Catch a Glimpse of Me : The development of staff videos to promote person-centered care

Introduction and background

Person-centered care (PCC) is the gold standard model of care for older adults, and particularly for those with dementia disorders (Edvardsson, Winblad, & Sandman, 2008). PCC focuses on maintaining personhood through social, relational and positive and enriching interpersonal relationships (Dewing, 2008; Kitwood, 1997). Through the generation of positive interactions and relationships the personhood of people with dementia is continually replenished (Epp, 2003).

Socialization for those with dementia is often threatened early in the disease process as other people change the way that they react and respond to the person (Buron, 2008). Loss of social connection can diminish further as the disease progresses and can limit linguistic and verbalization capabilities. PCC is based on the premise that persons with dementia must be understood by the care staff in order to nourish and preserve their sense of self (Stein-Parbury et al., 2012). According to Kitwood (1997) a person-centered approach requires that the care environment is informed of important details including a person’s social and functional history, strengths and preferences regarding their well-being.

Despite the emergence of person-centered approaches for persons with dementia disorders, questions still remain about effective and appropriate mechanisms in which to implement PCC. Despite these limitations, the literature clearly demonstrates benefits of using a person-centered approach to care for people with dementia (Chenoweth et al., 2009; Stein-Parbury et al., 2012) therefore we must continue to explore creative ways to practice the provision of PCC in long-term care settings.

Aims of the Catch a Glimpse of Me project

The primary goal of Catch a Glimpse of Me project is to create an evidence-base for the development of PCC videos. Catch a Glimpse of Me videos are designed as a person-centered approach to care by capturing the essence of an individual (e.g. their voice, facial expressions, wants, needs, preferences, life experiences, accomplishments, likes and dislikes) before they reach a time in their life when they can no longer communicate those things directly. Catch a Glimpse of Me videos address the need for care staff to personally understand and appreciate the personhood of their residents in order to fully nourish and maintain the residents’ sense of self throughout the disease process. Focus groups consisting of all stakeholders (residents, family and staff members) were conducted to identify information that each group regarded as important for inclusion in personalized PCC videos.

Methods

We used resident, family and staff member focus groups to generate ideas regarding what broad topics were identified as most meaningful and useful in the development of PCC videos. Participant recruitment was accomplished by distributing letters of invitation to all residents, family members and staff of a Continuing Care Retirement Community in Richmond, Virginia. Six focus groups, with a total of 30 participants, were held in January 2014. Two focus groups included residents living in the continuing care retirement community. Two focus groups included family who had relatives living in the assisted living, healthcare, or memory support neighborhoods in the continuing care retirement community. The final two focus groups included staff members who provide care for residents residing in the assisted living, healthcare, or memory support neighborhoods.

Researchers asked framing questions for guiding the discussion of the focus groups. The questions for the respective focus groups were designed to spark a dialogue among participants regarding their perspectives about what type of information they would want to include in a person-centered video. Sample questions included: What information would you want to share with staff members who may provide care for you in the future?, what is important for staff members to know about your loved one that will help them provide better care?, what general topics would you like to see a resident talk about in a video of him/herself and what questions would you ask them and why?, based on your job roles and responsibilities what information is important for you to know that can be captured in a video about someone you are providing care for?

Findings

Five categories emerged from the thematic analysis of the focus group data: family, interests and hobbies, memories and moments, life space and getting personal. Table 1 presents descriptions of each theme.

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Table 1.

Findings from thematic analysis of focus groups.

Theme	Description	Examples
Family	Information regarding the resident’s family of origin as well as current family structure in order to be familiar with important names and experiences that are meaningful to the resident.	• Meaningful childhood memories  • Important things learned at a young age.  • Family of origin—family member’s names and names of pets.  • Current family structure—family member’s names and names of pets.
Interests and hobbies	Activities from the past and present that hold importance to the resident.	• Things resident has collected over the years and their meaning  • Activities and hobbies enjoyed in the past  • Activities and hobbies currently enjoyed
Memories and moments	Meaningful memories and life moments that capture the personhood of the resident.	• Accomplishments from work/vocation/occupation  • Proudest moments (personal/professional)  • Most important life lessons learned
Lifespace	A description of the resident’s lifespace (e.g. current room or apartment).	• Video tour of the residents current room  • Description of items in the room and their meaning
Getting personal	Personal preferences topics from food preferences to spirituality expression intended to help staff members individualize their care by having a greater understanding of the residents needs.	• Eating likes and dislikes  • Sights, sounds, and smells that elicit feelings of comfort  • Spirituality or religious preferences

Discussion

The goal of the Catch a Glimpse of Me video project was to create a template for the development of training videos intended to assist staff members to gain insight into their residents as they progress with dementia or a related disorder. Catch a Glimpse of Me videos were conceptualized based on Kitwood’s (1997) person-centered approach that promotes optimal care through an informed care environment. The intention of Catch a Glimpse of Me project is to capture the essence of each individual resident, told in their own words, prior to the development of severe cognitive dysfunction. Catch a Glimpse of Me videos provide a mechanism to support personhood as defined by Kitwood (1997) by recognizing the centrality of uniqueness and personal preferences and relationships for all individuals including those with dementia.

A pilot video was created based on the themes identified during the thematic analysis of the focus group sessions. Examples of questions included in the pilot video are: What did you learn from your childhood?, are there any meaningful events that stand out to you?, tell me a little bit about your eating habits, do you have a favorite comfort food?, what is your happy place?, are there any sights, sounds, or smells that bring you comfort? This 20 min video was conducted with an independent living resident in a continuing care retirement community who did not participate in the focus group sessions. The pilot video is in the beginning stages of production and researchers are awaiting approval to pilot the video as a mechanism to promote PCC.

The next phase of research will then be conducted to determine the impact that the Catch a Glimpse of Me videos has on the PCC practice for staff members in long-term care communities. In addition, further examination of the videos is needed to discover the full range of potential benefits that these videos could provide for residents and family members. Possible resident implications could be increased self-esteem, a higher level of overall happiness, and a feeling of comfort in knowing that important personal information has been documented. For family members, these videos could provide peace of mind knowing that staff members know important information about their loved one. The Catch a Glimpse of Me project is ongoing, and its utility as a mechanism to educate staff on targeted individual PCC is currently being evaluated.