I’m really excited about how healthcare has been moving over the last several years. It’s been a shift from healthcare providers asking, “What’s the matter with you?” to “What matters to you?”
This is person-centered care.
According to CMS (The Center for Medicare and Medicaid Services), Person-Centered Care is “Integrated healthcare services delivered in a setting and manner that is responsive to the individual and their goals, values, and preferences, in a system that empowers patients and providers to make effective care plans together.”
This allows patients to be at the center of their care and to be able to make informed decisions about their treatment and well-being.
The medical team in a person-centered care model knows their patients, their values and preferences, listens to them and is held accountable to make sure the care plan for the patient matches those values and preferences.
What does person-centered care look like?
Care that is comprehensive, evidence-based, and guided by what is important to the patient
Patient-reported outcome measures are used to determine success and results
Care is coordinated across health systems, providers, and care settings
The on-going management of chronic and complex conditions
Relationships with care providers that are built on trust and a commitment to long-term well-being
Healthcare providers should look at the patient's comprehensive needs to create treatment plans that include empathy, dignity, and respect for their patients, their lives, and their values.
Life Speech Service is a leader in person-centered care: here’s how:
At the evaluation, we complete a thorough case history to understand not just your speech or swallowing deficit, but also your medical history and any additional factors affecting your life.
We use PROMS: Patient Reported Outcome Measures. PROMs are simple questionnaires that have the patient rate their deficit and how it impacts their everyday life. It gives us insight into their everyday lives and the areas they notice their deficits the most. This type of reporting system helps us create a care plan targeting those areas specifically. We determine our progress and success based on these ratings by providing the PROM at evaluation, discharge, and throughout to ensure that we are continuing to target the areas and the deficits our patient’s are experiencing the most trouble.
We write functional goals related to the skills that matter most to our patients and implement strategies that work for them. If a strategy doesn’t work for them, we try another!
Consistent conversation about values and what matters to them. Effective communication ensures that we keep the patient at the center of our care as their recovery continues.
Let's Dive into George's Story:
A Practical Demonstration of Person-Centered Care
I started seeing George about 4 months after his stroke. He had spent time doing inpatient rehabilitation and felt like his physical body was almost back to normal. However, his speech was nowhere near what it was before his stroke.
During the evaluation, we talked about his life before the stroke, including what he enjoyed doing, the people he spoke to, and what a regular day looked like for him. We compared it to his new every day routine and the things he was no longer doing. He wasn’t calling his children on the phone, they weren’t going out to eat at restaurants, and he was letting his wife do most of the talking at doctor’s appointments.
I provided George with a PROM, where he rated that he was not very confident in his ability to communicate with others, especially strangers. He felt it was easiest to let his wife talk, even though she didn’t always say what he thought or wanted.
Setting Meaningful Goals for Communication Rehabilitation
Based on the information gathered through the evaluation, we discussed goals that would be relevant and meaningful to him. We wrote a goal to identify the names of those he loved, like his wife, kids, and grandchildren. We wrote a goal to target naming the specific items he liked to have for breakfast and for things he used to draw, since that was his hobby.
His wife was also concerned that if he needed to call 911, would he be able to communicate with them? So, we also wrote a goal and targeted functional phrases for an emergency. We worked on these goals through evidence-based strategies like role-playing, semantic feature analysis, and communication partner training.
As we worked and his language skills began to recover, we could move forward and target other areas of communication, including conversational skills, being able to respond to questions within a conversation, and what to do if the wrong word did come out or if he couldn’t get the right word out.
Addressing Cognitive Challenges: Money and Time
Through continued conversations with the patient and his wife about areas where they still noticed deficits, George reported that he had a tough time with money. He didn’t understand how it worked anymore.
So, we added that as a goal! We began by identifying numbers, then adding them into the context of money and eventually time too!
I’m continuing to work with George on the many areas of language and thinking affected by his stroke. By focusing on what matters to him, we’ve been able to give him more independence and confidence in his everyday life.
Your care matters… you matter. Still not sure what person-centered care is or how to implement it? Check out this video.
And as always, if you need more help or guidance, I’m just one click away.