Person-centred decisions in emergency care for older people living with frailty: principles and practice
James David van Oppen, Tim Coats, Simon Conroy, Sarah Hayden, Pieter Heeren, Carolyn Hullick, Shan W. Liu, Jacinta A. Lucke, Bill Lukin, Rosa McNamara, Don Melady, Simon P. Mooijaart, Tony Rosen, Jay Banerjee
Abstract
Older people living with frailty are frequent users of emergency care and have multiple and complex problems. Typical evidence-based guidelines and protocols provide guidance for the management of single and simple acute issues. Meanwhile, person-centred care orientates interventions around the perspectives of the individual. Using a case vignette, we illustrate the potential pitfalls of applying exclusively either evidence-based or person-centred care in isolation, as this may trigger inappropriate clinical processes or place undue onus on patients and families. We instead advocate for delivering a combined evidence-based, person-centred approach to healthcare which considers the person's situation and values, apparent problem and available options.