Understanding Person-Centered Care Planning

Within the healthcare industry, person-centered care planning is a practice of fairly new origin. Person-centered care planning involves patients far more actively in their own course of medical care and treatment, with close cooperation with appropriate healthcare professionals. Relatives are also sometimes included in the care planning process. 

Settings Where Person-Centered Planning Is Utilized

Person-centered planning is utilizing in a range of settings. These include:

  • Inpatient hospital care
  • Outpatient medical care
  • Emergency care
  • Rehabilitation
  • Palliative care
  • Long-term care

This care planning paradigm is being used in the assisted living arena as well.

Key Principles of Person-Centered Care Planning

There are four primary principles associated with person-centered care planning. These are:

  • The health care should be based on the unique person’s needs and his or her right to health
  • The health institution should focus on the abilities of the person and encourage activity
  • The health care should be coherent
  • Health professionals should always approach patients with dignity, compassion and respect. They should work with an ethical perspective.

Goal or Person-Centered Healthcare Plan

A primary goal of a person-centered healthcare plan is to capture a patient’s narrative. This has been described by the John Hopkins University Medical Center in this way:

A common understanding of strategies, goals and evaluation of the outcomes should be established. The documentation should clearly state the responsibilities of each member of the team, including the patient’s own role and obligations. To fully live up to the person-centered care concept, patients should have full and easy access to all information and documentation about them. For reasons of security, accessibility and cost effectiveness, all documentation should be digital and include all medical records. The person’s own notes, reports of health status and the overall health plan should also be carefully documented. The collected documentation is the foundation of the health care.

Person-Centered Care Planning and Healthcare Activation

Person-centered care planning sets the stage for what many are beginning to call healthcare activation. Healthcare activation is a condition or state of affairs in which a consumer or patient (or prospective resident or resident of an assisted living community) is in a better position to make his or her own decisions, to advocate for his or her self. Health activation focuses primarily on the behavior and attitude of a patient. Specifically, healthcare activation ensures that a consumer is an educated, motivated, and equipped manager of his or her own healthcare. 

Older People and Long-Term Care

Writing in Promoting Good Care of Older People in Institutions, Gemma Perez- Rojo and Javier Lopez stated:

Good care focus on empowerment, respect, humanization, and absence of infantilization. Good care implies, on the one hand, prevention of abuse or mistreatment, and on the other, patient-centered care.

In Person-Centered Practice in Nursing and Healthcare: Theory and Practice by Jackie Riddett, Brendan McCormack, and Tanya McCance, what is described as a holistic framework for person-centered care planning is laid out for consideration. The framework consists of what is described as “four constructs.” These are:

  • Prerequisites
  • Care environment
  • Person-centered processes
  • Expected outcomes

This framework can easily be fitted around the consideration of whether or not an older individual should transition to assisted living:

  1. Prerequisites focus on the needs, goals, and objectives of the person who may or may not benefit from transitioning into an assisted living facility. Detailed assessments are made, that directly involve all due considerations put forth by the older individual his or her self, that focus on how he or she may benefit as a person by residing in an assisted living environment.
  2. If a preliminary determination is made that assisted living makes sense for that individual, the focus then turns to considering different care environments. Initially, a determination is made as to what type of long-term living environment makes the most sense for that person. If assisted living is the pathway selected, attention then is turned to considering different assisted living community alternatives.
  3. The entire process is person-centered. The needs, goals, objectives, and desires of the older person are at the heart of the process.
  4. Finally, close attention is paid to the expected outcomes (contrasted with the desired outcomes) of transitioning to a specific assisted living community. A decision with guidance from what is desired and what realistically can be expected in a particular assisted living community.

In the end, person-centered care planning is highly beneficial in making the initial determination of whether or not an older person is ready to transition into something like an assisted living community. Person-centered care planning also comes into play if the point in time is reached at which it seems that an older individual may be in need of a different type of long-term care environment that provides a more extensive array of services than what is found in an assisted living setting.