Taking older persons seriously: Exploring personcentred and participatory approaches for fair responsibility in health and social care

Abstract

Introduction and aim: As the older population grows, the need for care that respects their preferences becomes increasingly important. Frail and pre-frail persons, especially those in or approaching residential aged care facilities, often face barriers to participation and influence. The aim was to explore person-centred and participatory approaches to healthcare and social services with and for frail and pre-frail older persons, while ensuring opportunities for fair responsibility in knowledge creation.

Methods: Study I examined the applicability of photo-elicitation interviews as a method for engaging older persons residing in residential aged care facilities in conversations about everyday life. Building on study I, study II identified key concerns raised by residents themselves. Study III explored organisational capability for person-centred care through focus groups with residential aged care staff and managers. Study IV evaluated two health promotion interventions in a randomised controlled trial with prefrail older persons living in ordinary housing.

Results: Photo-elicitation interviews enabled frail older persons to participate meaningfully in research. Institutional and organisational barriers limit older persons’ influence in residential aged care, but person-centred approaches, supported by committed staff and inclusive communication may foster capability and participation. Health promotion interventions showed that tailored support can sustain participation in leisure activities among pre-frail older persons.

Conclusion: To ensure credible person-centred care, older persons need to be actively involved in research, not only as care recipients but as co-creators of knowledge. A person-centred research approach is essential for both research and practice to align care with lived experiences and promoting meaningful participation and occupational justice. Without it, care risks becoming standardised and disconnected from those it aims to serve.