Person-centred care of people living with dementia and its regulation in German-speaking nursing homes: A qualitative focus group study

Abstract

Background & aim: Although nursing homes are aware of the relevance of person-centred care, the translation of this approach into practice remains difficult. This study aims to explore the meaning of person-centred dementia care and the role of internal regulations in German-speaking nursing homes in translating this concept into practice.

Methods: This study (a qualitative exploratory design) is part of an overall study of internal regulations about person-centred dementia care in nursing homes. In this substudy, we conducted nine virtual focus group discussions with experts from theory, practice, and regulatory authorities from Germany, Austria and Switzerland about person-centred dementia care. We analysed the data via qualitative content analysis using a deductive-inductive approach.

Results: For experts, the leadership function is crucial for the concept of person-centred dementia care in nursing homes. Leadership is inextricably linked to other elements, such as setting priorities, mindset, structural requirements, internal regulations and outcomes. Leadership therefore has a hinge function: it enables a limited and controlled rotation of connected elements to illustrate the dimensions of the individual elements from person-centred to non-person-centred. In addition to setting priorities and outcomes, mindset development and structural requirements are particularly relevant for the implementation of person-centred dementia care in nursing homes. The experts described differences between traditional internal regulations and regulations about person-centred dementia care in nursing homes. The development of internal regulations for person-centred dementia care and the content of these regulations are consequences of a circular, dialogical collective understanding process. It leads processually in a bottom-up manner to a common understanding of person-centred dementia care, which is then written down. Experts recommend formulating these regulations as concepts and options analogous to mindset development, which employees can use in the care of the resident while maintaining autonomy.

Conclusions: The study provides 1) insight into how person-centred dementia care and the role of internal regulation are understood in German-speaking nursing homes and 2) a precise description of the development of a mindset and regulations for person-centred dementia care in nursing homes that requires both top-down and bottom-up processes.

Keywords: Dementia; Focus groups; Internal regulations; Long-term care; Mindset development; Nursing home; Person-centred care.

Fig. 1

Overview of the six main categories.