title: Appreciating the 'person' in long-term care.
abstract: BACKGROUND
  Internationally, approaches to the long-term care of older people are changing. New models are being developed that aim to de-institutionalise care settings, maximise opportunities for older people to participate in decision-making and move from a predominant medical model of care to one that is community orientated.
  
  
  OBJECTIVE
  The aim of this study is to highlight similarities and differences between the different models that exist and explore the implications of these for the role of the registered nurse in long-term care.
  
  
  METHODS
  We chose three models for review as these represent a range of views of person centredness, each having distinct roots and focus. The models chosen were as follows: (i) culture change, (ii) person-centred practice and (iii) relationship-centred care.
  
  
  RESULTS
  The review highlights two key issues - (i) the distinctiveness of different models and frameworks and (ii) different interpretations of 'person'. Firstly, we identify a disconnection between espoused differences between models and frameworks and the reality of these differences. The evidence also identifies how some models and frameworks adopt a more inclusive conceptualisation of person and personhood and do not define personhood in relation to role (resident, nurse and family member).
  
  
  CONCLUSIONS
  There is merit in the development of models and frameworks that try to make explicit the different dimensions of person centredness in long-term care. However, the focus on the development of these, without sufficient attention being paid to evidence of best practices grounded in the concept of personhood, person-centred care is in danger of losing its original humanistic emphasis. Further, models and frameworks need to take account of the personhood of all persons.
  
  
  CONCLUSIONS
  Registered nurses need to have an understanding of the concept of personhood to make sense of the various person-centred practice frameworks that exist. Without this understanding, there is a danger that the essence of personhood may be lost in the zeal to implement particular models and frameworks.
authors.affiliation: Institute of Nursing Research, School of Nursing, University of Ulster, Newtownabbey, Northern Ireland. bg.mccormack@ulster.ac.uk
authors.forename: Brendan
authors.initials: B
authors.lastname: McCormack
authors.forename: Tonya
authors.initials: T
authors.lastname: Roberts
authors.forename: Julienne
authors.initials: J
authors.lastname: Meyer
authors.forename: Debra
authors.initials: D
authors.lastname: Morgan
authors.forename: Veronique
authors.initials: V
authors.lastname: Boscart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005851:Geriatric Nursing / Q000379:methods*; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D028723:Personhood