Person-Centered Care for the Elderly with Dementia: a Qualitative Analysis of Hong Kong

Abstract

Introduction : The senile dementia population in Hong Kong reached 110,000 in 2010. Dementia care has become a more pressing issue, calling for a scientific and efficient care model to ensure quality of care. Person-centered care (PCC) was developed in response to the need for patient-oriented healthcare service, and has been adopted as a key standard for dementia care in many developed countries. This study aims to achieve a better understanding of stakeholders’ attitudes toward PCC, thereby contributing to policy-making. Method : A qualitative research method was applied. 14 focus groups and 21 indepth interviews were conducted among 106 participants who were elderly with mild cognitive impairment (MCI), family caregivers, care workers, and professionals from 17 care units provided by 9 local NGOs. This study adopted a tripartite model of attitude (affective, behavioral, and cognitive) and Brooker’s PCC=V+I+P+S model as its theoretical framework. Results : Elderly with MCI have strongly negative impressions of care homes, mainly because of the lack of PCC. Family caregivers are willing to provide good quality care, but lack knowledge about PCC, as well as social and psychological support. Formal caregivers have a more pessimistic attitude towards realizing PCC, due to a strained workforce and current policy. Innovative management can help to promote care workers’ motivation for practicing PCC. Conclusion : Understanding about PCC among both formal and informal caregivers is neither clear nor sufficient. Dementia care provision is limited and inflexible, leaving a big gap in meeting the real needs of elderly people with dementia. Systemic promotion of PCC is urgently in need.