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The Need to Reconstruct "Person-Centeredness" Based on Inherent Tensions.

Sheryl Zimmerman1, Walter Moczygemba1, Philip D Sloane2

  • 1Cecil G. Sheps Center for Health Services Research and School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Journal of Applied Gerontology : the Official Journal of the Southern Gerontological Society
|June 24, 2026
PubMed
Summary
This summary is machine-generated.

Person-centered care (PCC) faces challenges in practice, especially for older adults. Understanding and addressing six core tensions is crucial for a more realistic approach to PCC.

Keywords:
decision making, dementialong-term careperson-centered careperson-centerednessquality of lifetensions

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Area of Science:

  • Healthcare delivery
  • Geriatric care
  • Dementia care

Background:

  • Person-centered care (PCC) is a widely recognized approach in health and supportive services.
  • Despite its prevalence, the implementation of PCC is complex and not uniformly understood.
  • Challenges are particularly noted in the care of older adults, including those with dementia and in long-term care settings.

Purpose of the Study:

  • To explore the concept of person-centered care (PCC) in depth.
  • To identify and understand the inherent challenges in applying PCC.
  • To examine PCC within the context of older adults, dementia care, and long-term care.

Main Methods:

  • Qualitative analysis based on insights from 116 participants.
  • Discussions and meetings involving diverse professional perspectives and expertise.
  • Identification of deeply rooted tensions within the PCC framework.

Main Results:

  • Six fundamental tensions impacting PCC were identified: community vs. individual, efficiency vs. individualization, superficial vs. deep knowing, policy compliance vs. flexible decision-making, safety vs. freedom, and expense vs. investment.
  • These tensions highlight the inherent complexities and limitations in achieving "full" PCC.
  • Ongoing negotiation and adaptation are necessary for practical application.

Conclusions:

  • Achieving "full" person-centered care (PCC) is an unattainable ideal due to pervasive tensions.
  • The concept of PCC requires reconstruction towards a more nuanced and realistic model.
  • Practice, policy, and research must adopt a revised understanding of PCC to better navigate its complexities.