Table 4 Framework of person-centred care and support for dementia
Domain | Elements | From this study |
|---|---|---|
Foster a healing relationship | • Discuss roles and responsibilities • Communicate with honesty and openness • Foster trust in healthcare worker competence • Express caring and empathy • Build rapport | • Emphasize partnership • Ensure dignity and respect |
Exchange information | • Explore needs and preferences • All parties share information • Provide/refer to additional information • Assess and facilitate understanding | • Recognize the person’s life and current abilities through discussion, and verbal and behavioural cues • Allow time for questions |
Address emotions | • Explore and identify emotions • Assess anxiety or depression • Validate emotions • Express empathy or reassurance • Provide help to deal with emotions | • Reframe dementia as cognitive decline upon initial diagnosis to lessen impact • Address psychosocial issues in addition to biomedical |
Manage uncertainty | • Raise and discuss uncertainties in prognosis, management or outcomes • Explore and assess other uncertainties • Use problem-focused (behavioural) management strategies • Use emotion-focused (affective) management strategies | • Create stability through routines and continuity |
Share decisions | • Raise and discuss care or support options • Discuss decision process, and needs/support • Prepare persons/carers for deliberation and decisions • Jointly make and implement decisions and action plan • Assess decision quality and choices | • Tailor care and support to individual needs and preferences • Address or mitigate family conflict |
Enable self-management | • Describe the follow-up process • Provide information and training on self-care and self-monitoring • Share guidance on how to prioritize and plan self-care • Offer practical advice and support to implement self-care • Assess skills, self-care and progress | • Optimize independence • Engage persons in meaningful activity • Support carers • Provide information about available home or community support/services |