How to Provide Patient-Centered Care

There are 3 steps to providing patient-centered care:

  1. See your patient as a person with a whole life outside of dialysis
  2. Learn patients’ goals and how those mesh with their treatment plans
  3. Build a working relationship with patients

Before we look at these further, let’s meet Rosa.

Rosa has been on dialysis for about 6 months now and you notice that she isn’t doing quite as well as she was just a couple of months back. She has missed a few treatments. Her labs aren’t quite as good as they used to be, and she is not as pleasant. One day as you are putting Rosa on dialysis you let her know that you are concerned about her and have noticed that maybe she is struggling a bit. Since you have taken the time to build a relationship with Rosa, she trusts you and is willing to open up and tell you what is bothering her. Your talk sounds a bit like this:

You: “Rosa, you just don’t seem like yourself lately. Is there something going on that I might be able to help with?”

Rosa: “No, I am fine.”

You: “Really? I think we have had the chance to get to know each other over the last 6 months, and I sense you are not happy. I have seen that your labs aren’t where you might want them, and you’ve missed a couple of treatments, which is something you never used to do.”

Rosa: “Well sometimes this whole dialysis thing is just really hard. And to tell you the truth I don’t feel like I am even involved. All I do is come to dialysis and you people put me on, tell me what to eat, what to drink, what pills to take, when I have to be here. It seems like no one even cares what I want out of this whole deal.”

You: “Wow! I hadn’t really thought about it that way. I think we can get caught up just trying to do our job the best we can. Maybe we forget about what is important to each person getting treatment here. What do you say we talk more about this?”

Rosa: “Sounds good to me.”

Did this talk remind you of any of your patients? What Rosa is saying is that she is frustrated. She doesn’t feel like she is part of the decision-making process, and she doesn’t feel cared about. You might want to dismiss these feelings of Rosa’s as just part of being on dialysis, but many patients feel this way.