What is person-centered care?

Person-centered care is a philosophy of care built around the needs of the individual, which depends on knowing the person through a real relationship. An Alzheimer's Association review in The Gerontologist explains that it challenges the traditional medical model, which tends to focus on processes, schedules and staff needs, and that whether it is called person-directed or resident-focused care, the core principles are the same.

In dementia, person-centered care means valuing the person, treating them as an individual with unique needs, seeing the world from their perspective, and creating a positive social setting built on relationships. These four components come from Brooker, a colleague of Tom Kitwood, as summarized in the Alzheimer's Association's 2018 review. Seeing their perspective includes understanding behavior as communication and validating what the person experiences as real.

The Alzheimer's Association's 2018 practice recommendations set out six: know the person living with dementia; recognize and accept the person's reality; find ongoing chances for meaningful engagement; build and nurture authentic, caring relationships; create a supportive community for individuals, families and staff; and evaluate care practices regularly and make changes. Each rests on knowing the person's values, interests, abilities, likes and dislikes, past and present.

Examples include learning a person's values, interests, likes and dislikes and using them in every interaction, treating behavior as a form of communication, and offering activities that allow choice and success. The Alzheimer's Association's recommendations describe caring relationships as 'doing with' rather than 'doing for,' concentrating on the interaction rather than the task. Even when dementia is severe, it notes, a person can still experience joy, comfort and meaning.

Tom Kitwood first used the term person-centered care in 1988 to set apart an approach to dementia that emphasized communication and relationships over purely medical and behavioral approaches. According to the Alzheimer's Association's 2018 review, he proposed that dementia could be understood as an interplay between brain impairment and psychosocial factors such as health, individual psychology and the social environment, and that caregivers help maintain a person's identity.