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Abstract
Person-centred care places the person at the center of health care decisions, focusing on strengths and abilities rather than weaknesses and disabilities. Relationship-centred care expands upon person-centred care, emphasizing not only the inclusion of the person but also relational aspects, including family and others who support the person in coping with a disability. Eleven therapeutic recreation specialists were interviewed to explore their perspective of how person-centered and relationship-centred care were put into facility-wide practice. An interpretive framework and thematic analysis were used to compare the philosophy of each institution with current practice as reported by the TRSs. Findings indicate that person- and relationship-centred care are given prominence in the institutions' mission and philosophy statements but that tensions exist when implementing these philosophies into professional practice at these institutions.
Keywords: Person-centred care, relationship-centred care, therapeutic recreation practice, thematic analysis, inter professional practice
Person-centredness is becoming increasingly prominent in both research and practice related to health care. Emphasizing a holistic approach to care, placing the person at the center of all interventions and decisions, patient-, client-, or person-centred care has been used in a range of care environments, including long-term care (Henderson & Vesperi, 1995), rehabilitation (Nolan, Booth, & Nolan, 1997), community mental health (Williams & Grant, 1998), and dementia care (Kitwood, 1997). It is in the latter area, following the pioneering work of Kitwood (1997) and Kitwood and Benson (1995) at the Bradford Dementia Centre, that person-centred care (PCC) has been most fully explored.
Although the bulk of the research related to PCC has emerged in the nursing literature, the concept is particularly relevant and consistent with the foundations of the allied health profession of therapeutic recreation (TR). TR is a systematic process that uses recreation and leisure services to bring about favorable changes in the persons served (Carter & Van Andel, 2011). This specialized application of recreation interventions is based on the individualized assessment of client needs, strengths, and goals, focusing on maintaining or improving health status, functional abilities, and ultimately the quality of life of individuals who have physical, mental, social, or emotional limitations that impact their ability to engage in meaningful leisure experiences. At its core, TR embraces a holistic approach to care and is based on the concept of collaboration...