Person-centred care: Partnership

One lady I looked after was not eating much, losing weight, and had not opened her eyes at meal times for ages.  

We had to feed her but it wasn’t working well. 

 I changed tack and now I sit beside her instead of opposite her.  Instead of feeding her myself, I gently explain what I am doing and put my hand under her hand so that she can hold the spoon.  When she is ready I help her to feed herself in this way.  

She opens her eyes now, swallows safely, and eats much more.  She even talks with me sometimes now during meals.  It takes longer but the result is much better and we now have so much more interaction and connection!

• Partners negotiate a shared goal and how to achieve it. 
• Partners can achieve more working together.
• Partnership can take thought and effort, but it’s very satisfying! 
• Partnership leaves a better emotional ‘taste in the mouth’. Bear in mind that being task-focused or trying to bend reluctant people to our will it is also hard work and leaves a bad taste in everyone’s mouth. At worst, it is intimidating, and at best, it leaves people wondering if they are being cared for as an individual. How would you rather spend your time?

• Use invitations instead of demands (for example, “We would like to invite you to join us for our newspaper reading this morning, Mona” rather than “Come down to the lounge Mona, it’s time for newspaper reading”).
• Offer choices rather than demands (for example, “I’ve got some time to help you get ready for the day now, John.  Would you like me to help you get dressed?” rather than “It’s time to get dressed now, John”).
• Explore what is motivating a person to want to do something (especially if this is challenging for the situation they are in) rather than confront the person about the thing they want to do (for example, in the setting of someone wanting to go through the main exit their aged residential care by themselves when that might not be safe, “Kia ora Pita. You look like you would like to go somewhere.  Tell me what’s on your mind?” rather than “You can’t go out there now, Pita.”

 It is our non-verbal language that communicates our desire to engage in partnership rather than to dominate or intimidate someone even more powerfully.  This is true whether the person can use the same language as you or not.  The most simple things we can do might include:

• Standing beside a person rather than being opposite to them or facing the person head-on.
• Taking a gentle, non-threatening stance, such as bending toward a person or crouching beside them rather than standing tall or looming above them.
• Lightly touching a person’s arm or offering to hold their hand to help gain their attention rather than physically orientating their face to you.
• Adopting a questioning, friendly tone of voice rather than a brisk, business-like tone.
• Showing a person with actions or props what needs to be done rather than just leading them somewhere (for example, giving a person a flannel and soap rather than just leading them into the bathroom).
• offering a choice of two physical things to choose from.

•  You can read more about supported decision-making here.
•  You can read more about what empowerment means to people in a research article here.
•  You can read more about some of the key tips here