Person-Centered Communities: A Model for Assisted Living

More and more, the long-term care world is focusing on person-centered principles in the delivery of care and services.¹ With good reason: Practicing person-centered care can improve health and health-related outcomes and meet consumer expectations while reducing excess costs of care.²

With their broad range of care and services, assisted living communities may be especially well-positioned to implement the person-centered care model and even to think of themselves as person-centered communities. Some and perhaps even many communities may already be operating at this level.

To understand what a person-centered community looks like, it may be helpful to first understand what is meant by person-centered care. CareScout defines person-centered care as care that “looks beyond safety, to also integrate a person's values, preferences, and goals into the care they receive. Person-centered care creates a partnership between caregiver and care recipient that encompasses the physical, mental, spiritual, and social elements of a person's health.”

Person-centered care is holistic care based on who the person is rather than the condition of their health or level of function. It’s at the heart of the CareScout Quality Network, the nation’s first network of long-term care providers where every provider has met rigorous standards for quality and has committed to person-centered care.

Because assisted living communities provide a wide range of services to address nearly every aspect of a person’s life as well as their health, a community that is committed to person-centered care principles can help ensure that those services support a person-centered climate for its residents – a person-centered community. Here is what that might look like and how it helps both residents and their communities. 

A basic intake form for a senior living center, such as that offered by the Department of Health and Human Services, may include a person’s demographics, nutritional needs, and what assistance they require for activities of daily living (ADLs) and instrumental activities of daily living (IADLs) – but not much about their individuality.

In a person-centered community, the resident intake process – call it a welcoming process instead – includes an “All About You” interview that delves into what makes the person a person – favorite comfort foods, how they like to dress, and which activities they enjoy, as well as their story – what they did before coming to the community, their family history, which holidays and traditions are especially meaningful, and what values and beliefs have shaped their life.

This deeper level of information about what matters to the individual gives the community valuable data to inform everything from the dining room menu and the activities schedule to how staff interacts with the resident. More than that, understanding what makes a person tick and knowing their personal story helps the staff and indeed the entire community celebrate the individual’s identity. The intake process itself is part of the celebration by saying to the new resident, “We see you as a person first.” 

Because assisted living communities offer amenities as well as health and safety related services, they can meet not only an individual’s physical and mental health needs but their social and spiritual health needs as well. The more those amenities – such as a library, game nights, activity clubs, field trips, or Bible study groups – are carefully customized and individualized according to input from residents, the more person-centered the community becomes.

In addition to addressing all aspects of health, another key tenet of person-centered care is regarding the care recipient and family as full partners in creating the plan of care. For a person-centered community, that process naturally begins with the intake/welcoming process when nutritional, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) needs are assessed. By inquiring into the preferences as well, the person-centered community ensures that a resident’s wishes have been heard and may be incorporated into the services they receive. 

Another key tenet of person-centered care is continued assessment of a provider’s person-centered care climate to ensure quality. For providers in the CareScout Quality Network, that process includes surveying care recipients about their care with questions like: 

• “The staff are knowledgeable about my preferences, and they will change how they care for me based on my preferences.” 

• “The staff engages my family / support network in my care, and they respect my preferences for which members of my family and support network I want involved. 

• “I am listened to and have a voice in my own care and the services I receive.” 

• “The staff knows me and my values, and I have been able to get to know the individuals who work with me.” 

  
  For the person-centered community, continued assessment not only helps to ensure a person-centered climate, it sends a powerful message to residents that their dignity, comfort, and satisfaction matter. It can reassure families that their loved ones are being well cared for. 

Maintaining a person-centered climate can benefit caregiver staff, too – and position the community as an employer of choice. Studies of the effect of person-centered care programs on caregivers have found significantly higher ratings of job satisfaction,^3,4 reduced stress of conscience,⁵ lower emotional exhaustion,^6,7 and higher morale.⁸ 

In person-centered communities, continued assessment of the person-centered care climate can include honest employee feedback to measure job satisfaction objectively. During its provider assessment process, for example, the CareScout Quality Network surveys caregiver staff about their person-centered care climate with questions like:

• “My peers and co-workers respect the values and choices of our residents regarding how, when, and where they want to be cared for.” 

• “My peers and co-workers ensure that care plans reflect our residents’ choices, values, and beliefs.” 

• “My employer equips me with what I need to deliver care based on our residents’ choices and values. 

• “My employer gives me the time to engage with our residents and get to know them as individuals.”

Surveying employees not only delivers valuable data that can help strengthen person-centered practices, it tells employees they have a voice, which can help to improve morale and reduce staff retention.  

The aging care market is crowded and fragmented, and care seekers often struggle to identify quality providers, whether for home care, nursing care, or assisted living. Applying person-centered care principles in the community setting presents an opportunity for assisted living communities to stand out with a higher level of quality – the preferred quality of a person-centered community.