Does Person-Centered Care Improve Nursing Facility Residents"� Mental Health? A Review and Commentary PCC and Residents’ Mental Health
Main Article Content
Abstract
Loneliness, social isolation, and depression are prevalent among nursing home residents worldwide, causing mortality risks that rival those of major chronic diseases. Over the past three decades, the person-centered care movement has sought to replace the institutional medical model with care prioritizing residents" individuality, dignity, and meaningful relationships. This review and commentary traces the evolution of person-centered care models and evaluates the evidence regarding whether person-centered care improves resident mental health. As part of our review, we consider evidence gathered from nursing home residents and staff during the COVID-19 pandemic, which led to the removal of major elements of person-centered care from daily life.
Older, pre-pandemic studies yielded mixed but increasingly positive results, with higher-quality designs showing that thorough person-centered care adoption improves quality of life and reduces depressive and neuropsychiatric symptoms. Our own research has clarified mechanisms by which person-centered care improves residents" mental wellbeing. In a comparative observational study of homes differing in levels of person-centered care adoption, residents in high- person-centered care settings displayed greater positive affect, engagement, and social connection. In a follow-up longitudinal study, higher person-centered care scores predicted significant Patient Health Questionnaire-9 (PHQ-9) reductions and increased expressions of pleasure, mediated by stronger aide"resident relationships and timely depression treatment. Statewide analyses of Kansas"s Medicaid program to incentivize person-centered care adoption (the Promoting Excellent Alternatives in Kansas 2.0, or PEAK 2.0, program) showed that residents whose facilities were strong person-centered care adopters had strikingly lower odds of depression and better clinical outcomes overall.
Pandemic disruptions provided a stress test for person-centered care. When social contact and autonomy were curtailed, resident mental health declined sharply, underscoring the protective mechanisms person-centered care fosters. Emerging post-pandemic evidence reaffirms that comprehensive person-centered care improves psychological wellbeing and stabilizes the workforce through enhanced job satisfaction and lower turnover. Yet under 15% of U.S. facilities have fully implemented person-centered care, hindered by workforce instability and structural financial disincentives. Facilities should pursue thoroughly person-centered care adoption to transform themselves into communities where elders can live with dignity, purpose, and connection.
Keywords:
Person-Centered Care, Nursing Home Residents, Mental Health, Depression, Loneliness
Article Details
How to Cite
HERMER, Linda; NATARAJAN, Anusha.
Does Person-Centered Care Improve Nursing Facility Residents" Mental Health? A Review and Commentary.
Medical Research Archives, [S.l.], v. 13, n. 12, dec. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7050>. Date accessed: 02 jan. 2026.
doi: https://doi.org/10.18103/mra.v13i12.7050.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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14. Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. Department of Health and Human Services; 2023:1-82.
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18. Kitwood T. Dementia Reconsidered: The Person Comes First. Open University Press
19. Koren MJ. Person-Centered Care For Nursing Home Residents: The Culture-Change Movement. Health Affairs. 2010;29(2):312-317. doi:10.1377/ hlthaff.2009.0966
20. Brownie S, Nancarrow S. Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clin Interv Aging. 2013;8:1-10. doi:10.2147/CIA.S38589
21. White-Chu EF, Graves WJ, Godfrey SM, Bonner A, Sloane P. Beyond the medical model: the culture change revolution in long-term care. Journal of the American Medical Directors Association. 2009;10(6):370-378. doi:10.1016/j.jamda.2009.04.004
22. Neves B, Sandra A, Kokanović R. “It’s the worst bloody feeling in the world”: Experiences of loneliness and social isolation among older people living in care homes. Journal of Aging Studies. 2019;49:74-84. doi: https://doi.org/10.1016/j.jaging.2019.100785
23. Pomeroy ML, Cudjoe TKM, Cuellar AE, et. al. Association of Social Isolation With Hospitalization and Nursing Home Entry Among Community-Dwelling Older Adults. JAMA Internal Medicine. 2023;183(9 ):955-962. doi:10.1001/jamainternmed.2023.3064
24. Hermer L, Bryant NS, Pucciarello M, Mlynarczyk C, Zhong B. Does Comprehensive Culture Change Adoption via the Household Model Enhance Nursing Home Residents’ Psychosocial Well-being? Innov Aging. 2017;1(2):igx033. doi:10.1093/geroni/igx033
25. Thomas WH. Evolution of Eden. Journal of Social Work in Long-Term Care. 2008;2(1-2):141-157. doi: https://doi.org/10.1300/J181v02n01_10
26. Hermer L, Cornelison L, Kaup ML, Poey JL, Stone R, Doll G. The Kansas PEAK 2.0 Program Facilitates the Diffusion of Culture-Change Innovation to Unlikely Adopters. The Gerontologist. 2018;58 (3):530-539. doi:10.1093/geront/gnw210
27. Thomas WH. The Eden Alternative: Nature, Hope and Nursing Homes. Eden Alternative Foundation; 1994.
28. Pioneer Network. https://www.pioneernetwork.org
29. Rabig J, Thomas W, Kane R, Cutler LJ, McAlilly S. Radical redesign of nursing homes: Applying the Green House concept in Tupelo, Mississippi. Gerontologist. 2006;46(4):533-539. doi:10.1093/ geront/46.4.533
30. Promoting Excellent Alternatives in Kansas. Kansas State University Center on Aging. https://www.hhs.k-state.edu/aging/research/peak20/
31. Doll GA, Cornelison LJ, Rath H, Syme ML. Actualizing culture change: The Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK 2.0) program. Psychological Services. 2017;14(3):307-315. doi: https://doi.org/10.1037/ser0000142
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