Understanding the Person-Centred Review Process
A person-centred review (PCR) is a powerful tool used in care and support planning, especially for seniors and those with complex health needs. Unlike traditional reviews that focus on a person's deficits or medical problems, a PCR emphasizes the individual's unique strengths, interests, and aspirations. This approach ensures that care plans are not just medically sound, but also reflect the individual's preferences and priorities for a high quality of life. The conversation is typically led by a facilitator and involves the individual, their family, caregivers, and other relevant professionals in an informal, supportive setting.
The Foundational '4 Plus 1' Questions
One common framework for a person-centred review uses the "4 Plus 1" questions, which help guide the discussion in a constructive, forward-looking way. These are not a checklist, but rather prompts to spark a deeper conversation and gather meaningful insights.
- What have you tried? This question encourages reflection on past actions and solutions. It helps identify what strategies have been successful and which have not, providing valuable context for future planning.
- What have you learned? Moving beyond simple action, this question focuses on the wisdom gained from past experiences. It highlights the individual's own insights and understanding of their situation.
- What are you pleased about? This positive and affirming question celebrates successes and achievements. It shifts the focus away from problems and towards the individual's strengths, building confidence and a positive atmosphere.
- What are you concerned about? This provides a safe space for the individual and their supporters to voice worries and anxieties without judgment. It ensures all challenges are acknowledged and addressed constructively.
- Plus 1: What should we do next? Based on the collective answers to the first four questions, this final query guides the group toward a clear, actionable plan for the future, centered on the individual's goals.
Deeper Dive: Comprehensive Questions for Discussion
Beyond the foundational questions, a comprehensive person-centred review will explore various facets of the individual's life. The facilitator may use large pieces of paper, flip charts, or post-it notes to capture these thoughts visually, ensuring everyone feels heard.
What is working and not working?
This is a crucial comparison within the review, inviting honest feedback from everyone involved—the individual, their family, and professionals.
- What's working?
- What aspects of the current care and support are successful?
- What routines, activities, or relationships bring joy?
- What are the individual's personal strengths and talents?
- What's not working?
- What challenges or frustrations are the individual experiencing?
- Are there aspects of the care plan that are not being met?
- What needs to change, be different, or stop entirely?
What is important to and for the person?
This is a powerful distinction in person-centred planning, clarifying the difference between what makes the individual happy and what keeps them safe and healthy.
- What is important to you?
- What makes you happy and gives you a sense of purpose?
- What are your interests, hobbies, and passions?
- Who are the important people in your life?
- What is important for you?
- What support do you need to stay healthy and safe?
- What are your medical needs and how can they be best managed?
- What legal or financial matters need attention?
The Importance of the Individual's Voice
The entire purpose of the PCR is to ensure the individual's perspective is paramount. For seniors, this can mean restoring a sense of control and dignity that may have been lost due to age-related changes. Questions focus on personal choice and empowerment.
- Daily Life and Routine: "What does your perfect day look like?" and "Are you satisfied with your daily routine?"
- Relationships: "Who are the most important people in your life?" and "Do you feel understood by those around you?"
- Future Hopes and Dreams: "What are your hopes for the future?" and "What is one thing you would like to change or do differently?"
Comparison Table: PCR vs. Traditional Review
| Aspect | Person-Centred Review (PCR) | Traditional Review |
|---|---|---|
| Focus | Holistic view of the individual: strengths, interests, and aspirations. | Medical diagnoses, problems, and compliance with regulations. |
| Driving Voice | The individual receiving care, supported by their network. | Professionals (doctors, social workers) and administrative requirements. |
| Atmosphere | Informal, conversational, and appreciative. | Formal, often sterile, and focused on risk management. |
| Questions Asked | Open-ended: "What brings you joy?" "What's working?" | Closed-ended: "Has the person's condition worsened?" "Are medications being taken?" |
| Outcome | Creates a personalized action plan for well-being. | Checks off items on a compliance or medical checklist. |
| Goal | Empowerment, dignity, and a better quality of life. | Risk mitigation and managing deficits. |
The Conclusion: Actions and Outcomes
The final stage of the review process is to synthesize the information gathered into a concrete action plan. This involves exploring any differences of opinion and prioritizing outcomes based on what the individual wants for their future. A detailed action plan is then created, outlining who will do what, and by when. The person-centred review ensures that the support provided is not just effective, but truly meaningful to the individual's life. This process reinforces that care is not just about what is being done to a person, but what is being done with and for them, as they define it. For more information on advocating for older adults, the Administration for Community Living provides valuable resources.
Final Thoughts
By prioritizing the individual's voice and valuing their unique perspective, a person-centred review can lead to more effective, compassionate, and dignified care. It is an essential practice for anyone involved in supporting older adults and a key to healthy, meaningful aging. The questions asked are not just about gathering data; they are about building a relationship and fostering genuine understanding.
