Person-centred care in Covid times

It’s hard to believe it’s almost two years now since the coronavirus pandemic began to impact upon all of our lives.

One of the major problems many care providers have had since then is how to balance the need for infection control measures with the needs of the people they support to have person-centred care. Or to put it simply, for those who need care and support to feel connected to those who provide it in the way that most people did before any of us had heard of COVID-19.


Balancing infection control with human interaction

Whilst restrictions change regularly, for many social care providers little changes in terms of the coronavirus-related measures that they need to continue to implement. Rigorous infection control is still needed in care homes and by care workers who make domiciliary care visits. Mask wearing is inevitably going to have to remain for any staff who provide care to multiple people during a shift, along with gloves, aprons, scrupulous hand washing and extensive cleaning.

For older, vulnerable or disabled people needing support these measures may be confusing, seem unnecessary (particularly if the person doesn’t understand about the pandemic), or feel like another barrier to human interaction. But is that an inevitable consequence of infection control measures, or the consequence of a loss of focus on humanity?


Safety + Person-centred care and support = Win-Win

I personally believe we can have safety and person-centred care. Many aspects of what makes great person-centred care are deliverable regardless of whether a care professional is wearing a mask and gloves or not. There is no doubt that it’s easier to convey a warm expression if a person can see your whole face, and you can’t share a meal or a tea break if the staff member is wearing a mask, but many other ways in which we can support a person’s individuality and make them feel special are still possible.

To illustrate this, in a recent Zoom training session I asked staff to close their eyes and consider how they might ensure person-centred support for a person who can’t just not see their mouth but can’t see them at all.

We came up with some great ideas and I shared my own ideas too. We concluded that all of the following is perfectly possible alongside infection control, and would undoubtedly enhance how a person who needed care and support experienced that care and support.


What’s possible?

Life story work. This is the cornerstone of all person-centred care and support. You can only be person-centred if you know about the person. It’s that simple. Read my blog: ‘Life story work – The gift that keeps on giving’ for tips and ideas.

Individually personalised activity items. This follows on from life story work. In a care home setting a person should have their own items that they use for reminiscence, comfort, hobbies and activities, just like a person living in their own home would.

Occupation (in many forms). Encourage a person to remain occupied, whether that’s by participating in their own personal care (IE: washing themselves, brushing their hair, choosing clothes and putting items of clothing on themselves), or through tasks like helping with cleaning, cooking and/or administration in their care home or their own home. Some activities may require additional hand-washing or the person to wear a mask if they are volunteering in the community, but it’s important to present opportunities to the person and give THEM the choice about whether they participate, rather than just assuming they won’t want to or won’t be willing/able to follow any additional safety measures that are needed.

Opportunities to learn, explore, create and make. With personalised items and 1-1 support if needed, a person can still create and make things, they can still explore their local area (even if this is only outside and with lots of layers on to keep warm) and most importantly they can still learn. There are many different learning opportunities on Zoom, including gardening tutorials offered by Trellis Scotland, and some fantastic resources have been made available to support creativity including Art by Post from the Southbank Centre. Some simple Google searching will provide many more examples. Intergenerational work is still possible through either virtual connectivity or through exchanging good old-fashioned letters, postcards and pictures. Be creative and explore opportunities rather than assuming things won’t be possible or will be too difficult.

Connection from behind a mask, apron and gloves. Aspects of interactions like our positioning when supporting a person, making eye contact, ensuring we are treating a person with dignity and respect, communicating in a way that makes sense to the personbeing a good listener, showing warmth in our body language and through our tone of voice, using touch (either with clean hands or gloves), talking/explaining about what we are hoping/trying to support with, and tapping into our life story knowledge all make a person feel focused on and cared about.

Creative safety.There are many examples of how professionals have tried to make their necessary PPE and other safety measures less intimidating and more human. Adapted masks with a clear panel in them that have been created to help deaf people lip read are one example, and some care homes have managed to increase resident’s hand washing by giving them bowls of soapy water to wash sundry items in whilst getting water and soap on their hands too (Occupation + hand hygiene = Another win-win).


Person-centred care as we learn to live with Covid-19

To conclude, someone pointed out to me recently that pre-pandemic just because a care worker was smiling at you didn’t mean you were going to have a positive, person-centred interaction.

Person-centred care has always been about being creative, empathetic and adaptable, and we need those skills now more than ever. Or to put it another way, as I did in my ‘We are all individuals’ blog:

“Understanding each person’s unique qualities, interests, aspirations, preferences, abilities and needs and acting on that understanding in everything that you help that person with.”

Getting to know a person can break down so many barriers, including those we’ve created with enhanced infection control. It’s easy to hide behind the excuse of the pandemic to cut back on tasks (like life story work) that may feel onerous to some staff when they have extra cleaning to do, but living with coronavirus is surely going to mean that we get back to being as person-centred as possible as quickly (and safely) as possible.

Until next time…

You can follow me on Twitter: @bethyb1886
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