Patient centred healthcare in gerontological services
This blog’s latest post on multidisciplinarity and quality assistance produced a comment by Josep de Martí, director of the retirement home portal Inforesidencias and author of the book “How they cheated us with the Disability Law”. Mr. de Martí drew my attention on a post at his blog written by gerontologist Teresa Martínez about person centred assistance (PCA) in gerontology services.
Mrs Martínez writes about how more and more countries are changing the “hospital” model of nursing homes towards a more “home like “model and more people centred. One of the merits of the SeniorLab project I had the privilege to direct for Citilab was to put elders in the centre of innovation and co-design with them. This work allowed many insights about elderly people to come to the surface; insights that are still ignored by a number of technology companies for elders (ambient assisted living) or by nursing home managers.
First of all, seniors do not want necessarily more security and more assistance; they would rather like to feel they are socially valuable and that they can still contribute. Second, instead of a hyper-medicalization and hyper-monitoring, what they need is to be more independent: assisting technologies developed with that goal are much more likely to gain market acceptance. Third, even at a very advanced age, seniors want to be active. When institutions define “active” we find activities designed by physicians, psychologists, physiotherapists and gerontologists: physical exercise, brain games, social programs, cultural activities…but what did anybody ask the elder?
In this sense the work of Intress is paramount. Intress is a non-profit association that manages nursing homes in several Spanish provinces. The firs good practice is the frequent dialogue with the family and their active involvement, so that elders are not left alone and can have a meaningful family life. The second good practice is that seniors themselves can design their activities too (without diminishing the importance of medical and psychological assistance), for instance practicing agriculture small gardens (because they had been peasants before retirement, for example), ride a motorbike and other activities outside “catalogue”.
There is a lot of literature on patient or person centred care, but to understand what this means examples like Intress are more useful than reading. And foremost, ask oneself: “if I was in the place of that older person, how would I like to be treated. The answer is easy: next time ask directly that older person.