Conceptual Profile of Older-Person-Centred Care Within the General Framework of Person Centred Medicine

Abstract

Background: The elderly represents a growing segment of the population for whom person-centred medicine (PCM) has been pointedly argued as highly relevant. This is due to demographic weight, clinical complexity, and ethical challenges. Therefore, it should be valuable to elucidate the key elements of person-centred care for this important population. Approaches for doing this may include analyses of aging-related studies selected from general populationstudies engaged for the systematic conceptualisation of PCM.
Objectives: The purpose of this study was to delineate the conceptual profile of person-centred care for older people within the general framework of PCM.
Methods: The main methodological approach employed in the present study was analyses of older-person studies selected from a large set of general population studies reviewed towards exploring the systematic conceptualization of PCM. That general study yielded eight principles as follows: (1) Ethical Commitment, (2) Cultural Sensitivity, (3) Holistic scope, (4) Relational Focus, (5) Individualised Care, (6) Common Ground for Collaborative Diagnosis andCare, (7) People-centred Systems of Care, and 8) Person-centred Education and Research.
Results: It was found that the eight principles of PCM elucidated for the general population were present in older-person-centred care papers, although to various degrees across principles. It was evidenced that the principles on Ethical Commitment, Holistic Framework, Relationship Focus, Individualised Care, and Person-centred Education and Research had the greatest presence in the articles on older-person-centred medicine.
Discussion: The considerable consistency found between the conceptual profile of person-centred care for older persons and the principles of PCM in the general population may reflect that the PCM perspective was historically pioneered within the old-age health field and that the PCM perspective continues to attract enormous interest in the old age field. This is highlighted by the fact that ethical commitment was a key motivator for the pioneering development of PCM in the geriatric field and that this principle has been prominently identified in recent systematic conceptualisation studies of PCM for the general population and appears as well among recent academic developments and proposals from major international institutions.
Conclusions: The fundamental characteristics of older-person-centred care appear to have considerable consistency with the general principles of PCM, with particular attention to ethical commitment, holistic framework, communicative and relational focus, and attention to the values and needs of the older persons involved.