Friday, September 10, 2010

Person-centered Caregiving

I recently was asked by a local Hospice to meet with a patient (I’ll call her Ann) who had created a piece of artwork. They wanted me to consider writing an article about it, and her. She was a lovely, feisty woman. I met with her a number of times, taking notes as she spun out the stories behind the artwork and her process in making it.

Though the artwork had brought me to Ann, what became most important was Ann’s journey. I continued to write and will publish an article, but the point of our meetings became connection. The life of our budding relationship feeds the life of the article I am writing. When I stray to focusing on the article as an end in itself, the relationship Ann and I are building loses energy. When I focus on Ann, the writing comes to life. The life of both depends on the life of our connection.

This is a perfect analogy for caregiving. In the busy life of a family or professional caregiver, it can be too easy to forget, to mistakenly become too focused on the day-to-day tasks and agenda, and thereby sap the life of the human connection with a loved one, which is the true source of healing and wellness. Mind-body-spirit wellness. Excessive focus on the tasks of caregiving saps your relationship, and drains both you and the life of your loved one or client. Focus on your connection, in service to the wholeness of your loved one (as Rachel Naomi Remen would say) and you’ll find that you both have more energy. If you have neglected to make a bed, opting instead for having a good laugh together, good for you! If you are being drained by care giving, check out where your focus has been and change course.

This principle of Human Connection First, or Person-centered Care, is the core principle of the culture change movement in nursing homes that is radically changing the experience of living in long-term care. It is the catalyst of wellness for care receivers and givers. To learn more, check out the Eden Alternative (, The Pioneer Network (, and the ChangingAging blog ( and his ChangingAging LinkedIn discussion group (

This movement was begun by Dr. Bill Thomas and is spreading, now backed by the federal government in changes in the annual nursing home surveys. Nursing homes are now being designed, architecturally and in management structure, to follow the Eden Alternative principles. The result? Some residents who have been walking with walkers, throw away their walkers. Others who have stopped speaking and feeding themselves sing “Amazing Grace” and grab the spoon. (See YouTube on “The Green House Nursing Home Alternative.” ) Staff retention dramatically improves. And, miracle of miracles, it doesn’t necessarily cost any more than the old model. It actually can be cheaper. Read about the data in “Culture Change Goes Mainstream,” downloadable at The Eden Alternative also has a program for family caregivers.

As I write this, I am at home with the latest “bug” that has been going around. I had to cancel my visit with Ann and will deeply miss her this afternoon. We were going to play Scrabble together. When we do get to play, I’m betting that she will win.
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