4. Empowering people

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Understand the process of enabling the person to take control of their rehabilitation.

Person-centred and person-directed planning

Person-centred planning is a familiar term across the rehabilitation sector and is applicable across all settings of rehabilitation care. As people progress along their rehabilitation journey, they should develop improved health literacy and greater self-efficacy. This can include becoming more directive in goal setting and making intervention choices. This is commonly referred to as person-directed planning or person-directed care.

Rather than making a distinction between the two approaches, it is most important to understand that both are based on:

valuing dignity and respect for every person
belief in fairness and equity
ability to listen and appreciate what the person is saying
shared decision making
avoiding assumptions based on cultural, racial, gendered or other personal factors
being flexible and enabling choice

Shifting the locus of control

In the early days of recovery, the person is more dependent on you to provide information and advice. As the person becomes more familiar with their condition, their prognosis and the rehabilitation services available to them, the planning becomes more person-directed.

Facilitate the move towards a more person-directed planning process by:

  • building trust and confidence in the rehabilitation team and process
  • encouraging engagement and providing a safe environment for the person to be honest about hopes and fears
  • supporting the person’s understanding of their health condition and their prognosis.

The change over time in the locus of decision-making control is illustrated in figure 7.1

The level of responsibility decreases for the clinician and increases for the person over time.
Figure 7: Transition of locus of control from clinician to client1

Factors that influence a person’s level of control

As outlined in section 3, the ICF helps us to understand what influences a person’s ability to take control and achieve self-directed rehabilitation planning.

While the severity of the health condition is significant, often it’s the personal and environmental factors which have greatest impact as barriers or facilitators on their ability and/or desire to take control.

Taking the time to identify and understand these contextual factors will help you support the person to greater engagement and control in their rehabilitation planning.

References

  1. Glover H. Care planning processes: Auseinet recovery online toolkit. GPs NSW: 2006.
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