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Title: Reconciling conceptualizations of relationships and person-centred care for older people with cognitive impairment in acute care settings.
Austin Authors: Rushton, Carole;Edvardsson, David 
Affiliation: School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
La Trobe University/Northern Health Clinical School of Nursing, Heidelberg, Victoria, Australia
Department of Nursing, Umea University, Umea, Sweden
La Trobe University/Austin Health Clinical School of Nursing, Heidelberg, Victoria, Australia
Issue Date: Apr-2018 2017
Publication information: Nursing philosophy : an international journal for healthcare professionals 2018-04; 19(2)
Abstract: Relationships are central to enacting person-centred care of the older person with cognitive impairment. A fuller understanding of relationships and the role they play facilitating wellness and preserving personhood is critical if we are to unleash the productive potential of nursing research and person-centred care. In this article, we target the acute care setting because much of the work about relationships and older people with cognitive impairment has tended to focus on relationships in long-term care. The acute care setting is characterized by archetypal constraints which differentiate it from long-term care, in terms of acuity and haste, task-orientated work patterns and influence from "the rule of medicine," all of which can privilege particular types of relating. In this article, we drew on existing conceptualizations of relationships from theory and practice by tapping in to the intellectual resources provided by nurse researchers, the philosophy of Martin Buber and ANT scholars. This involved recounting two examples of dyadic and networked relationships which were re-interpreted using two complementary theoretical approaches to provide deeper and more comprehensive conceptualizations of these relationships. By re-presenting key tenets from the work of key scholars on the topic relationships, we hope to hasten socialization of these ideas into nursing into the acute care setting. First, by enabling nurses to reflect on how they might work toward cultivating relationships that are more salutogenic and consistent with the preservation of personhood. Second, by stimulating two distinct but related lines of research enquiry which focus on dyadic and networked relationships with the older person with cognitive impairment in the acute care setting. We also hope to reconcile the schism that has emerged in the literature between preferred approaches to care of the older person with cognitive impairment, that is person-centred care versus relationship-centred care by arguing that these are complementary rather than mutually exclusive and can be brought together in one theoretical framework acknowledging personhood as relational in essence.
DOI: 10.1111/nup.12169
ORCID: 0000-0002-0829-3544
PubMed URL: 28185398
Type: Journal Article
Subjects: acute care
cognitive impairment
older person
Appears in Collections:Journal articles

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