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| Enablers for the person-centred care approach |
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| Enablers | Examples provided by Champions |
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| Management support for incorporating personalized care into daily care practices | “…allowing residents to sleep-in and providing them with breakfast when they awoke and requested it” (SCC01) |
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| Management allowing Champions and staff to try out new ideas | “ …. letting the nurses try different approaches for some residents….and discovering what worked, and what was not working” (SLC01) |
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| Shared governance in decision-making | “… input and feedback and discussion with direct care staff on resident preferences, needs and issues”
(WMC01) |
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| Clear communication between managers, nurses, direct care staff, the Champions, the resident’s family and the GPs | ‘… good communication greatly improved the buy-in by all stakeholders and the capacity for speedy problem solving on issues regarding resident health and well-being” (AHC01 ) |
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| Barriers to the person-centred care approach |
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| Barriers | Examples provided by Champions |
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| Reluctance of residents’ families to agree to deprescribing | “....it was important for Champions to give families and GPs advice on the person-centred approach to behaviour reduction and management, to show how this approach was embedded in the approved deprescribing protocol and to emphasise that the approach was unlikely to cause any harm to the resident” (MC01) |
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| Reluctance of resident’s GP to deprescribe | “… the GPs needed to feel they were making the decision based on knowledge and evidence” (BHC01) |
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| Reluctance of some nurses to support deprescribing | “some RNS would only agree to comply if the doctors allowed it” (BPC02)
“ some direct care staff expressed fear to RNs (nurses) that they could suffer assault from a physically stronger and aggressive resident” (SC02) |
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| Negative family attitudes towards non-pharmacological management of behaviour | “a culture of blame seemed prevalent if staff were unable to contain the resident’s behaviour,” (WDC01) |
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| Task-focused care culture | “…. not having the person-centred approach in the forefront of their thinking amid all the things they have to do for residents” (BLC01) |
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| Time to implement person-centred behaviour responses | ‘…(direct care staff) being too busy to really take notice of what was going on for residents” (WC01) |
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| Lag time in reporting of the study findings | “….(Champions) having insufficient feedback on the study’s progress” (MRCO2), “… (study findings) would have helped to inspire the direct care staff to maintain their interest and commitment to person-centred approaches to behaviour reduction and management” (BHC02) |
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