Conceptualizing the role of narratives in person-centered care

Abstract

Person-centered care in nursing homes requires that care teams know each resident as an individual, with attention to their life history, current experiences of health and illness, and preferences for care. This personal knowledge can be understood as an evolving “narrative” – rather than a static, pre-given set of facts – which both reflects and determines patterns of action and interaction. This paper develops the concept of “person-centered narratives,” defined as temporal, meaningful, and social discourses (Elliott, 2005) that are shared about individual nursing home residents among members of the care team, and considers their causal significance for care interventions and outcomes. We discuss person-centered narratives in terms of content, or the meaning and significance of different narrative elements; form, or the ways that narratives develop and change; and performance, or the social context of narratives (Mishler, 1995). The extent to which narratives align or conflict within the care team is highlighted.