Browsing "Person-Directed Care"

Person-Directed Care – Entry 2

Dear Diary:

Based on feedback from our residents and families, we have been working hard on providing choices and individualizing care for the residents. The team on the Ivy neighborhood spent quite a bit of time last month completing the Advancing Excellence Person- Centered Care Tracking Tool. This afternoon, our QAPI team met to talk about how we can better meet the individual needs of each resident. We reviewed the data we collected on this tracking tool. We got some pretty great information. It turns out that we’re doing pretty well with resident choices regarding clothing, bathing, and eating. However, many of our residents would like to be around pets more often, go outside regularly when the weather is nice, be offered more activities that are of interest to them, and have more opportunities to listen to their favorite music.

Our administrator Dan and I attended family and resident council meetings this week to share what we learned and to get additional feedback. The QAPI team helped us develop some questions to ask residents and families to get more information. There was lively discussion and a few residents and family members volunteered to serve with interdisciplinary staff on a resident/family performance improvement project (PIP) team to find ways we can:

  • Have pets regularly on the neighborhoods
  • Gather information about what activities and music each of the residents prefer
  • Include the residents and families in the planning of neighborhood activities, and
  • Include outside activities every day when the weather permits.

This team has agreed to meet weekly for four weeks to put together a plan that we’ll trial on the Ivy neighborhood. In the meantime, we’ll be completing the Advancing Excellence Person- Centered Care Tracking Tool to gather data on the other neighborhoods. If all goes well on the Ivy neighborhood, we’ll complete the same process in the rest of the neighborhoods.

Our goals are to offer residents more choices for activities that interest them and help them to feel happier. Hopefully, we’ll this will show as an improvement in our next satisfaction survey results!

I wonder what other system changes nursing homes are doing to make sure they are hearing and responding to the voices of residents and families?

Signed, Donna


  • I recently had the pleasure of attending a work shop on resident centered care …Sometimes we are so focused on the term “Resident Centered Care” thinking the choices we will offer, time of day to get up and what activiites and what food choices and all that but this speaker went beyond that and maybe this is where we should focus for a bit…Yes the choices are huge don’t get me wrong but…let’s start with
    R E A C T!

    Respect: Acknowledge by their preferred name, Introduce yourself, Eye Contact, a Professional Image.

    Explain: Use clear and understandable terms. What you are doing , how long it takes, next steps…

    Answer: Summarize what the resident says, answer questions, address concerns, check for understanding.

    Connect: Actively listen, sit down, empathize, ask clarifying questions.

    Thank: Offer additional support, provide information about next caregiver…”Thank them” for allowing you to take care of them ..

    I think doing this will make all the differenc in the world and maybe, just maybe a not so hot bowl of soup will be the focus of the next satisfaction survey…

  • I advocate to improve the caregiving experience for those unable to access traditional bathrooms on their own. Wondering if there are unique characteristics about the choice of assistive devices for those in this situation. Have you thought about illustrating the pros/cons of the various choices, since none are perfect substitutes for being able to toilet onself. For example, how does someone help a resident choose between transfer to bedside commodes, bedpans, urinals for men (though not likely for women), adult diapers, catheters? Always seems that we shy away from this topic, yet it may be key to a resident’s sense of self-directionn . . .

Share your nursing home perspective on this quality improvement issue.

Person-Directed Care – Entry 1

Dear Diary:

Recently, our residents and families completed our annual satisfaction surveys. Over the past year we have been working hard to change our culture so it is more person directed. We have been providing more meal choices as well as schedules and bathing options based on resident preferences. With all of that, only 70% of our families and residents are satisfied that we are meeting resident’s choices and preferences. That is just not good enough! I’d like to see at least 90%.

Our QAPI team is in agreement that we need more information to find out why so many families and residents perceive that we are not providing choices and individualizing care for the residents.  Now I need to figure out how we should we go about getting more information. But how?

Signed, Donna


  • We are working on the subject of food for our person centered care journey. Both our resident and family surveys indicated that we were well below others in this area so we have met on monthly basis to trial new things.
    We have added more scratch cooking to our menu with real vs. fake potatoes, more fresh baked buns, working on presentation of food on plates along with dining room environmental changes. Allowing more choices for residents at meals and in between snack options.
    Numbers are slowly moving in the right direction.

  • We have tried “drill down” surveys of our families, to try to get more specific information on an satisfaction that doesn’t meet our goals. Sometimes we don’t get great returns. We have also started family meetings, so we can use those forums for feedback.

Share your nursing home perspective on this quality improvement issue.