By Adeola Akindana, DNP, CRNP, FNP, CDE
A core pillar of AADE’s new Vision for the Specialty, the person-centered care approach relies on putting the person at the center of all we do. It lends itself to making them an active participant in the decision-making process, builds a relationship of respect and helps to customize a care plan and education that takes into account their preferences, cultural values, traditions and individual needs.
As an organization, we believe that all people with diabetes should have access to care and education that is provided by, developed by or supervised by a diabetes educator. We also believe it is important for diabetes educators to ensure they are meeting their patients “where they are.” This is important as person-centered care lends itself to a quality of personal, professional and organizational relationships. Having this type of relationship has also been said to help reduce feelings of diabetes distress thus improving outcomes and effectiveness of communications between the patient, family and provider.1
I often ask if they are able and willing to do each item we agreed upon and if not, we re-negotiate. This allows them to feel they have options and feel more in control and in the driver’s seat.
So, you ask why person-centered care and why follow this approach when seeing a client for diabetes care and education? For me when I first meet one of my patients, I ask them to tell me their story, how did we get here, what do they think happened? I reassure them that it is not their fault and we are in this boat together. My primary role is to help them navigate the maze of managing a chronic condition and be successful at it. According to Inzucchi, et. al (2012), it is important to take into consideration many factors including age, sex, racial and ethnic background, genetic differences and comorbidities. I totally agree as this will help you to see the person with diabetes differently and as a unique person. This can also help when you negotiate on next steps.
My primary role is to lay out benefits, options, pros and cons of different directions we could take, and then assist them in determining which they should consider and why. Before they leave, I often type up an Instruction Letter of Agreement based on our agreements. I often ask if they are able and willing to do each item we agreed upon and if not, we re-negotiate. This allows them to feel they have options and feel more in control and in the driver’s seat.
The good news is by using the person-centered care approach you will find yourself interacting with your patients with a more genuine approach that goes beyond communication but rather listening more to both their verbal and non-verbal communication, reflecting on what they said to better meet their needs, and making the encounter more meaningful and valuable for them. Ultimately, it is important to have empathy towards the people you serve which allows you to see and understand things from their perspective rather than yours.
- Epstein, R. M. & Street, Jr, R. L. (2011). The values and value of patient-centered care.Annals of Family Medicine, Vol. 9, No. 2, March/April 2011
- NEJM Catalyst. (2017). What is patient-centered care? Retrieved online June 11, 2019. https://catalyst.nejm.org/what-is-patient-centered-care/
- Oneview. (2015). The eight principles of patient-centered care. Retrieved online June 11, 2019. https://www.oneviewhealthcare.com/the-eight-principles-of-patient-centered-care/
- Silvio E. Inzucchi, S.L., Bergenstal, R.M., Buse, J. B., et. al (2012). Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach: Position Statement of American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, Volume 35, June 2012.