Person-Centered Caregiving

In honor of me going back to dementia caregiving, I decided to make a post on person-centered care. So, what is person-centered care? It’s exactly what it sounds like! Taking the person’s beliefs, wishes, preferences, and culture- among other things, to influence how you take care of them. Using myself as an example, if I was unable to live independently, I would want my preferences catered to! For example, my two least favorite foods are raw onions, and jello (*gags*). If someone was using the person-centered care model, those foods would not even be considered as options to feed me. Another example is with bathing. I shower, without fail, every evening before bed. If a caregiver was to not use person-centered care, they may have me shower in the morning upon waking up out of convenience. I prefer to listen to music to watching TV. I’m not really into movies. I like to play piano and read in my free time. I prefer to wear minimal clothing when home alone. I like my privacy. I’m an atheist. When I am on hospice and dying, I want to be LOADED THE FUCK UP with morphine and ativan. All of these things, and so much more, are integral to providing customized, appropriate care for individual human beings. 

I think the one thing many new caregivers- especially when someone’s mental capacity is diminished, such as the case with dementia and mental health patients, is assuming that they are all the same. This is farthest from the truth. Every single person has different needs and wants, and as a caregiver, it is your obligation to cater to all of them as long as it is physically safe for the person, yourself, and others (at least in group settings). Remember, for many of the people who are in care homes, they have been independent adults in society, living how they wished until their physical and mental health deteriorated to the point of no longer being able to take care of themselves and live safely and independently.

Something that many family members of people in care homes do not understand is that med passers, unless there is an order from a doctor saying otherwise, MUST tell the person that they are taking medication. It does not matter if the medication is crushed and mixed with food, liquid, over-the-counter, or whole pills. Even the most advanced dementia patient can refuse medications, even if that means that they will be anxious, in pain, or aggressive, or will exacerbate any other physical or mental health conditions they have. It is their right to refuse, and they can revoke consent for any care task for any reason, at any time. That doesn’t mean that you can’t leave and come back later to see if they changed their mind, but a refusal is a refusal. Period. This is why I do not like to work in mental health settings, as many of the residents there have “hide orders,” which means that you crush or mix the medication into food or drink, and intentionally not tell them that there is medication in it. It makes me very uncomfortable to do that. Luckily in memory care, this is exceedingly rare. In the two years I worked in a care home, I have only seen one hide order, and it made me feel super shady to honor it. Hopefully, this time around, there won’t be any. 

One more time, consent can be revoked for any person, in any situation, at any time.