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Person-centred care for patients with dementia may also benefit caregivers

The Bottom Line

  • Many long-term care residents have some form of dementia and may exhibit symptoms that contribute to job stress and burnout in caregiving staff.
  • Person-centred care is an approach that focuses on the patient’s unique abilities, interests, habits and wishes.
  • Care providers who receive training in person-centred care may have higher job satisfaction and experience less career burnout.

The statistics on dementia are both staggering – it affects close to 36 million people worldwide – and sobering, as that number will continue to rise in the coming years as the population ages (1).  In the advanced stages, symptoms such as agitation, aggression and wandering are the main reason people are admitted to long-term care facilities (2) where in turn, those same symptoms are the main causes of stress and burnout among caregiving staff (3).  

In Canada, close to 50% of women living in long-term care facilities and 37% of men in the same circumstances have some form of the condition (4).  This prevalence has prompted changes in traditional care to better meet patients’ needs. One approach – person-centred care – seeks to create a more respectful, positive environment by emphasizing the individuals’ abilities, habits, interests and wishes. So far, it’s showing great promise: person-centred care appears to result in less aggression, fewer falls and increased participation in tasks, among other benefits (5). But how does it affect caregivers and the way they perform and feel about their responsibilities? Does it result in more or less job stress?  

Those are important considerations because of the close interrelationships between dementia patients and their caregivers. Person-centred care may be a preferred approach, but if caregivers are feeling burned out, those feelings will negatively affect care delivery (6). A recent systematic review is thought to be the first to address the impact of person-centred care on staff providing that care (7). Seven studies were included in the review and the participants – caregivers in residential care facilities – received extensive training in how best to interact with patients. For example, emotion-oriented approaches include reminiscence therapy and other ways of enhancing mood and feelings of self worth, while stimulation-oriented approaches encourage participation and social engagement through activities like art, music and dance.  

What the research tells us

While there are limitations with the review, including a limited amount of evidence, most of the studies show positive outcomes with staff reporting less stress, burnout and job dissatisfaction, pointing to potential benefits of person-centred care for caregivers. Further investigation into this important aspect of dementia care is urged. Meanwhile, it is suggested that the positive reports may be due to the training and education that staff received which helped them better connect with their patients and enjoy more rewarding work experiences. 

Click here to read more about dementia symptoms and some possible treatments


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References

  1. World Health Organization. Dementia: a public health priority. Geneva: WHO; 2012. 
  2. Ballard CG, Gauthier S, Cummings JL et al. Management of agitation and aggression associated with Alzheimer disease. Nat Rev. 2009; 5:245-255. 
  3. Miyamoto Y, Tachimori H, Ito H. Formal caregiver burden in dementia: impact of behavioural and psychological symptoms of dementia and activities of daily living. Geriatr Nurs. 2010; 31:246-253. 
  4. Public Health Agency of Canada. Mapping Connections: An understanding of neurological conditions in Canada. Table 3-2: Prevalence of neurological conditions among Canadians living in long-term care facilities, by gender. [Internet] 2014. [cited 25 Mar 2015] Available from: http://www.phac-aspc.gc.ca/publicat/cd-mc/mc-ec/section-3-eng.php#tab3-2 
  5. Sidani S, Streiner D, Leclerc C. Evaluating the effectiveness of the abilities-focused approach to morning care of people with dementia. Int J Older People Nurs. 2012; 7:37-45. 
  6. Gray-Stanley JA, Muramatsu N. Work stress, burnout, and social and personal resources among direct care workers. Res Dev Disabil. 2011; 32:1065-1074. 
  7. Barbosa A, Sousa L, Nolan M et al. Effects of person-centred care approaches to dementia care on staff: A systematic review. Am J Alzheimers and Other Demen. [Internet]. 2014. [cited 25 Mar 2015]  Available from:  http://aja.sagepub.com/content/early/2014/01/20/1533317513520213 

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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