“All illness, care, and healing processes occur in relationship—relationships of an individual with self and with others. Relationship Directed Support (RDS) is an important framework for conceptualizing health care, recognizing that the nature and the quality of relationships are central to health care and the broader health care delivery system. RDS can be defined as care in which all participants appreciate the importance of their relationships with one another. RDS is founded upon 4 principles: (1) that relationships in health care ought to include the personhood of the participants, (2) that affect and emotion are important components of these relationships, (3) that all health care relationships occur in the context of reciprocal influence, and (4) that the formation and maintenance of genuine relationships in health care is morally valuable. In RDS, relationships between patients and clinicians remain central, although the relationships of clinicians with themselves, with each other and with community are also emphasized.”[1]

The GERATEC value proposition is based on authentic relationships – we value our relationships with residents, their families, our employees and their families, as well as the broader community within which we operate. We have trusting relationships with our suppliers, and honour the relationships with clients. The focus on relationships makes for a discerning business model – we are not “just the outsourced service provider”. In fact, relationship directed business practice is a complex position in a world often focussed purely on “the bottom line”. As an entrepreneurial family business, we cannot do business without forming relationships. In fact, our entire business model is based on it.

We believe that our employees are our business, bringing their own relationships into the everyday lives of our work family. Being a mother, a grandmother, a wife or husband defines who our employees are. They are never just a number. We know that the person who goes home at night after a long shift, goes home to being a mother or father. We like to believe that the work environment impacts on what kind of mother or father that person will be when they get home at night. Dr. Bill Thomas, founder of The Eden Alternative, says that if your employees’ children are doing better at school because their mother or father works for you, then you understand relationship directed support.

For many older people the relationship that they have with our employees is often the only real, meaningful relationship. The person who cleans their room, who brings their laundry to them, serves their meals, helps them with daily chores might be the only people they see on a given day. Not rotating employees means that they do indeed form very meaningful relationships with residents. The reciprocal nature of these relationships cannot be underestimated. For many employees, coming to work is a haven away from difficult domestic circumstances. It is the relationship between employees and residents that serve both in creating quality of life.

“According to Kitwood (1997) personhood is ‘a standing or status that is bestowed upon one human being, by others, it implies recognition, respect and trust’. Through this recognition, respect and trust, the personhood of an individual will be enhanced as well as their wellbeing.” (Wikipedia) If we agree that long term care is primarily aimed at enhancing the wellbeing of those who live and work within the system, we know that relationships affect everything that we do. Changing our views of older people from being a care burden to our most valuable asset, or a resource of society, we will find a different ageing trajectory. People flourish in an environment where they are respected, where they are seen as valuable, where they feel secure enough to be trusted and trusting, and where they are not just passive recipients of care tasks. Our primary focus should be creating an environment within which relationships can flourish.

COVID-19 has shone a very bright, if not blinding light, onto the long-term care sector. The vulnerability of older people and the disregard for those who care for them has questioned the morality of society in general. Is this the way that we would like to age? Questions of agency, citizenship and ultimately power are highlighted more than ever. We can no longer turn a blind eye. We must do everything in our power to empower people, all people. It is the right thing to do.

[1] Relationship Directed Support – A Constructive Reframing

Mary Catherine Beach, MD, MPH,1,2 Thomas Inui, ScM, MD,3 and the Relationship Directed Support Research Network*

J Gen Intern Med. 2006 Jan; 21(Suppl 1): S3–S8.

doi: 10.1111/j.1525-1497.2006.00302.x

This article is a general information sheet and should not be used or relied on as other professional advice. No liability can be accepted for any errors or omissions nor for any loss or damage arising from reliance upon any information herein. Always contact your adviser for specific and detailed advice. Errors and omissions excepted (E&OE)