“Men must necessarily be the active agents of their own well-being and well-doing… they themselves must in the very nature of things be their own best helpers”

– Samuel Smiles

doctor and elderly patient shaking hands and smiling


Active Participation

A skilled nursing facility (SNF) can conjure various images in a resident’s mind. Taking an active part in the healing process, though, typically isn’t one of them.

However, according to Dave DeBronkart, “The most underutilized resource in all of health care is the patient [1].”

In this post, we introduce the argument for taking an active role and advocate a stance of greater resident-involvement in skilled nursing facilities.

Looking at the broader health field, changes in payment and care delivery across the U.S., have led Len Schlesinger and John Fox [2] to promote a “fundamental redesign of the patient’s role – from that of a passive recipient of care to an active participant …” And this is not limited to the U.S. Joan Saddler [3], associate director of the NHS Confederation, argues, “Patients need to empower themselves to direct their own health.”

The Argument for Involvement

The enthusiasm for empowering healthcare recipients to assume an active role in their care, has its roots in science.

In 1980, researchers Sheldon Greenfield, Sherrie Kaplan and John Ware, Jr. studied [4] the effects of patient involvement in their care, at the Center for Ulcer Research and Education, in Los Angeles, California.

They found that compared to control group patients, patients who were involved in their care:

  • Were equally satisfied with their care
  • Reported less limitations in physical and role-related activities
  • Were twice as effective in obtaining information from physicians

Similarly, a review [5] of 21 studies, concerning physician-patient relations, found that the majority showed evidence for correlation between effective doctor-patient communication and positive health outcomes.

Simply put, when the patients are actively involved in their treatment, they seem to have better health outcomes.

Resident Involvement at SNF’s

Although these studies may not reflect the situation at SNF’s today, the importance of involvement in one’s care, certainly does not exclude residents in skilled nursing facilities. In-fact, the U.S. Centers for Medicare and Medicaid Services (CMS) [6] views “empowering patients to work with their doctors,” as the means for fulfilling their pledge to put patients first.

Choosing Delmar, is the perfect first step, but it doesn’t end there; resident participation is our ultimate goal.

What has been your experience regarding resident involvement? Please share in the comments below.

[1] http://www.times-standard.com/article/zz/20130313/NEWS/130319488

[2]  http://hbr.org/2016/11/giving-patients-an-active-role-in-their-health-care

[3] http://www.theguardian.com/healthcare-network/2016/jun/17/patients-active-role-healthcare-decision-making

[4] Greenfield, S., Kaplan, S., & Ware, J. E. (1985). Expanding patient involvement in care: effects on patient outcomes. Annals of internal medicine, 102(4), 520-528.

[5] Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: a review. CMAJ: Canadian Medical Association Journal, 152(9), 1423-1433.

[6] http://www.cms.gov/

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