Person-centered is a philosophy of care that is transforming the way organizations care for older adults in memory care, assisted living, and long-term health care services. Person-centered care puts patients and their families at the center of all decisions. Cultural and systematic health care system changes are the driving forces behind replacing the institutional model of care with one of an individualized person-centered care model. Research shows that this patient-centered care model leads to a more efficient level of care and improved quality of life by focusing on the needs of the individual, rather than the schedule of an institution. However, person-centered care is still in the early stages of implementation across our health care system.
The recent changes with health care reform in the U.S. have shifted the focus from a disease or provider model to one that rewards better communication and continuity across all health care providers. Increasing demand for senior care services is paced by an aging population in the U.S. over the next few decades. This, combined with rising health care costs, poses challenges and opportunities for the health care system. According to Genworth, the average cost of long-term care in New York State is more than $120,000 annually. This is a growing and potentially lucrative marketplace. Leading organizations providing assisted living, memory care, and long-term care are leading the way by embracing this patient-centric philosophy to deliver better care outcomes for patients, resulting in improved quality of life and quality of care.
Here are two fundamental changes under way in the senior living marketplace:
Investment in training
Health care organizations considering switching care models from an institutional version to one that is person-centered require a change in internal culture and caregiver training. Depending on the facility, caregivers must be trained by an organization to prepare for a completely different mindset when caring for and interacting with residents of senior care services. Dementia care is a great example of where completely different skill sets are needed, especially with a person-centered philosophy. With this must come more staff empowerment. Rather than correcting behaviors and focusing on symptoms, caregivers must follow person-centered principles of care that take into account the whole person, each with their own unique qualities, preferences, and needs. The control essentially resides with the patient in this model of care.
For example, the Green House Project offers a model for long-term care where residents and caregivers reside in Green House homes. These homes are open environments where residents with long-term care and memory care needs reside with certified nursing assistants (or CNAs). Residents in these homes tend to have more meaningful lives residing in a home like environment where individuality and choice are honored. The results are increased quality of life for residents and healthy bottom lines for service providers.
Creating a community
Many health care organizations are realigning services, consolidating, exploring partnerships, or merging with other care providers to function more efficiently within the new parameters of health care payment reform. One of several benefits to older people is senior living and care organizations focusing on creating a community feel offering a “continuum of care” with several levels of service all within one campus. Continuing Care Retirement Communities (or CCRCs) are organizations accredited by CARF International offering retirement community services and several levels of health care services on one campus. There are just over 250 accredited CCRC communities across the country with one in our region.
So what are some of the benefits to residents? First is convenience with several levels of care on one campus. Someone in independent living can also take advantage of transitional care or a health and wellness center that may be part of the same community campus. Residents can “age in place” with a broad continuum of care as their health care needs evolve with independent living, assisted living, and more. A second benefit is the care experience. Clinical studies have revealed that in a person-centered care model there are many more opportunities for social stimulation and interaction, shared decision making and greater choice, all leading to a more fulfilling experience for residents and staff. At CCRCs, enrichment activities are often the norm and collaboration across the campus offers ample opportunity to interact with a variety of residents that otherwise would not be possible in a hospital-like institutional model of care. Finally, cost certainty can be attained with most CCRCs through life care contracts or modified contracts. Essentially, a resident’s fee would not change with any changes in levels of health care required. The difference between the two contracts is unlimited skilled nursing care with life care and a specified limited number with a modified contract.
The marketplace is beginning to transform to meet emerging market demands. Embracing person-centered care is beneficial for our nation’s older adults and the thousands of senior care service providers. Older adults benefit by enjoying a more independent care experience in home like environments, and senior care service providers are able to deliver more efficient and profitable person-centered care services. Greater advocacy is needed to train staff, reallocate resources, and be better prepared to meet the growing needs for individualized care.
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