Hello, and welcome to Late Life Insights: A series of short, informational pieces on all things aging. I’m Dr. Lisa Rill, your friendly social gerontologist and Executive Director of Senior Life Source. Today’s topic is understanding the difference between the medical model, person-centered, and person(self)-directed care found in long-term care (LTC) communities.
At Senior Life Source, one of our main goals is to help you become a confident advocate for yourself (and loved ones). This means being prepared with the knowledge and resources needed to make informed decisions with regards to your desired care in later life. One of those likely decisions will be choosing a long-term care community for you or a family member, whether it’s for a short-term rehab stay, or longer.
There is no one-size-fits all type of care community. Once you decide which type of care community best fits your level of care needs, for instance an assisted living community vs. a nursing home, the next step is to inquire about the type of care model that the community provides. This is important because not all communities (nursing homes in particular) deliver the same model of care.
Knowing the different care models that exist will help you make a better decision with regards to the specific community you end up choosing.
The three types of care models found in the LTC industry are the medical model, person-centered care, and person(self)-directed care:
- The medical model puts all the control over the lives of individuals in the hands of the medical professionals. The medical decisions regarding treatments and all aspects of daily life, such as bed and mealtimes, are controlled by the medical professionals with little conscious consideration of the impact on the person. Individuals often accommodate the staff preferences and follow the decisions of the professional. Does this sound a little inflexible for you? Don’t worry, today many of the care communities are moving away from this model of care. But they still exist!
- With person-centered care, individuals are better informed and have some choice within existing routines. The preferences of each person are considered when creating a life plan. The staff organize and incorporate certain aspects of the individual’s preference into their daily routine. Overall, individuals can make some decisions, but most of the power remains with the health care professionals. For example, people can choose what they want to eat from a menu, but the choice is still limited to what is listed on the menu.
- Person (self)-directed care goes a step further and empowers the individual to direct their care. It gives more control to the person by enabling self-determination, freedom, choice, and autonomy. The difference is the shift from the person as the object of care (person-centered) to participating as a care partner (person-directed). The individuals make the decisions about their daily routines, and the staff members organize their schedule to meet the needs of those preferences. For example, compared to the meal choice with person-centered care, in this case the individual is not limited to a selection from a menu, but rather is free to choose any type of meal.
The take-away: If the time comes that you must choose a long-term care community for yourself (or loved one), make sure that you ask questions focused on the model of care that you prefer. This will have a huge impact on your quality of life while living in the care community. Not sure what questions to ask? Contact me and I will assist you with creating a list of questions: lisa@seniorlifesource.org
Thank you for joining me for Late Life Insights from Senior Life Source, where we provide education on aging for all ages.
Lisa Rill, PhD Executive Director, Senior Life Source
