Person centered care, wormholes, pesterers and care domains (i)

Student: I am puzzled as to how we can achieve and represent person centered care? Where does person centered care fit in Hodges' health career model?

Mentor: Can you recall the questions posed to formulate the model?

Student: Yes, I think so ... In h2cm there are two axes. The first is the vertical with the INDIVIDUAL - GROUP. The INDIVIDUAL is the primary recipient of nursing, medical and other disciplinary care. [Pauses] That's right, in the question posed in creating the model, the individual is identified first. Followed by the GROUP. It is the individual that I must learn to assess, plan care for, intervene and then evaluate that care. It is the individual who provides consent and then ... whose observations I record. It is this one person I am learning to observe, understand, reassure, and nurse back to health, or a peaceful, dignified and comfortable end.

Mentor: And in these times of the demographics, economic pressures 

and ongoing organisational change is that all?

Student: Mmm... No. The individual can also self-care and be taught to manage their condition and whenever possible to find their own (unique) way to recovery.

Mentor: That is right and will be very important in this century.

Student: What I do not understand is that in the model the INDIVIDUAL is hardly at the center, but at the top. This can very quickly become a word game played by the policy makers and the authors of care philosophies. It seems to me this model is merely playing games too. After all there are only so many letters in 'person centered' however we spell it!

Mentor: Enough ... to spell ... 'conned pesterer'?

Student: [Pauses, scribbles...] Hah! Goodness me! Hardly an appropriate term, even if my path crosses that of someone the 'team' regards as an 'unpopular patient'. That certainly highlights the true state of affairs. The public, and not just the public is repeatedly duped into believing person-centred care is a reality. Patients who are ill, not taking advice and especially those with long-term medical conditions and so a potential 'pesterer' [looks aside...]...

Mentor: Yes [wry smile] - do go on....

Student: Well your words not mine... These people, plus those who recover - are also citizens and they are the - supposed - stock in trade of the politicians. In that sense you are quite right - they are 'conned'. There aren't always the resources to deliver person centered care. Even then there is no definition of what person-centered should mean now - is there?

Mentor: Well I thought I was being clever with the anagram, but that is an excellent response.

Well done. I don't believe we are done here yet though...