Practice person-centred care for demented older adults in Hong Kong residential care facilities: a qualitative exploration

Abstract

Introduction: Along with the rapid pace of an aging society in Hong Kong, the demand for dementia care becomes an increasing pressure in long-term care services industry. A scientific care approach is urgently needed to ensure quality of care. Person-centered care (PCC) has been proved as “most desirable” for demented older adults. However, how PCC has been understood and practiced in Hong Kong is unknown. This study aims to examine practices of PCC for demented older adults in residential care facilities in Hong Kong. Method: Qualitative method, in particular in-depth interviews was applied to this study. Brooker’s four major elements of PCC were used to guide developing interview guidelines. 11 superintendents of residential care facilities in Hong Kong were interviewed on their perceptions of PCC towards demented older adults in their service settings, their daily practices relating to Brooker’s four major elements of PCC, and barriers of applying PCC. Findings: Findings showed that interviewees have a diversified understanding of PCC, which failed to reach a consensus of PCC conceptualization. A variety of practices, including conventional practices and innovative ones have been identified, which shows a strong identification towards PCC. Interviewees reflected a range of good practice relating to Brooker’s four major elements of PCC. It includes 1) valuing demented older adults and their caregivers as a stepping stone of practicing PCC; 2) individualized care as a mechanism of practicing PCC; 3) continuous assessment as a pathway to practicing PCC; and 4) nurturing environment as a facilitator in practicing PCC. Lack of knowledge and skill competence, and increasing work stress and environmental constraints have been seen as the major barriers towards PPC. Implications: This situation calls for further policy intervention on setting up consensus and standards of PCC; systematic training; scientific evaluation on quality of care; and evidence-based research on the PCC.