The Need to Reconstruct “Person-Centeredness” Based on Inherent Tensions

The concept of person-centeredness (PC) is ubiquitous in health and supportive care regardless of recipients’ age and condition, which might suggest that the concept is clear, uniformly understood, and its provision straightforward; however, such is not the case. To more fully understand the concept and challenges inherent in applying PC overall and in the care of older adults, including persons with dementia and receiving long-term care, this special article draws on meetings held with 116 participants representing diverse perspectives and expertise. Six deeply rooted tensions were identified: community (public) versus individual (private); efficiency versus individualization; superficial knowing versus deep knowing; policy compliance versus flexible decision making; safety versus freedom; and expense versus investment. Given these pervasive tensions, full PC can never be achieved, and requires ongoing negotiation. Therefore, the concept of PC must be reconstructed, adopting a more nuanced and realistic approach to practice, policy, and research.