Resident’s rights, autonomy and personhood

People who live in residential aged care facilities are entitled to full and effective use of their personal, civil, legal and consumer rights ¹ in the same way as any other citizen. Staff play an important role in ensuring that resident’s rights are upheld and this may involve working collaboratively with the older person, their family and/or significant others to ensure this.

 

Even residents who have been diagnosed with dementia have the right, and should be encouraged; to make their own decisions to the extent they are able. Similarly unless there is a safety issue they are able to participate in activities that take them into the community. Assisting an older person to maintain their autonomy has been identified as a key element in providing person centred-care ². The term autonomy is often linked to independence, however this does not mean you have to be able to do everything yourself. Maintaining a person’s autonomy is about enabling and allowing them to make meaningful decisions about what happens to them ³.

 

The notion of personhood and well-being in relation to people with dementia is closely associated with the work of Kitwood, who with colleagues developed a model of person centred-care for people with dementia ⁴. The model requires care providers to consider the whole person through individualised care plans that take account of the person’s social and functional history as well as clinical history ⁴. Moreover, organisational systems and structures need to enable staff to work from a person-centred perspective rather than routine and tasks based care ⁵. Bird and colleagues identified time, funding, staff attitudes and training as key barriers to the practice of person centred care ⁶.

 

Each residential facility has policy and procedures to ensure that all staff members are performing their duties in such a way as to abide by government policies and site specific ethos and approach. All staff and students are expected to refer to and follow the Policy and Procured Manual.  The manual details, among many things, risk management procedures.

 

 

 

 

References

1. Health Department Australian Government Charter of Residents Rights and Responsibilities http://www.health.gov.au/residentscharter
2. Rodgers V, Welford C, Murphy K & Frauenlob T. Enhancing autonomy for older people in residential care: what factors affect it? International Journal of Older People Nursing. 2012; 7: 70-74.
3. Tuckett A G. On paternalism, autonomy and best interests: Telling the (competent) aged-care resident what they want to know. International Journal of Nursing Practice. 2006; 12: 166-173.
4. Kitwood T & Bredin K. Towards a theory of dementia care: personhood and well-being. Ageing and Society. 1992; 12: 269-287.
5. Forbes-Thompson S & Gessert S. End of life in nursing homes: connections between structure, process and outcomes. Journal of Palliative Medicine. 2005: 8: 545-555.
6. Bird M, Jones R H, Korten A & Smithers H. A controlled trial of predominantly psychosocial approach to BPSD: Treating causaility. International Psychogeriatrics. 2007: 19: 874 -891.