CCAL coined the term person-centered living (PCL) as a reminder that as people grow older or have disabilities they should not experience a loss of humanity. PCL means living as one chooses to. If support is needed, supports are centered on personal preferences and values that stress dignity, choice, self-determination, respect, privacy, and individuality. PCL means being kind, respectful, and sensitive to those being served and honoring their right to make their own choices, regardless of the setting.
There are many ways that what might appear to be insignificant items that are not person-centered can have negative and perhaps unintended outcomes. The following are some examples:
- Mrs. B. was having a difficult time sleeping in the hospital following surgery. Not only was she physically uncomfortable, but all the hospital sounds and nurse routines were not conducive to sleeping. Mrs. B. finally fell asleep only to be awakened by a housekeeping staff member who had come to empty the trashcan. The hospital thought it was being efficient to use the night housekeeping staff to empty trash. While it was efficient, it was not person-centered. Mrs. B. needed sleep to maximize her cognitive function and mood in what was already a difficult situation.
- Mr. M’s daughter suspected her father was experiencing dementia. He was a stoic and not inclined to visit a doctor, so she knew that getting him to see a neurologist was going to be challenging. After much effort, she finally had Mr. M waiting in the neurologist’s exam room. The doctor entered and began addressing questions directly to Mr. M’s daughter as if Mr. M. were not there. Mr. M. was cognitively intact enough to realize this and stormed out of the doctor’s office – never to return. Assessment of Mr. M. by the neurologist was prevented because of the non-person-centered approach taken.
- At 87, Mrs. W. had a cascade of chronic health care conditions. While she was in the hospital for a surgical procedure, sleep apnea was diagnosed. With a CPAP machine, Mrs. W. could have safely returned home under family and a home care aide support. In order for her to get the CPAP machine, the insurance rules required her to undergo a sleep study at a designated sleep study center despite the fact that a physician had observed the sleep apnea in the hospital and had written an order for the machine. Mrs. W. was in no condition to undergo a sleep study and would recover better from the surgery in her home environment. The insurance rules were not person-centered and not only caused Mrs. W. and her family distress, but cost the insurance company much more in the long run due to the extended hospital stay.
The following are CCAL’s Principles of Person-Centered Living
- Consumers are provided choice, privacy, dignity, respect, independence, and autonomy.
- Consumers have the right to determine their HCB services and support needs, decide how best to have those needs met, and to be provided a means to give feedback about the quality and nature of the services and supports.
- A person-centered culture is nurturing, empowering, and respectful, and optimizes the well-being of consumers as well as the family and extended caregiving services and support network.