Over 20 years ago, Tom Kitwood introduced the world to Person-Centered Care. That was in 1997. It is now 2021. Where have we taken his invitation? Person-centered care has become a buzzword, a warm fuzzy to slap on a marketing brochure or announce at a conference, or talk about in a YouTube video. Yet, are we? While some care communities and organizations have taken a great charge in this direction, working to enact Tom Kitwood’s findings and invitation, few have done anything with it. Much like Creative Engagement, it has become something it is not. So, how do we get back to the roots? How do we start from the beginning and accept the invitation to live a person-centered, creative life with dementia?
We are called to become relational with everyone we meet.
It is that simple and that complex. Become relational with your residents and clients, and you will find yourself in a person-centered care community. You will be open to the creativity required to help each person live life to its fullest, rich with purpose, joy, and connection. Okay, so how do you become relational with someone in this setting, who might be living with dementia, who doesn’t remember me, who may not be able to communicate? I hear your questions, and I have a somewhat simple answer for you.
First of all, everyone can communicate. Communication is far more than the words we speak. Second, how would you become relational with a new friend? A new employee, peer, or volunteer? How would you become relational with a family of one of your residents (or soon-to-be residents) when they are touring the community or coming in for a visit or care meeting?
You would likely follow any number of the following steps.
- Greet them. Say Hello, state your name, and add a “good to see you!” or a “lovely to meet you.” We would not get right down to business. We would have a greeting a moment to say hello, to see where the person is at that moment. Each resident deserves that same respect. They don’t need to know your name, title, or reason be being there. They need to know they can trust you. That you are there for good and not ill. Say hello, share your name if they don’t call it out when they see you and exchange a pleasantry even if they are not able to respond as you would respond. If you have attended one of my training workshops, you know about the creative greeting. This would be the time to enact that moment of creativity. Do this at their eye level. Don’t bend over at the waist, but sit in a chair next to them, or crouch down.
- Be observant and find a point of connection. Look at the clothing they are wearing, if they are carrying anything with them, doing anything when you happen to walk up to them. Take note of what they have in their room. Keep what you see in mind as points to create conversation or spark a program or event they might be interested in. Comment on something you see or ask a question. Connect what you see to something that is part of your story. If you both appear to like the same artist, have traveled to similar places, or even have the same number of members in your family. Connect with them in a personal and emotional way. This doesn’t mean spilling your entire life’s story but finding moments of shared interests, experiences, enjoyment. This can be food, family, faith, hobbies, artistic interests. Do this in a way that respects the many years of life experience they have lived, the journey they have taken, the wisdom they have acquired. If they don’t want to engage in something you bring up, move on. In whatever way they respond, take it in and be present for them. Don’t shy away from “negative” emotions.
- Invite them, and continue to invite them to programs. Even if you always get a no, invite them anyway. Unless they told you not to do so for any given event, sometimes the simple act of an invitation is enough to feel connected to you and the community at large. You never know what conversations may occur while giving the invitation. You may learn that they love music, but hate the music that so often is played. With this information, you can ask them what music they enjoy and see if it can be included next time or in future programming.
- When something is requested, be it a small moment for conversation or sitting in silence looking out the window, or a request for a program or the ability to participate in an element of their faith, do all you can to offer that program or moment.
- Engage the person. Don’t talk over or around them. Don’t assume they cannot participate, communicate, or have something to offer others. Learn about who they are, ask them questions, learn what they love and what they hate (not just what the family tells you,) and do what you can to bring joy into their life simply by being your fullest self. Smile, communicate, engage. Allow them into your life to the appropriate point and allow yourself to enter their life. Think about what matters to you in a relationship, and offer that to your residents.
Person-centered care is what we strive for, yet we stumble and fall. We hide behind its words and use it as a shield. It is time we take the invitation from so many years ago to heart. It is time we embrace what can be and the beauty of our humanity across the lifespan.