Beyond ‘person-centred’ care: a new vision for gerontological nursing
Mike R. Nolan PhD, MA, MSc, RN
Search for more papers by this authorSue Davies PhD, MSc, BSc, RGN, RUV
Search for more papers by this authorJayne Brown M. MedSci, DipEd, RGN
Search for more papers by this authorJohn Keady PhD, RMN
Search for more papers by this authorJanet Nolan MEd, BA, RGN, RUV
Search for more papers by this authorMike R. Nolan PhD, MA, MSc, RN
Search for more papers by this authorSue Davies PhD, MSc, BSc, RGN, RUV
Search for more papers by this authorJayne Brown M. MedSci, DipEd, RGN
Search for more papers by this authorJohn Keady PhD, RMN
Search for more papers by this authorJanet Nolan MEd, BA, RGN, RUV
Search for more papers by this authorAbstract
Currently considerable emphasis is placed on the promotion of person-centred care, which has become a watchword for good practice. This paper takes a constructively critical look at some of the assumptions underpinning person-centredness, and suggests that a relationship-centred approach to care might be more appropriate. A framework describing the potential dimensions of relationship-centred care is provided, and implications for further development are considered.
References
- Barker P.J., Reynolds W. & Stevenson C. (1997) The human science basis of psychiatric nursing: theory and practice. Journal of Advanced Nursing 25, 660–667.
- Brechin A. (1998) What makes for good care? In Care Matters: Concepts, Practice and Research in Health and Social Care ( A. Brechin, J., Walmsley J. Katz & S. Pearce eds). Sage, London, pp. 170–187.
- Bright R. (1997) Wholeness in Later Life. Jessica Kingsley, London.
- Brown J. (2002) ‘The AGEIN Project’. Paper presented at RCN Research Conference, Exeter.
- Clark P.G. (1995) Quality of life, values and teamwork in geriatric care: do we communicate what we mean? Gerontologist 35, 402–411.
- Clark P.G. (2002) Values and voices in teaching gerontology and geriatrics. The Gerontologist 42, 297–303.
- Davies S., Nolan M.R., Brown J. & Wilson F. (1999) Dignity on the Ward: Promoting Excellence in the Acute Hospital Care of Older People. Report for Help the Aged/Order of St John's Trust, London.
-
Department of Health (2000) The NHS Plan: A Plan for Investment, a Plan for Reform. HMSO, London.
10.1037/e363212004-001 Google Scholar
- Department of Health (2001) National Service Framework for Older People. HMSO, London.
- Evans M. (1999) Ethics: Reconciling Conflicting Values in Health Policy. Policy Futures for UK Health no. 9. Nuffield Trust, London.
- Evers H.K. (1991) Care of the elderly sick in the UK. In Nursing Elderly People ( S.J. Redfern ed.). Churchill Livingstone, Edinburgh.
- Fagermoen M.S. (1997) Professional identity: values embedded in meaningful nursing practice. Journal of Advanced Nursing 25, 434–441.
- Forsgärde M., Westman B. & Jansson L. (2002) Professional carers’ struggle to be confirmed: narratives within the care of the elderly and disabled. Scandinavian Journal of Caring Sciences 16, 12–18.
- Hanford L., Easterbrook L. & Stevenson J. (1999) Rehabilitation for Older People: The Emerging Policy Agenda. King's Fund, London.
- Happell B. (2002) Nursing home employment for nursing students: valuable experience or harsh deterrent? Journal of Advanced Nursing 39, 529–536.
- Happell B. & Brooker J. (2001) Who will look after my grandmother? Attitudes of student nurses towards the care of older adults. Journal of Gerontological Nursing 27, 12–17.
- HAS (1998) ‘Not Because They are Old’: An Independent Inquiry into the Care of Older People on Acute Wards in General Hospitals. Health Advisory Service 2000, London.
- Henderson J.A. & Vesperi M.D. (1995) The Culture of Long Term Care: Nursing Home Ethnography. Bergin and Garvey, New York.
- Herdman E. (2002) Challenging the discourse of nursing ageism. International Journal of Nursing Studies 39, 105–114.
- Jones M., O'Neill P., Waterman M. & Webb C. (1997) Building a relationship: communication and relationships between staff and stroke patients on a rehabilitation ward. Journal of Advanced Nursing 26, 101–110.
- Kitwood T. (1988) The technical, the personal and the framing of dementia. Social Behaviour 3, 161–180.
-
Kitwood T. (1989) Brain, mind and dementia: with particular reference to Alzheimer's disease.
Ageing and Society
9, 1–15.
10.1017/S0144686X00013337 Google Scholar
-
Kitwood T. (1990) The dialectics of dementia: with particular reference to Alzheimer's disease.
Ageing and Society
10, 177–196.
10.1017/S0144686X00008060 Google Scholar
- Kitwood T. (1993) Person and process in dementia. International Journal of Geriatric Psychiatry 8, 541–545.
- Kitwood T. (1997) Dementia Reconsidered: The Person Comes First. Open University Press, Buckingham.
- T. Kitwood & S. Benson (eds) (1995) The New Culture of Dementia Care. Hawker Publications, London.
- Kitwood T. & Bredin K. (1992a) Towards a theory of dementia care: personhood and well-being. Ageing and Society 12, 269–287.
- Kitwood T. & Bredin K. (1992b) A new approach to the evaluation of dementia care. Journal of Advances in Health and Nursing Care 1, 41–60.
- Kivnick H.Q. & Murray S.U. (1997) Vital involvement: an overlooked source of identity in frail elders. Journal of Aging and Identity 2, 205–225.
- Lee K., Volans P.J. & Gregory N. (2003) Trainee clinical psychologists’ views on recruitment to work with older people. Ageing and Society 23, 83–97.
- McCormack B. (2001) Negotiating Partnerships with Older People: A Person-Centred Approach. Ashgate, Aldershot.
- McCormack B. (2004) Person-centredness in gerontological nursing: an overview of the literature. Journal of Clinical Nursing 13, 3a, 31–38.
- MacDonald C. (2002) Nursing autonomy as relational. Nursing Ethics 9, 194–201.
- McKinlay A. & Cowan S. (2003) Student nurses’ attitudes towards working with older patients. Journal of Advanced Nursing 43, 298–309.
- Mintz S. & Marosy J.P. (2000) Family caregivers and home care: a declaration of interdependence. Caring Magazine June 2000, 24–26.
- Mulrooney C.P. (1997) Competencies needed by formal caregivers to enhance elders’ quality of life: the utility of the ‘Person- and Relationship-centred Caregiving (PRCC) Trait’. Sixteenth Congress of the International Association of Gerontology, Adelaide.
- Nay R., Rowell G. & Hock S. (2000) Nursing Care of Older People: Developments and Innovations Internationally. International Council of Nurses, Geneva.
- Nolan M.R. (1997) Health and social care: what the future holds for nursing. Keynote address at Third Royal College of Nursing Older Person European Conference and Exhibition, Harrogate.
- Nolan M.R., Grant G. & Keady J. (1996) Understanding Family Care. Open University Press, Buckingham.
- Nolan M.R., Booth A. & Nolan J. (1997) New Directions in Rehabilitation: Exploring the Nursing Contribution. Research Reports Series No. 6. English National Board for Nursing, Midwifery and Health Visiting, London.
- M.R. Nolan, S. Davies & G. Grant (eds) (2001) Working with Older People and their Families: Key Issues in Policy and Practice. Open University Press, Buckingham.
- Nolan M.R., Davies S., Brown J., Keady J. & Nolan J. (2002) Longitudinal Study of the Effectiveness of Educational Preparation to Meet the Needs of Older People and Carers: The AGEIN (Advancing Gerontological Education in Nursing) Project. English National Board for Nursing, Midwifery and Health Visiting, London, 320 pp.
- M.R. Nolan, L. Lundh, G. Grant & J. Keady (eds) (2003) Partnership in Family Care: Understanding the Caregiving Career. Open University Press, Maidenhead.
- Packer T. (2000) Does person-centred care exist? Journal of Dementia Care 8, 19–21.
- Philp I. (2003) The development and implementation of the National Service Framework for Older People's Services. Generations Review 13, 24–25.
-
Pryor J. (2000) Creating a rehabilitative milieu.
Rehabilitation Nursing
25, 141–144.
10.1002/j.2048-7940.2000.tb01889.x Google Scholar
-
Rønning R. (2002) The importance of care as a positive concept.
Quality in Ageing
3, 34–43.
10.1108/14717794200200025 Google Scholar
- Reed J. & Bond S. (1991) Nurses’ assessment of elderly patients in hospital. International Journal of Nursing Studies 28, 55–64.
- Reed J., Cook G., Childs S. & Hall A. (2003) ‘Getting Old is Not for Cowards’: Comfortable, Healthy Ageing. Joseph Rowntree Foundation, York.
- Scheidt R.J., Humphreys D.R. & Yorgason J.B. (1999) Successful ageing: what's not to like? Journal of Applied Gerontology 18, 277–282.
- Schumacher K.L., Stewart B.J. & Archbold P.G. (1998) Conceptualisation and measurement of doing family caregiving well. Image – the Journal of Nursing Scholarship 30, 63–70.
- Standing Nursing Midwifery Advisory Committee (2001) Caring for Older People in Nursing Priority. Department of Health, London.
- Tresolini C.P. & the Pew-Fetzer Task Force (1994) Health Professions Education and Relationships-centred Care: A Report of the Pew-Fetzer Task Force on Advancing Psychosocial Education. Pew Health Professions Commission, San Francisco.
- Wadensten B. & Carlsson M. (2003) Nursing theory views on how to support the process of ageing. Journal of Advanced Nursing 42, 118–124.
- Wells T.J. (1980) Problems in Geriatric Nursing. Churchill Livingston, Edinburgh.
- Whall A.L. (1999) Bridging the gap between nursing and gerontology: an epistemological view. In Gerontological Nursing Issues for the Twenty-first Century ( S.H. Gueldner & L.W. Poon eds). Center Nursing Press, Sigma Theta Tau International, Washington, DC, pp. 29–34.
- Williams B. & Grant G. (1998) Defining ‘people-centredness’: making the implicit explicit. Health and Social Care in the Community 6, 84–94.
- Zgola J.M. (1999) Care that Works: A Relationship Approach to Persons with Dementia. John Hopkins University Press, Baltimore, MD.