Geriatric MedicineTier 2Topic

Patient-centred care and multidisciplinary issues - person- or patient-centred care as a concept, such as actively including patients, families, and carers in decisions regarding the health care or rehabilitation process

The concept

Person-centred care treats the older patient, their family, and their carers as active partners in the care/rehabilitation process, rather than passive recipients of a plan devised solely by clinicians
Care that explicitly incorporates the patient's own priorities is associated with better engagement, adherence, and satisfaction, and reduces the mismatch between what clinicians offer and what the patient actually wants

Paternalism vs partnership

Traditional paternalistic models assume the clinician knows what is best; person-centred care instead starts from the patient's own values, priorities, and definition of a good outcome, which frequently differs from the clinician's default assumptions (e.g. valuing independence or comfort over survival or disease control)

Eliciting goals and involving family

Explicitly ask about and document the patient's goals and priorities early in an admission/care episode, not only when a difficult decision point (e.g. resuscitation status) is reached
Involve family/carers to the extent the patient wants, respecting their right to also exclude family from certain discussions if they choose - person-centred does not automatically mean family-centred

In practice

Comprehensive geriatric assessment is inherently a person-centred process when done well - it should surface what matters to the patient, not just catalogue their deficits
Goals of care, rehabilitation targets, and treatment intensity decisions should all be traceable back to the patient's stated priorities, revisited as circumstances change

Related concepts

Comprehensive geriatric assessment, advance care planning, shared decision-making, carer involvement

Key point

Person-centred care is not simply being polite or communicative - it requires actively restructuring the assessment and planning process around the patient's own priorities, which can and should change clinical decisions, not just how they are communicated

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