Title
Person Centred Care in the Community
Research team
Prof Murna Downs, Head of School, School of Dementia Studies, University of Bradford
Results
2016

Person Centred Care in the Community

This paper is part of a series of Learning Papers commissioned by Genio to explore learnings in practice on specific topics within Dementia and results from a workshop titled "Person Centred Care in the Community", facilitated by Prof Murna Downs and attended by representatives of dementia projects supported by the HSE & Genio. Person-centred care is widely recognised as the preferred approach to care. How it is understood reflects on its implementation in practice across a variety of settings. The purpose of this workshop was to revisit the theory behind the practice and to consider its applicability across the community setting.

The following key areas emerged from the workshop

  • Risk identification and risk assessment were found to be some of the most complex aspects of professional practice, with a responsibility to protect yet not diminish someone’s quality of life. 
  • Positive risk taking enables those working in the dementia space to address both safety and protect the person with dementia’s quality of life.
  • It is important to take a broad view of subjective risk and ensure that everyone, especially the person diagnosed with dementia, has a clear voice within the process.
  • The dilemmas faced by practitioners and service managers in risk assessment in dementia care are complex, and profoundly influence the nature of care available to people.
  • Within these complex dynamics of judgements and team-working, it is important to include the person diagnosed with dementia so that they can influence decisions about their own support, yet at times the voice of the person with dementia is relatively silent. 
  • Advocacy services, although rather underdeveloped in dementia care, can play a very important role to support the person with dementia be able to verbalise their needs and wishes and communicate these effectively to services.
  • A risk enabling approach offers the opportunity to attend to safety, welfare and quality of life.
  • It is not possible to eliminate all risks – the focus should be on the least restrictive care and environment.
  • Enable people to manage uncertainty rather than create certainty - to avoid unnecessary dependence and risk avoidance.
     
Key Points
  • Risk identification and assessment is one of the most complex aspects of professional practice, with a responsibility to protect without diminishing quality of life.
  • Positive risk taking can help balance safety concerns without diminshing the person with dementia’s quality of life.
  • It is important to take a broad view of subjective risk and ensure that everyone, especially the person diagnosed with dementia, has a clear voice within the process.
  • Care should enable people to manage uncertainty rather than create certainty, avoiding unnecessary dependence and risk avoidance.

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