Earlier this month, I had the pleasure of joining my fellow Mount alumnae in a fundraiser for a classmate we lost. It was my first 5K, but to say I “ran” it would be a gross exaggeration: the ’05 ladies and I participated. We strolled through the streets of Essex Fells like we had all the time in the world; after starting late, we did one of three laps and celebrated like we’d actually accomplished something other than a makeshift reunion.
Shortly after my 1.5K, I attended a much-anticipated seminar with the founder of Dementia Village as its keynote speaker. As expected, Eloy van Hal completely blew me away. When describing the community’s unique approach to care, he stressed the importance of individuality and learning as much as possible about each resident. There is, of course, no one-size-fits-all when it comes to this disease or its management.
Eloy affectionately picked on a woman in the audience who, based on appearance alone, was extremely different from him. He made assumptions about her taste in music and pastimes, both of which she confirmed to be accurate. He then described his own preferences. Being a traditional Dutch man, they were obviously nothing like hers. What would happen, then, if the two of them were to be placed in the same nursing home? If he had to listen to pop music on repeat, or do chair yoga between meals? Most likely, he noted, he’d end up a bit restless. Agitated, even.
Eloy’s analogies really stuck with me. His focus was on person-centered care, an approach that has received worldwide recognition and called for a redesign of our own nation’s healthcare system. According to a 2001 report by the Institute of Medicine, we in the US are fragmented and impersonal; we harp on disease and impairment rather than individuality and aptitude.
Person-centered care originates from the works of Carl Rogers and later Tom Kitwood. It emphasizes communication and relationships as opposed to only health and diagnoses. It explains that the environment has just as much of an effect on the brain as the brain has on a person’s abilities. It navigates from the outdated medical model of dementia care and stresses the social piece, instead. Most importantly, it
enables encourages people to get involved in how the services they receive are both organized and delivered.
I remember learning about person-centered therapy in grad school. It was one of my favorite approaches, with core conditions that I find so powerful:
- Unconditional Positive Regard, or deep, genuine caring for the client as a person no matter what, and
- Accurate Empathic Understanding, or sensing a client’s feelings as if they were your own
PCC seems simple enough to implement, but we’ve got quite a ways to go. In the 10+ years following the IOM-necessitated shift, little progress has been made in the United States as compared to other countries. Our move-in packets feature surveys and our activity calendars improved, but we’re coasting. We boast diversity in facilities yet strive for conformity and compliance. We shoot for “home like” and comfy yet solicit input from outsiders (whose homes do we think we’re mimicking anyway?! Not my grandparents’, that’s for sure). We may be on the right track, but we’re still strolling our first lap.