Negotiating Risky Preferences in Nursing Homes: A Case Study of the Rothschild Person-Centered Care Planning Approach

Area of Science:

• Gerontological Nursing
• Healthcare Quality Improvement
• Patient-Centered Care

Background:

• Nursing homes receiving Medicare and Medicaid funding must provide person-centered care (PCC).
• Staff require evidence-based protocols to support resident choices, particularly those deemed risky.
• The Rothschild Care Planning Process for Resident Choice was developed to facilitate honoring resident preferences.

Purpose of the Study:

• To demonstrate the application of the Rothschild Care Planning Process for Resident Choice.
• To illustrate how to manage resident choices perceived as risky within a nursing home setting.
• To highlight best practices in delivering PCC through a case exemplar.

Main Methods:

• A case exemplar was used to showcase the six-step Rothschild Care Planning Process.
• The process focused on areas for attention and documentation in managing resident choice.
• The exemplar addressed complexities and best practices in implementing PCC.

Main Results:

• The case study demonstrated the practical application of the Rothschild Care Planning Process.
• The process facilitated the honoring of a resident's choice, despite staff perceptions of risk.
• Key areas for focus and documentation were identified for effective PCC.

Conclusions:

• Implementing structured care planning processes is crucial for supporting resident autonomy.
• Recommendations include adapting policies, engaging direct care staff, and providing staff training.
• Facilitating resident choice, even when perceived as risky, is integral to delivering high-quality PCC.