How does person-centred care promote self-esteem?

According to the World Health Organization, healthy aging is linked to maintaining functional ability and well-being in older age. A critical, yet often overlooked, aspect of this is self-esteem. Understanding precisely how does person-centred care promote self-esteem is fundamental to empowering older adults and ensuring a high quality of life.

Quick Summary

Person-centred care bolsters self-esteem by prioritizing the individual's unique needs, values, and preferences, thereby restoring a sense of control and purpose. It achieves this by treating seniors with unconditional positive regard, fostering autonomy, and validating their lifelong identity and experiences, which can be vulnerable during care transitions.

Key Points

• Restores Autonomy: Shifts control and decision-making back to the individual, reversing feelings of powerlessness often associated with aging and illness.

• Affirms Identity: Values the individual's unique life history, preferences, and personality, reinforcing a sense of self-worth and continuity.

• Cultivates Dignity: Treats individuals with profound respect and empathy, acknowledging their inherent value regardless of their health status.

• Empowers Choice: Involves individuals in daily care planning and activities, fostering a sense of control and purpose.

• Provides Unconditional Positive Regard: Embraces the individual without judgment, which is fundamental to psychological well-being and a healthy self-image.

• Fosters Meaningful Connection: Prioritizes social interaction and emotional validation, reducing loneliness and strengthening social identity.

The Foundations of Person-Centred Care

Person-centred care (PCC) is an approach that places the individual, not their illness or disability, at the center of their care plan. This philosophy moves away from a one-size-fits-all model toward a more holistic, respectful, and collaborative framework. This shift in perspective is crucial for promoting self-esteem, especially for older adults who may experience a loss of independence or identity through life changes and health challenges.

The Humanistic Core: Unconditional Positive Regard

At its heart, PCC is rooted in humanistic psychology, famously articulated by Carl Rogers. A central tenet is unconditional positive regard—the practice of accepting and valuing an individual for who they are, without judgment. In a caregiving context, this means that a person's worth is not diminished by their age, condition, or dependence on others. When a senior is shown genuine, non-judgmental acceptance, it sends a powerful message that their feelings, thoughts, and personal history are still relevant and cherished. This acceptance is a powerful catalyst for rebuilding a positive self-image.

Empowering Practices That Build Self-Worth

Practically, PCC translates into several key actions that directly impact a senior's self-esteem. These practices are designed to restore agency and purpose, qualities often threatened during later life.

Promoting Independence and Choice

One of the most significant blows to self-esteem can be the loss of independence. In traditional care, schedules and routines are often dictated by the care provider. In contrast, PCC actively seeks to involve the individual in all decisions about their daily life.

• Decision-Making: A care plan is developed with the individual, not for them. This might include choices about meal times, clothing, or daily activities.
• Support, Not Control: Caregivers support the senior in doing as much for themselves as possible, rather than simply doing tasks for them. For example, instead of dressing a person, a caregiver might assist them, allowing the senior to maintain a sense of accomplishment.
• Respecting Preferences: Even seemingly small preferences, like the order of a morning routine or the choice of a TV show, are respected. This affirms that their opinions still matter and are valued.

Valuing Personal Identity and History

Identity is closely tied to self-esteem. Many older adults find their identity challenged by health conditions or a move to a new care setting. PCC combats this by recognizing and celebrating the individual's life story and unique personality.

How to Integrate Personal History into Care:

1. Life Story Work: Documenting a senior's life story, hobbies, and career can help staff understand who the person is beyond their care needs.
2. Personalized Environment: Encouraging the senior to decorate their space with personal belongings, photos, and items that hold meaning helps them feel at home and connected to their past.
3. Encouraging Strengths: Rather than focusing on limitations, caregivers identify and leverage the person's existing strengths and abilities. This might mean supporting a former artist to continue painting or a former baker to help with kitchen activities.

Comparison: Person-Centred Care vs. Traditional Task-Centred Care

Feature	Person-Centred Care	Traditional Task-Centred Care
Primary Focus	The individual's unique needs, preferences, and identity.	The completion of care tasks and medical routines.
Decision-Making	Collaborative, involving the senior as an active partner.	Top-down, with staff or protocols dictating actions.
Staff Role	Facilitator, partner, and relationship-builder.	Task-completer and schedule-follower.
View of the Person	As a whole, unique person with a rich history.	As a recipient of services; defined by their needs.
Outcome for Self-Esteem	Enhanced; promotes autonomy, dignity, and a sense of worth.	Often diminished; can lead to feelings of powerlessness.

Creating Meaning and Connection

Loneliness and social isolation are major risk factors for low self-esteem. PCC emphasizes the importance of social and emotional well-being by creating opportunities for meaningful connection and purpose.

• Facilitating Social Engagement: Care plans include opportunities for social interaction based on the individual’s preferences, whether it's one-on-one chats, group activities, or visits from family and friends.
• Community Connection: Some PCC models involve connecting the senior with their wider community through volunteering or community-based projects, affirming their continued value to society.
• Addressing Emotions: Caregivers are trained to listen and respond with empathy, validating feelings of sadness or frustration without dismissing them. This emotional validation is critical for psychological well-being and self-respect.

Addressing Challenges and Fostering Resilience

PCC is not about shielding individuals from all challenges, but about building their resilience to face them. For individuals with dementia, where cognitive abilities may be impaired, this approach is adapted to meet them in their reality, using non-verbal cues and emotional connections to maintain a sense of safety and self-worth. By focusing on what a person can do, rather than what they can no longer do, PCC protects and promotes self-esteem even in the face of significant decline.

Conclusion: A Shift Towards Dignity and Empowerment

In conclusion, the answer to how does person-centred care promote self-esteem lies in its fundamental shift away from a task-oriented approach to a relationship-based one. By consistently practicing unconditional positive regard, respecting individual choice, affirming personal identity, and fostering meaningful connections, this model of care empowers seniors to maintain a strong sense of self-worth. It recognizes that every person, regardless of their age or health, has intrinsic value and the right to a dignified and self-determined life. This focus on the individual's humanity is not just a method of care—it is a pathway to improved well-being and a healthier, more fulfilling existence.

Person-centred care made simple

Frequently Asked Questions

How does person-centred care differ from traditional care?

Traditional care focuses on completing tasks and following a rigid schedule, often prioritizing institutional efficiency. Person-centred care, conversely, prioritizes the individual's choices, preferences, and personal well-being, making the care plan collaborative and flexible.

Can person-centred care improve self-esteem for people with dementia?

Yes. Even for people with cognitive impairments, person-centred care can be highly effective. It focuses on non-verbal cues, emotional connection, and engaging the individual in familiar, strength-based activities, which helps preserve their sense of identity and worth.

What are some examples of person-centred practices that boost self-esteem?

Examples include allowing a senior to choose their own clothes and meal times, incorporating their favorite music or hobbies into daily routines, and encouraging them to share life stories and experiences with caregivers.

How can families support person-centred care for a loved one?

Families can contribute by sharing stories about the senior's life, helping personalize their living space, and being actively involved in care planning. They can also ensure that their loved one's preferences are communicated clearly to care staff.

Is person-centred care more expensive than traditional care?

While it may require more initial training for staff, person-centred care can lead to better health outcomes, fewer hospital visits, and increased patient satisfaction, potentially leading to long-term cost savings. Its value is measured more in quality of life than in monetary terms.

Why is it important to focus on self-esteem in senior care?

Low self-esteem in older adults is linked to depression, anxiety, and social withdrawal. Promoting self-esteem improves mental health, enhances engagement, and contributes to overall well-being, resilience, and a higher quality of life.

How does a caregiver's attitude influence a senior's self-esteem?

A caregiver's attitude is paramount. A respectful, patient, and empathetic approach that views the senior as a partner, rather than a passive recipient of care, builds trust and reinforces the senior's sense of value and dignity.