An absolute abstraction of person in person-centred care: A contemporary issue

Extensive nursing literature exists on the term person-centred care. Nevertheless, there is scant literature defining or explicating the concept. Rather, necessary contextual pre-conditions are often presented under the guise of explicit definitions. Person-centredness appears to be explained as a culture that could allow person-centred care to exist. This raises problems knowing what is being provided and what is being received in a person-centred care experience.

Within a caring space, a nurse providing person-centred care assumes an ontological perspective to provide such care. Specifically, it is typically assumed that the care giver is oriented to a single objective reality and the needs and desires of the care receiver can and should be judged from that perspective. However, when perceived reality noticeably differs between people, this ontological position may not hold. This is particularly apparent when a care receiver is experiencing dementia or other conditions which appear to alter conscious experience. This fundamental problem raises the contemporary issue of the nature of consciousness, as reality is perceived in the context of consciousness.

Some recent evidence such as that presented by Hoffman, suggests that consciousness may be more fundamental than physiology. This may form a basis for connecting with and understanding the experience of another. Consistent with this perspective, we introduce the concept of a Multiple Ego State System (MESSy). This concept may be a starting point for a theory-based person-centred approach to nursing which truly honours the perspective of the care receiver.

An ontological position inclusive of all individual realities as parts of one consciousness is an attractive position for the theoretical placement of person-centred care. Foundational work is therefore needed to explicate this concept.