Person-centred care models for institutionalised older adults requiring palliative care: an integrative review.

backgroundThis review explores strategies for implementing person-centred care (PCC) for older adults in institutional care settings with palliative care needs. Such settings present complex challenges, including loss of autonomy, multiple chronic conditions and psychological or existential distress. Integrating PCC principles with palliative care is an appropriate approach as it promotes shared decision-making, dignity, comfort and well-being. This approach contributes to individual satisfaction and the sustainability of care systems.

aimTo synthesise the scientific evidence on person-centred care models for institutionalised older adults in need of palliative care. MATERIALS AND

methodsA literature review was conducted using five databases. The initial search covered the period from December 2017 to August 2022. An additional search was performed between September 2022 and June 2025 to ensure coverage. The search strategy incorporated Medical Subject Headings (MeSH) terms and equivalent descriptors, including palliative care, end-of-life care, palliative nursing, long-term care, nursing homes, residential care, person-centred care, patient-centred care and client-centred care. The review was conducted in accordance with the PRISMA methodology and was registered in the PROSPERO database (CRD42022373388).

resultsA total of 201 records were identified, of which nine studies met the inclusion criteria and were included in the final synthesis. Effective implementation of PCC requires more than technical proficiency; it demands advanced communication, interpersonal, reflective and analytical skills, which are rooted in ethical reasoning and collaborative practice. Major barriers included insufficient staff competencies, limited training, resource constraints, and institutional rigidity. Facilitators included motivational leadership, continuous professional development, interdisciplinary collaboration, and organisational support. These findings are consistent with the Person-Centred Practice Framework developed by McCormack and McCance and the work of the Gothenburg Centre for Person-Centred Care. Both frameworks emphasise co-constructed care planning and respect for patient narratives as core principles of PCC.

conclusionThis integrative review provides a comprehensive synthesis of the conditions that enable PCC implementation in long-term care. The findings emphasise the importance of ethical care practices, structural support, and ongoing investment in workforce development. The study reinforces the relevance of transdisciplinary, human rights-based models and offers practical recommendations for care delivery, education, and policy design.