What Does it Mean When We Talk About “Person-Centered Care”?

Nancy Lundebjerg resized


Nancy Lundebjerg, MPA
Chief Executive Officer
American Geriatrics Society

Bruce A. Chernof, MD, FACP
President & Chief Executive Officer
The SCAN Foundation


Are YOU at the center of your own health and care? It may seem like an obvious question, but it’s an important one to consider since our medical system has often focused on treating illnesses rather than caring for people with illnesses.

That’s because the medical system usually measures success as decreasing the negative effects of disease. That’s an important aim, but ask any person what “well-being” looks like and they’re likely to talk more about being able to live well in spite of disease. This divide can be especially difficult to navigate for older adults with complex health problems: owing to the status of their health, older people may feel like they have a limited say in how they are treated by a network of primary care providers and specialists, with various family members and caregivers expressing their own points of view, too.

How do we better connect to people when it comes to elder health and care? A group of experts recently convened by the American Geriatrics Society (AGS) with support from The SCAN Foundation has taken steps toward answering that question by helping to define an innovative approach to health care: person-centered care.

Based on a broad review of existing research, as well as findings from interviews with health and social service organization leaders, the expert panel defined person-centered care as “care in which individuals’ values and preferences are elicited and, once expressed, guide all aspects of their health care, supporting their realistic health and life goals.”

A person-centered care approach starts with gathering information about the values and preferences of a person in light of health status, with input from family or others important to the person when desired. When reviewed along with a traditional health assessment by a healthcare provider, this person-centered information is used to help shape and articulate specific goals based on what an older person wants and needs from care. Rather than being driven only by clinical outcomes, these goals are directed by how a person wants to function and what he or she hopes to accomplish when thinking about future well-being.

So what can you do to make health and care more person-centered? Well, the group of experts brought together by the AGS identified several “essential” elements of person-centered approaches to health care.  While no two experiences of person-centered care will be the same (they are, after all, person-centered!), recognizing when and how you can discuss the following with your healthcare providers is an important step toward ensuring you’re at the center of your own well-being:

  • An individualized, goal-oriented care plan based on your own expressed preferences.
  • An ongoing review of your goals and care plan (including opportunities to reassess the plan regularly to address health status changes over time).
  • Care supported by a team of healthcare providers with different kinds of expertise, and with you as a key member of the team.
  • One primary contact on the healthcare team who is responsible for communicating information and coordinating care with you and all the other team members.
  • Continual information sharing and communication between you, family, and all healthcare and supportive service providers.
  • Education and training about person-centered care for providers and, when appropriate, for you and your caregivers.

The Health in Aging Foundation has some great resources to help you learn more about the importance of person-centered care.  You can read about the expert panel’s research in one of the Foundation’s latest research summaries available here, and you can even use this quick-reference guide as a conversation starter between you and your healthcare providers.  Want even more information? Check out materials from the AGS and The SCAN Foundation, too!

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Nancy Lundebjerg, MPA, is CEO of the American Geriatrics Society

Bruce Chernof, MD, is president and CEO of The SCAN Foundation

National Family Caregivers Month

HealthinAging.org Offers Valuable Support for Caregivers all Year Long

November is National Family Caregivers Month.  Even though it’s now December, it’s still a great opportunity to ensure that caregivers across the country get the recognition and resources they deserve all year long. 43.5 million caregivers—many of whom may be older adults themselves—provide care for someone over the age of 50, and 14.9 million care for someone who has Alzheimer’s or another form of dementia.

Caregiving is a full time job, often performed by family members whose responsibilities may also include a career, maintaining a home, parenting teenagers and sometimes helping to raise grandchildren—all in addition to caring for an older, vulnerable parent or other older family member or loved one who needs help with the daily activities of life.

The job of a caregiver can be extremely stressful, and can take a toll on a caregiver’s health, especially if the person being cared for has Alzheimer’s disease or dementia. In fact, some 50% of people who care for people with cognitive disabilities develop psychological distress.

You can’t be an effective caregiver unless you take care of your own health needs. You’ve probably heard the pre-takeoff speeches flight attendants give, about putting on your own oxygen mask before assisting others? It’s the same with your health. Seeing to your own mental and physical well-being helps you to take on the demanding task of taking care of a vulnerable older adult.

Here’s a place to start: The Caregiver Health Self Assessment Questionnaire, which was originally developed and tested by the American Medical Association. This questionnaire can help you look at your own caregiving behavior and health risks. With your healthcare provider’s help, this questionnaire can help you make decisions that may benefit both you and the person you’re providing care for. It may also improve communication and enhance your partnership with your own health provider.

This questionnaire is meant to serve as a guide only. Be sure to speak to your healthcare provider about any concerns you may have about the questionnaire or your results.

HealthinAging.org has many other tools and tips for family caregivers. These resources offer valuable support and advice when you’re caring for a loved one:

2016 Medicare Open Enrollment Is Underway – Don’t Miss Out!

Shah headshotKrupa Shah, MD, MPH
Assistant Professor
University of Rochester School of Medicine & Dentistry

Medicare open enrollment only comes once a year. It is important that you mark your calendar and consider enrolling or reviewing your plans, especially if your needs have changed. Are you fully satisfied with your current medical care? If not, this is the right time to consider your options. Choosing the right healthcare providers, hospitals, and other care settings can make all the difference in your health and satisfaction with life. You can’t stand still, though.

Who is eligible for Medicare?

  • You are eligible if you are:

1) a US citizen 65 years old or older, or

2) a permanent resident of the US for five continuous years and 65 years old or older.

  • Individuals younger than 65 years old can be eligible for Medicare under certain circumstances; the Medicare Eligibility Calculator can help determine if your situation qualifies you for Medicare.

Open enrollment for Medicare runs from October 15th to December 7th.

  • Your demand for health care is constantly changing. It is important for you to review your coverage and see if you need to make any changes to your coverage for the upcoming year.
  • If you are happy with your current coverage, there is no need to do anything.

Continue reading

Social Connectedness: A Key to Healthy Aging

Shah headshotKrupa Shah, MD, MPH
Assistant Professor
University of Rochester School of Medicine & Dentistry

In an average day, Ms. Alvarez interacts with many people.  In the mornings, she frequently walks to a neighborhood café to have coffee with her best friend.  In the afternoons, she likes to go to the local senior center, where her favorite activities are water aerobics classes and playing bridge.  In the evenings, she often calls her daughter to chat, and likes to send emails and pictures to her grandchildren in college.  Ms. Alvarez’s daily life has a lot of social connectedness.

What is social connectedness?

  • A person’s level and quality of contact with other people

Why is social connectedness important?

  • It is key to healthy aging. Studies have shown that older people who have close connections and relationships not only live longer, but also cope better with health conditions and experience less depression. Life transitions can impact the number and quality of people’s social and community networks. For example, friends and family members may move away, which can have a negative impact on someone’s social network. But a transition such as the birth of a new family member can bring positive changes.

What are some of the life circumstances that can affect one’s social connectedness?

  • Changes in health and ability to walk and get around
  • Changes in work status and income
  • Changes in living arrangements
  • Loss of family and friends, particularly a spouse
  • Commuting challenges. When driving is no longer an option, isolation becomes a significant issue, especially in communities where there is little or no public transportation.

Below are some proactive steps you can take to prevent loneliness and stay connected. Continue reading