Jennifer Nilsson is a regional manager for Revera Long Term Care in British Columbia. She is inspired by the older adult population and while working on her Master’s in Leadership (Healthcare Specialization) at Royal Roads University, she completed an Organizational Leadership Project with long-term care staff and leaders on person-centred care. Jennifer shares with us some of her learnings and ideas.
What can staff do to deliver person-centred care in a system that is heavily constrained by a lack of resources and time?
JN: Although employees working in our care environments do have many challenges, key components of person-centred care—empathy, caring and choice—were evident when I was doing the research. These person-centred behaviours were being exemplified and helped foster the connection between care workers and the elder.
In addition, workers identified choice as another key aspect of person-centred care. The ability to offer as much choice as possible was seen to positively affect the elder. Staff expressed that the more choice they could offer in the day, the better care they could deliver, and the more positive the effect on their workdays.
Staff acknowledged the balancing act between task completion and the flexibility required to offer choice. Providing choice was a constant challenge in such a highly regulated environment. It was suggested that overcoming these obstacles involved granting employees more autonomy in planning an elders’ day based on past routines. This also leads to a safe care environment, as it reduces the likelihood of responsive behaviours.
How can leaders incentivize staff who believe implementing person-centred care strategies will add additional workload to their busy schedule? What do staff stand to gain from improved client-staff interactions?
One of my personal biases that was challenged and altered through my research was that person-centred care was not being delivered. I found that what we needed was not incentivization but facilitation and that perhaps we overcomplicated person-centred care. The importance of the trusting relationship between the caregiver and seniors was a consistent theme that emerged throughout my research; this suggested that person-centred care was alive and well through relationships already being built between the employee and the elder. What is needed is for that relationship to be nurtured.
Most employees that I have spoken to agree that if they know the resident, it is an advantage to them. That “knowing” is person-centred care. It happens while they provide care to the elders and is not separate. When the relationship is strong between the employee and the elder, elders will exhibit less responsive behaviour. The literature also supported that many employees choose this type of work because they have an opportunity to form a relationship with seniors.
Can you share some strategies to involve frontline staff in developing care guidelines, policies and practices to deliver person-centred care?
JN: I would recommend we engage and empower our employees by including them in the conversation. Are employees at the table when policy is developed? I believe that front-line caregivers should play a role in developing policy. This is particularly important for care aides, who spend the most time with the elder.
In your experience, what does it take to create and support a dynamic learning environment in an organization that wants to implement a culture of person-centred care?
JN: Most important is strong foundational education by organizations, through staff orientation and continuing education, that supports and reinforces the message that the relationship between the elder and caregiver must be protected. I would also recommend education for leadership, so they understand the challenges in care environments for the front-line caregiver. Strong messaging, in combination with good policy structure, not only prevents injury but also keeps employees engaged and empowered in the care environment.
