Person-centered care means respecting personality traits
In today's "Minding Our Elders" column, Carol offers advice to a reader whose grandmother doesn't want to go to the dining room for meals at her nursing home.
Dear Carol: My grandma’s in a nursing home and now that we’re vaccinated, we get to see each other. Yay! When she was home, she was always content with making art, listening to music and seeing friends and family. Now, she has fewer choices, of course.
At first, the nursing home staff encouraged her to go to the dining room for meals, but that stresses her, so they eventually let her do what she wants and eat in her room. They told me they are respecting her choice which I know is true. When she’s alone, she can still enjoy reading, music and TV, and she has family and friends who visit which makes her happy. What worries me is that I’ve read that not taking people in care homes to communal dining rooms is a form of neglect. — MH.
Dear MH: Your grandma is extremely fortunate to have you as her advocate. Not everyone has someone so dedicated.
I believe you’ll feel better if you understand that the advocates who compile recommended criteria are taking a broad view. In general, not taking the time to bring residents to a dining room for meals signals that the facility could be cutting corners with more important care needs, too — COVID aside, of course.
In my opinion, lists such as you mentioned should be considered in setting up care plans, but in the end, it should be the individual preferences that matter (within reason). A fundamental aspect of person-centered care recognizes that preserving as much autonomy as possible is vital to helping people thrive.
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Having said that, most people living in a nursing home would likely benefit from at least some communal dining and/or group activities. In fact, many would benefit from some socialization even when they at first try to decline. So, gentle encouragement is fine.
In your grandma’s case, maybe they could suggest that she eat one meal a day with others, but even that shouldn’t be forced if she still resists after trying it for a while. Some people have a history of finding eating in groups stressful, but others may simply find a big dining room uncomfortably stimulating.
There are alternatives to communal meals that can encourage some socialization. With your grandma, perhaps they could look at art. Many facilities now recognize the value of making art, so maybe she could be encouraged to go to art activities and, since she’s got a history of making art, they might even ask her to help teach.
This would depend on how able she is physically, of course, but my point is that with person-centered care, there are often alternate ways to encourage people. For your grandma, that may mean letting her eat her meals as she chooses and looking for other ways to help her engage.
Your involvement, MH, as well as the fact that this care home seems to be a good one, should guarantee that your grandma is receiving the best care that can be reasonably expected.
Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.