Promoting compassionate care with the older people: a relational imperative.

We have been invited to imagine a future where the care for older people goes beyond the current paradigm. This article challenges the fundamental assumptions that underlie current care practices and, instead, promotes systems and processes that elevate nourishing and stimulating relationships with basic dignity, as well as personal agency, in the later days of life. Healthcare professionals still base current care systems on a medical model that emphasises the diagnosis, treatment and cure of disease (Kane RL & West JC, 2005It Shouldn't Be This Way: The Failure of Long-Term Care, Vanderbilt University Press, Nashville, Tennessee). In contrast, we highlight principles of relating that support care to older people during the final stages of life, and promote systems, processes, and design elements that constitute compassionate care. To do so, it is necessary to move from a model that responds to the dominant regulatory environment to a model that is designed in the ongoing processes of human relationships. Specifically, we are including all dimensions of relating including relations among the residents and between and among residents' families, and all levels and functions of caretakers and the community.