The number of older people who are requiring for acute care services is ascending as the population ages (Peek et al, 2007, Traynor, Brisco & Coventry, 2005, McCormack, 2002). As reported in McCormack’s (2002) research, the older people, represented 12.5% of the population, is 30% of all hospital discharge and 46% of all hospital bed days. Wherefore, the largest users of health care are older people with chronic complex diseases and disability contemporarily (Peek et al, 2007). Improving the care quality for older person in acute care setting in is becoming a significant issue. The best practice in the care of older people is considered to be person-centred care contemporarily (Peek et al, 2007). This essay will discuss about what is person-centred care, how to put person-centred care in nursing practice, the barriers may influence the outcome of person-centred care and how to conquer the barriers to make a best result in three aspect.
The concept of person-centred care has been widely discussed for a long time and has variety explained by different authors. Person-centred care is defined as ‘having the information they need to make informed decisions about their care and treatment and, where appropriate to support them to manage their conditions themselves’ (The Department of Health, cited in Williams et al 2005, p. 14). On the other hand, through Edvardsson, Winblad and Sandman’s (2008) opinion, the content of person-centred care included respecting individual’s rights, values and beliefs; knowing their biography and sharing information to help them making decision. Moreover, focusing on strengths of the persons what they can do rather than what they cannot do is the central of person-centred care (Edvardsson & Nay, 2009). In summaries, the right of individuals as persons is the underpinning of the concept of person-certred care. To respect the right of individuals as persons, the staff need to have an attitude of respect of patient to make decisions themselves (McCormack, 2003). Furthermore, Kitwood (cited in McCormack, 2004) also stated that person-centredness is ‘a standing or status that is bestowed upon one human being, by others, in the context of relationship and social being. It implies recognition, respect and trust.’ Therefore, seeing the patient as a person and building a trusting relationship is also important as respect patients’ rights as persons. Although the concept of person-centred care still has an unclear definition, it still been identified as a contemporary gold-standard model within sub-acute care for older people (Edvardsson & Nay, 2009). The aims of using person-centred care in acute ward are improving the quality of care which the professions provide, helping the older be individual and avoiding function decline (Edvardsson & Nay, 2009, Clarke, Hanson & Ross 2003, Gordge, Young and Wiechula 2009). We will discussion how to work out the aims in three ways.
Building a trusting relationship
Building a trusting relationship between nurses and patients is a component of person-centred care. Moreover, Nolan et al (2004) suggest that relationship-centred care is more appropriate in gerontology. During Bridges, Flatley and Meyer’s research (2010), patients and their family considered the relationship between patients and staff as the key feature of patients’ acute care experience result in it is very important to build a trusting relationship between the professionals and patients. A trusting relationship also can reduce the feeling of being observed and cared for, or the discomfortable of been treated like an object and neglected (Edvardsson & Nay, 2009). Therefore, the first process for nurse to provide person-centred care is to establish a trusting relationship. As acute hospital is an unfamiliar and confusing environment for the older people, some older people may have an episodes of acute confusion or cognitive impairment during...