Person Centred Care:
Partnership
Person-centred care involves working in partnership with the person.
Partnership is about ensuring that we base care decisions on the wishes of the person living with dementia, not just for the big decisions but for all the little moments of care. It’s about doing things with people rather than doing things for them.
Ernesto’s Story
One lady I looked after was not eating much, losing weight, and had not opened her eyes at meal times for ages. We had to feed her, but it wasn’t working well.
I changed tack, and now I sit beside her instead of opposite her. Instead of feeding her myself, I gently explain what I am doing and place my hand under her hand so that she can hold the spoon. When she is ready, I help her to feed herself in this way.
She opens her eyes now, swallows safely, and eats much more. She even talks to me sometimes during meals now. It takes longer, but the result is much better, and we now have so much more interaction and connection!
What Do We See in Ernesto’s Story?
Partners negotiate a shared goal and how to achieve it.
Partners can achieve more working together.
Partnership can take thought and effort, but it’s very satisfying!
Partnership leaves a better emotional ‘taste in the mouth’. Bear in mind that being task-focused or trying to bend reluctant people to our will is also hard work and leaves a bad taste in everyone’s mouth. At worst, it is intimidating; at best, it leaves people wondering whether they are being cared for as individuals. How would you rather spend your time?
Tip 1: Think About How We Talk
Use invitations instead of demands (for example, “We would like to invite you to join us for our newspaper reading this morning, Mona” rather than “Come down to the lounge Mona, it’s time for newspaper reading”).
Offer choices rather than demands (for example, “I’ve got some time to help you get ready for the day now, John. Would you like me to help you get dressed?” rather than “It’s time to get dressed now, John”).
Explore what is motivating a person to want to do something (especially if this is challenging for the situation they are in) rather than confront the person about the thing they want to do (for example, in the setting of someone wanting to go through the main exit their aged residential care by themselves when that might not be safe, “Kia ora Pita. You look like you would like to go somewhere. Tell me what’s on your mind?” rather than “You can’t go out there now, Pita.”
Tip 2: Think About Our Nonverbal Language
It is our nonverbal language that communicates our desire to engage in partnership rather than to dominate or intimidate someone. This is true whether the person can use the same language as you or not. The simplest things we can do might include:
Standing beside a person rather than facing them or standing opposite them.
Taking a gentle, non-threatening stance, such as bending toward a person or crouching beside them rather than standing tall or looming above them.
Lightly touching a person’s arm or offering to hold their hand to help gain their attention, rather than physically orienting their face to you.
Adopting a questioning, friendly tone of voice rather than a brisk, business-like tone.
Showing a person with actions or props what needs to be done rather than just leading them somewhere (for example, giving a person a flannel and soap rather than just leading them into the bathroom).
Offering a choice of two physical things to choose from.
Tip 3: Think About the Person and Not Just Getting the Task Done
Being a true partner means accepting that we will not always get our way. Good questions to ask ourselves include: “Does getting my way really matter in the big picture? ”
Partnership is about a strengths-based approach: ‘How can I support this person to continue to use their abilities?’
Partnership encourages us to find out “What is important to this person in this moment? What is important in their life?”
