Hodges' model in Murphy & Welford (2012) Agenda for the future: enhancing autonomy for older people in residential care. Int. J. of Older People Nursing

ABSTRACT: This is the concluding paper of a three paper publications. Paper 1 focused on specifically understanding what autonomy for older people in residential care means. Paper 2 discussed the various factors that either facilitate or hinder residents autonomy and directed readers to reflect upon their practice. This final paper outlines the findings from the action research phase of a study aimed at enhancing resident autonomy. It describes just one way in which residential care units can work on enhancing residents autonomy and enables the reader to reflect upon nursing practices, which with the right approach can be resident-centred.

Murphy and Welford write:

Hodges (1997) model is essentially concerned with the person (resident) in a social context. The notion of it derives from the intervention of the nurse being future orientated, increasing the health choices, health chances or health prospects of individuals or groups (including families) taking cognisance of the biography of the person or persons being helped. The person already has a biography that has been influenced by their physical and psychological make-up, the kinds of families and social networks they have experienced and the culture or geographical location in which they live. The nurse then is also influenced by personal factors of their individual physical or psychological origin and factors relating to their social world and the policies that govern their daily life. The nurse (assessor) must take cognisance of the attributes the person (resident) brings with them in their current presentation (problem) and how this affects their future choices both in terms of ability to make them and the range of choices available. Thus, this approach to care planning recognises the importance of negotiating care.  (online source - see doi link below)

I am not just very grateful to Murphy and Welford for their adopting Hodges' model in their study, but this supports my own use of the model in teaching staff about person-centred care and communication skills in residential and nursing care homes. The inclusion of a political domain and individual and group (populations) dimensions is a great asset in this context. Their conclusion also identifies the limitations of individually directed change, something that seems apparent from my own experience in nursing home liaison.
 
Murphy, K., Welford C. (2012) Agenda for the future: enhancing autonomy for older people in residential care. International Journal of Older People Nursing. 7, 75–80. doi: 10.1111/j.1748-3743.2012.00309.x