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Pre-talk questions. Please complete the two questions that are on your seat There will be no request to share your answers with anyone else. Partner logo here. Contemporary extensions of the Person Centred Approach Geoff Jones.
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Pre-talk questions • Please complete the two questions that are on your seat • There will be no request to share your answers with anyone else
Partner logo here Contemporary extensions of the Person Centred ApproachGeoff Jones Training support • Skills development • Competency • Assessment • Scholarships • Education
Review 3 extensions • Implications for services Aims
Brooker - VIPS • Cheston & Bender – Person-focused Care/ Client-focused approach • Nolan, Keady et al – Relationship centred care Three Extensions
Focus • Better dementia policy • Better implementation by providers Method • Easy description – VIPS • Quality tool – VIPS framework # One Dawn Brooker - VIPS
Resulting in: • Broader PCC policy initiatives for dementia • More effective action by managers & staff • Systematic tracking of implementation VIPS – 2
V = Valuing people with dementia and those who care for them I = Treating people as Individuals P = Looking at the world from the Perspective of the person with dementia S = A positive Social environment VIPS = V+I+P+S
?Easy to convey/catchy • Strong on ‘dementia-ism’ • Links management policies to PCA VIPS – strengths/additions
PCA/VIPS > individualised services • Describes mis-applications • VIPS framework – quality tool VIPS – strengths/additions(contd)
Limited scope – group, centre-based services • Person with dementia & paid carers only • Limited description of the social environment • ‘Soft’ on theory of dementia VIPS – weaknesses
PCA both a theory of dementia and an approach to service delivery • D = NI + H + B + P + SP Kitwood Enriched Model
Focus • Subjective world of PWDementia • Cultural & social context • People at home • Psychological interventions #2 Cheston & Bender Person-focused care or client-focused approach
Method – to focus on: • Person with dementia • Emotions and understandings • Person in the context of spouse or family • Within a wider society and its values Cheston & Bender - 2
Resulting in: • Possible psychological explanations for confusion and memory loss Cheston & Bender - 3
Properly attributing relevant behaviour to emotional & identity needs • Effective, life-enhancing forms of (psycho-social) help Cheston & Bender - 4
People at home/alone • Psychological explanations for all/part of confusion & memory loss • Social role loss C&B Strengths/additions
Psychological theory of dementia – emotional security and safety • Person focused assessment • Therapeutic interventions C&B Strengths/additions
Only those PWDementia seeking help • Evidence is from small informal studies – but has stimulated research C&B Weaknesses
Focus • Relationships – PWDementia, carers • Gerontological nursing Method • Qualitative descriptions of experience • Inclusive value base eg research design #3 Relationship centred-care Nolan, Keady
Resulting in: • ‘Senses’ for long term care • Emphasis on interdependence • Stage models to use when working with families Relationship centred - 2
Dyads/family as focus of intervention • Use of grounded theory – voices • Carer as alternative expert • Challenges that PWD is always a burden Relationship centred – Strengths/additions
Stage theories from pre-diagnosis to post-death • Structure for staff to use when working with families • Explanations for low take-up of services Relationship centred – Strengths/additions (contd)
Results are local – research method • Purely descriptive - ?little new • Narrow focus Relationship centred – weaknesses
Utility for policy makers and staff? • How dementia is portrayed? Policy and Practice
Principles • the human Value of people with dementia, regardless of age or cognitive impairment, and those who care for them • the Individuality of people with dementia, with their unique personality and life experiences among the influences on their response to the dementia • the importance of the Perspective of the person with dementia • the importance of Relationships and interactions with others to the person with dementia, and their potential for promoting well-being. UK NICE 2006
What are the elements for a person-centred description of dementia? Do PCA services need a person centred description of dementia?
Still to be resolved • Multiple levels of explanation • Multiple research methodologies • Task/relationship tension • Primary and secondary prevention
The 3 extensions differ in focus – none offer a comprehensive account of PCA • PCA does not yet offer comprehensive guidance for dementia services Summary