It’s in all the guidance and expectations about care, but what does it really mean to DO person-centred care in real life, and what difference does it make? Find out in this episode of SNACK.
Special thanks to all our guests, and to the organisations that helped:
Looking for some inspiration? Check out these great resources and links:
SNACK has been produced by COTA Queensland as part of the Homecare Workforce Support Program, which receives grant funding from the Australian Government.
We acknowledge the traditional owners of the lands on which this podcast has been produced and we pay our respects to elder’s past and present.
00:08
This listening to the person and trying to understand their perspective, appreciating how important it is for that person to be heard.
00:17
And I think we’ve had, the trouble is, most people are really good. But then you only remember the bad bits.
00:27
So I value the personal touches that remind me that I’m a human being worth being cared about.
Andrea Petriwskyj 00:39
Welcome to snack, the aged care podcast where we break down some of the big questions around what it really means to be person centred. I’m Dr. Andrea Petrovsky. I’m a gerontologist and I’m passionate about hearing and sharing the real life experiences of ageing.
Andrea Petriwskyj 00:57
Today, we’re kicking off the series by looking more deeply at what person centred care really means. We hear it talked about a lot. It’s something that’s in all the guidance and expectations about care, including the aged care quality standards. So we know it’s essentially how well we work with and support someone to be an active partner in their care how we help ensure their care meets their needs and preferences and their goals. But what does it really mean to do person centred care? And what difference does it make?
Andrea Petriwskyj 01:26
In this episode, we’re going to find out what this can look like in real life, and how you can develop your own person centred approach. Here’s a conversation with Renee who receives support in her home and has experience with a number of different care staff. Renee, you’ve had some great experiences with personal carers in your home, what does good person centred care look like to you?
01:53
For me, really good quality personal care means that a worker or carer who comes into my home is actually doing tasks requested by me and in ways that respect my individuality, I suppose. But not automatically in in the same way for everybody. I think a visitor who comes to my home, who asked questions about, you know, my current well being or, and really listens and responds by words and actions. I think that person is a true carer.
Andrea Petriwskyj 02:28
Do you have any examples of that in your experience that you’d be happy to share with us?
02:33
I guess I do. I’ve got a carer at the moment who has been with me for about three years. And she now does my grocery shopping, because I can no longer do it. And we’re all alone. And she comes in and takes my list and we sit down with a quick drink, not an alcoholic one. We go over the list. And she asks appropriate questions about, you know, the needs, and should she substitute all that sort of thing. So it’s a very focused kind of attention on that grocery list. And when she’s in the shop, she can tell whether something’s not on the list that is on special and is running low in my house. And I find that really incredible. No, it’s not an automatic response to a job.
Andrea Petriwskyj 03:26
Yeah. So why does that kind of person centred care matter? What difference does it make to you?
03:32
Oh, my goodness, so many ways it matters. When my independence went away, and life kind of shrank to bare existence, which it has done. I guess it became important to avoid being dehumanised any further, by efficiently, you know, I’m carrying workers in the home. So I value the personal touches that remind me that I’m a human being with being cared about.
Andrea Petriwskyj 04:04
So it’s really it’s a way of working with you that you know, they’re not there to do a task. They’re, they’re there to care about you and for you and with you.
04:17
Yeah, absolutely.
Andrea Petriwskyj 04:23
I want to share another example with you that came from Janet who not only receives care in her home but also supported her husband, and is a community advocate for people living with disability and people receiving aged care.
04:36
I think that’s most important. The carer who comes out, does listen to that person, to see what they actually need and what they want, I think important that the older person who’s having the care is involved in organising what she needs, they need to understand what that person needs weathers that person is to first and aggravated for them and they can’t handle it.
Andrea Petriwskyj 05:04
Yep. So their approach really needs to be responsive to, and really understanding of that individual that yes, I think that’s most important because that person with what age or what disability I’ve gotten the ageing side of things, needs to have respect and dignity.
Andrea Petriwskyj 05:26
We’ve been hearing some examples of things care staff do that make people feel heard and responded to, and some examples that people see as good practice. But on the flip side of that, let’s hear what Margaret had to say about things that can happen that frustrate her in her home.
I resent people coming into having to come in to do the work that I used to do quickly at the moment, it’s fraut, because I we have changing people coming in. So we have to chair tell every person where the mop is, the vacuum cleaner is what we don’t say. But we should say is, please put everything back when you found it.
06:09
I mean one dreadful day, one lady came in young lady and started doing stuff. And she said, oops, my time is up. So she left the vacuum cleaner in the middle of the lounge room floor. And then I discovered the mop and the bucket, were left in the laundry on the floor. Now for Tony, he’s now been declared legally blind. Now I’ve got a few problems of my own physical problem bending over, I’ve got bad knees, I’ve got poor hearing poor vision. But I have to watch to see that Tony’s safe. And then I can’t leave vacuum cleaners in the middle of the floor where he might walk. And the other thing is that we have a couple of maps and mats on the floor. And people pick them up and shake them on that said, it would be better if they didn’t, because that creates dust and my husband has COPD, he can’t breathe, we try to keep the area as dust free and fresh as possible. And that’s I think it’s not understanding who you’re cleaning the house for. Everybody is different. So I guess knowing what the person is, what their sort of problems are, you people can sort of work within that. But if you don’t know, well, you might be creating more of a hassle.
Andrea Petriwskyj 07:37
I think these examples from Margaret and Janet are the kinds of things that really put into perspective how big the implications can be of really understanding the person you’re working with and being responsive to that. And I love the way Renee talked about being efficiently uncaring. That’s such a good reminder that while efficiency is of course appreciated, this really is about humans who care.
Andrea Petriwskyj 08:04
We also spoke to some family carers. Jenny has experienced with the homecare system, both personally in her family as well as professionally. And Angela supported her parents over a number of years as they receive support at home and then move to residential care. So Angela, if I can just jump in right into questions here. From your perspective as a family member, what have you seen done really well?
08:30
The way they come into the house and immediately happy and smiling and ask about their state of health? And is there anything you want me to do that’s different and just be friendly? Yeah. And, and unreliable? Or they could come in and say, you know, my son is driving me insane. But let’s get on with it. Yeah, and they always were there on time. And if they weren’t, they’d ring up and say, Look, I’m going to be 10 minutes late. Is that okay? And they say now, what else do you want me to do? Okay, let’s do that. And then if they had 10 minutes, 15 minutes at the end, they say, Oh, can I make your cup of tea? Just the way that they knew exactly what they had to do. And yet they had time to be friendly and encompassing sort of thing.
Andrea Petriwskyj 09:27
Yeah. So a kind of a combination of ease and confidence.
09:32
That’s right, oh definitely confident.
Andrea Petriwskyj 09:37
Now Jenny, as a family member and a professional, what does good person centred care look like to you?
09:43
Yeah, thanks, Andrea. I think good person centred care, it really is very different in somebody’s own home environment is my take on it anyway, particularly personally. And part of that is understanding mum in her own surroundings, and how she feels seeing and how she navigates her way around her day. So it is being able to step in and be flexible enough to work around her. I think respecting that privacy, I think some flexibility, allowing the person to have that autonomy to make their decision about, I don’t really want to do that at the moment, or I prefer to do this, allowing them to make the decisions. And the the homecare worker helping to support that, I think, I think for mom, particularly with her cognitive impairment, that gives her that sense of control. And, you know, it makes the day go quite smoothly. Yeah. And I think a lot of older people can be very private. So if somebody is going to take someone out to do the shopping, you know, maybe they don’t want to have a coffee that day, or maybe they would prefer to do something else.
Andrea Petriwskyj 10:52
Yeah. So really being able to be understanding someone well enough to be flexible, and to have some options that you can offer.
Andrea Petriwskyj 11:02
I think what we’ve heard there from Jenny, and Angela really resonates also with the importance of being present in the moment with people and being adaptive. And it’s clear that something our guests really value is feeling seen and heard and in control of their lives and their homes. And I loved hearing some of those really practical examples of how this plays out in real life. Now, hearing perspectives from other professionals is always really useful, and especially when it comes to some of those really up close and personal care tasks. So we spoke with Leonie from Seniors Dental Care Australia, Leonie does a lot of work with aged care providers and staff to improve oral care. And we asked her about what person centeredness can look like when you’re doing some of those tasks that are very personal, like helping someone care for their mouth. So let’s hear what they only had to say.
11:54
To me, person centred care is individualised. It’s enabling. And it’s also a coordinated care. That’s, that’s performed in a compassionate and respectful manner. And it’s a lot easier to say those words than to actually put that into action, we’ve actually got to start with that person themselves. And we, we need to understand their experiences with dental care, or their experiences with their mouth, and their attitudes and behaviours. And the second one is how we approach the person in that respectful and compassionate way. And, and the enabling part is about utilising the strengths that that person has in how much of the brushing that that person is able to do themselves. And the last one, I think, for the carers, by being able to have an early diagnosis of dental diseases, and then being alert to some pathologies, like dry mouth, ulcers, and then being able to refer on to somebody. That’s that part of the coordinated care.
Andrea Petriwskyj 13:16
That’s a really great example of how some of those ideas about being person centred can look, because it can feel a bit abstract some of those concepts, but what we’ve just heard is a really useful explanation of what it might mean in that situation to understand where someone’s coming from, to provide support rather than taking over. And it’s also really important for every member of the care team to remember their role in observing, communicating, connecting people with the supports that they might need. Now advocates like the folks at Ada, Australia see lots of both the good and the bad. Here’s a conversation with one of ADA advocates, Lizzie about what good practice looks like to her.
13:58
I think when we’re looking at person centred care, we’re really trying to look at a model of key that is being approached from the perspective of each individual person that you’re attending to. So what that person’s needs are that person’s preferences, and really approaching that role from a human rights perspective. So I think it’s very interesting as an advocate, because very often we’re getting that direct feedback from the older person around the experience of their care and services. So it becomes very obvious when a care worker or anyone within that workforce is able to carry out and conduct those Karen’s services from a person centred approach, again, a person very much can feel it, through that experience, often feel respected, cared for, again, that they have choice they have connection, they have an equal partnership within those care and services, and again, will often feel those attitudes of respect, safety trust,
Andrea Petriwskyj 15:30
why is that approach to care? So critically important, at the absolute crux of it, we’re talking about whether a person feels safe and respected. It’s about whether we’re protecting people’s wellbeing their physical and mental wellbeing methods of self, or whether again, we’re actually causing harm to that person in a direct or indirect way, in the way that we’re interacting and caring for them. I think, when we are coming from that approach, we’re entering into a partnership. So we’re engaging with them, rather than doing for them. We’re giving them choice and control. We’re supporting their abilities rather than diminishing and reducing them. So again, we’re not just assuming that every time we go to that particular person, we’re going to do this specific thing in this specific way. We’re actually approaching them individually every single time on where are they at that day. So to me, it’s, it’s a model where we’re supporting independence, well being self esteem, dignity, human rights, you know, validating a person to be seen and heard. And again, having a say, which they absolutely should have, not only in their care and services, but again, in the way they are living their life.
Andrea Petriwskyj 17:01
I’m not sure I can sum things up any better than Lizzie has just now. But we’ve certainly heard a strong message from all our guests in today’s episode, that person centeredness is really fundamentally about a respectful, two way relationship. It’s one that values individuality, it’s one that can be dynamic and can adapt to really be what’s needed. And importantly, it’s a human relationship, not a transaction, not just a task list, or what’s written on a page.
Andrea Petriwskyj 17:37
That’s today’s snack. Thank you so much for joining us. And a big thank you to our guests for sharing their insights and ideas. If you want to find out more, you’ll find some great resources and other good stuff on our website Kota QL de.org.au. You’ll find links in the show notes. And please don’t forget to subscribe wherever you get your podcasts to make sure you get the next episode as soon as it’s out. Until next time, thanks again and goodbye from the coda Queensland team.
Andrea Petriwskyj 18:10
This podcast is part of the homecare workforce support programme, which receives grant funding from the Australian Government
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