Person-centred care linked to quality leadership
All people in residential aged care including staff and family members need to be treated in a person-centred way for person-centred care to flourish, research finds.
For person-centred care to flourish in residential aged care, all people in the environment including staff and family members need to be treated in a person-centred way, according to Charles Sturt University research.
Dr Sean Mack spent the last five years researching into the role of leadership in building, facilitating and sustaining a person-centred approach in residential aged care for his recently completed PhD.
He found a dynamic relationship between person centeredness and leadership, with each defining the other.
“To be a good leader, you need to be person-centred. And to have person-centredness, you need to have good leadership,” Dr Mack told Australian Ageing Agenda.
The research focused on the lived experience of participants – residents, families and staff – in two aged care homes where person-centredness has been achieved.
“It was a bottom-up process of looking at people’s lives; their lived realities,” Dr Mack said. “I was trying to actively avoid too much academic theory or being shaped by anybody else’s theories.”
He found that at its core, person-centredness is expressed as people living in community.
“It’s about valuing each individual for themselves – not treating them like a medical condition, but as someone living in that environment. Then to make that meaningful you have to treat everybody in that environment in a person-centred way, which includes family members and staff.
“If you treat staff in a person-centred way, they are much more likely to treat residents in a person-centred way.”
Dr Sean Mack
“And that was the big thing – if you treat staff in a person-centred way, they are much more likely to treat residents in a person-centred way. Because it then becomes part of the ethos or culture of the whole organisation,” Dr Mack said.
He said the aged care homes in the study demonstrated “leadership from the heart”. The leadership was also shared by staff who took active responsibility for the care and wellbeing of residents as well as family members and other staff, said Dr Mack – who runs his own business Core Directions Consulting, and has over 25 years of experience in aged care including as a researcher, consultant and quality assessor.
“The combination of shared leadership and person-centredness towards all, formed the fabric of the person-centred environment – the caring community.”
Applying the learnings
To foster person-centred environments, Dr Mack recommends senior managers in aged care, such as chief executive officers and others in formal leadership roles:
- know and live their leadership values plus be authentic and aware of the messages they send through their actions, behaviour and words
- paint a picture through imagery and metaphors to inspire, motivate, empower and guide the organisation towards a person-centred culture
- ensure staff selection is in line with the organisation’s philosophy and values of person-centredness so the right people are working in the home.
These are three among 15 recommendations made in the research with other advice going to aged care providers, accreditation bodies and policymakers.
Dr Mack said providers – including boards – should encourage the CEO to lead authentically from the heart and act in a humane, person-centred way at the same time as ensuring the financial viability of the aged care home.
“They’re still running a business and they’ve got to make it viable. But despite that, people can also build positive relationships with everybody who are part of what is effectively a community of people.”
“You want to reinforce good practice where you can and not kill it off through a regulatory process.”
Dr Sean Mack
He also recommended aged care accreditation bodies ensure accreditation and compliance personnel and processes support and encourage aged care homes that are implementing person-centred philosophies and processes. This, said Dr Mack, takes a particular mindset.
“Assessors need to be able to recognise that individualised and relationship-based approach, and they need to become more open and skilled at recognising those cultural factors,” Dr Mack told AAA. “And when they see good practice, they need to be able to encourage it, to accentuate the positive rather than trying to find fault.”
Similarly, aged care legislators and policy writers should consider person-centredness at the heart of an effective aged care system through a review of processes, policies and legislation and firm and visible support for aged care homes implementing person-centred philosophies and processes, he said.
“You want to reinforce good practice where you can and not kill it off through a regulatory process,” Dr Mack said.
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So true is that simple proposition. It is what happens in successful families, after all. And how often do institutions, and some families, walk in the other direction. Even those that express good intentions. What damage then follows.