes. Facilities are not viewed as health care institutions, but as person centered home offering long term services. The movement encompasses almost three decades of consumer advocacy coupled with legal, legislative, and policy work aimed at improving both the quality of care and the quality of life in nursing homes. (Koren, 2010). Koren believes that if nursing home operations were geared more toward the residents, the quality of life for those living there would be vastly improved. For example, residents would be offered choices and encouraged to make their own decisions about things personally affecting them, such as what to wear or when to go to bed (Koren, 2010). Other small changes such as giving the residents access to refrigerators so that they can get snacks as needed, would also give the residents more control over their lives. In fact, more and more facilities are making refrigerators a standard option in private rooms and rooms billed as private. Two other examples of person centered care practices are being able to choose who to live with and being able to choose what you eat. In most long term care facilities, people are placed two to a room. It would make the experience person centered if the person already in the room got to at least meet the potential roommate. No one should be made to live with someone they do not get along with or someone who may yell and scream throughout the night. One of the last things that a person who lives in a nursing facility may have to enjoy is food. Most long-term facilities prepare food according to a rotating menu. If residents

were allowed to choose their own menu, this would be person-centered practice. In recent years, nursing facilities have been moving more toward this practice. Most nursing facilities offer "anytime menus". These items are offered to the residents every day, at no extra cost. Fine dining is also a concept that may help residents have a more home like atmosphere. The use of real tablecloths, china, and silverware will reduce the feeling of living in a hospital like setting. Soft music and candlelight also may help to make the dining experience more enjoyable.

Another point that Koren makes is that though regulations have been put into place to encourage person centered care, quality continues to be an issue in nursing homes. Quality continues to be criticized. Research suggests an association between poor outcomes for nursing home residents,