Two people with apparently similar care needs can require very different support. An older woman who needs help with personal care may value remaining in the neighbourhood where she has lived for forty years. Another person with comparable physical dependency may feel safer moving closer to family. A disabled adult may need substantial daily assistance while still wanting control over relationships, routines, money and community participation. Person-centred care begins with these differences rather than treating them as complications around a standard service.
This distinction is increasingly relevant to Türkiye as population ageing, disability rights, home-based support and changing expectations reshape long-term care. Across the Türkiye Aging, Long-Term Care & Community Support Knowledge Hub, one recurring issue is that care is distributed among health services, the Ministry of Family and Social Services, provincial structures, municipalities, residential organisations, families and private provision. A person's life, however, is not divided according to those institutional boundaries.
Türkiye already has important foundations for more individualised support. The Law on Persons with Disabilities establishes independent community living and access to community-based support as principles. The country's disability-rights direction has emphasised independent living and participation, while the 2026 regulation governing Ministry nursing homes and elderly care and rehabilitation centres requires individual care plans for residents. The Twelfth Development Plan also prioritises home and family-based care, wider daytime and support services, stronger standards and improved social-service quality.
The central challenge is therefore not simply to adopt the language of person-centred care. It is to make choice, autonomy and individual goals influential enough to change what services actually do.
Person-centred care changes the starting question
Traditional service systems often begin with categories. Does the person meet the criteria for a benefit? Do they require residential care? Which health condition is being treated? Which programme has capacity?
Those questions remain necessary because public services require eligibility rules, professional assessment and responsible use of resources. Person-centred care changes what happens around them.
Instead of asking only what service somebody qualifies for, it asks what matters in the person's life, what they can do, what support they need, what risks concern them and what outcomes they want to preserve or achieve.
For an older person, the priority may be continuing to prepare meals rather than simply receiving nutritional support. For somebody with mobility impairment, the objective may be returning to work rather than completing a standard rehabilitation programme. A person with dementia may value maintaining a familiar daily walk even when others perceive that activity primarily as a risk.
The World Health Organization's person-centred approach to long-term care similarly connects comprehensive assessment with individual goals, personalised planning, coordinated implementation and continuing review. The emphasis is on functional ability and what enables somebody to live according to their values, not solely on diagnosis.
This approach aligns with wider person-centred strengths-based planning. Its relevance extends beyond intellectual disability: the underlying principle is that support should be organised around the individual rather than requiring the individual to fit the convenience of the service.
Türkiye already has individual planning within parts of its care system
Person-centred care is not entirely new to Türkiye's formal care architecture.
The Regulation on Nursing Homes and Nursing Home Elderly Care and Rehabilitation Centres, published in May 2026, defines an individual care plan as a written plan detailing the type, content and frequency of health and social care services to be provided to an older person. The plan is prepared by the care assessment team according to individual need and covers services across the organisation.
The regulation also requires the plan to be reviewed when necessary and revised as the person's needs change.
This is significant because it establishes individualisation within the operating structure of residential care rather than leaving it solely to professional discretion.
Türkiye's disability-care framework also contains concepts of individual care and rehabilitation planning. Home Care Assistance operates through assessment and an individual care plan, with control and guidance processes examining whether care is being provided accordingly.
Plans, however, are only instruments.
A technically complete plan can remain service-centred if it describes what workers will do without showing what the individual wants to achieve. "Assistance with bathing three times each week" specifies an intervention. It does not explain whether the person's priority is privacy, maintaining as much self-care as possible, choosing when assistance occurs or being supported by somebody with whom they can communicate comfortably.
The stronger opportunity lies in connecting assessed need with preference, capability and outcome.
Choice is meaningful only when there is something to choose between
Person-centred care is sometimes presented as though choice can be created entirely through better conversations. In practice, choice is partly a question of service capacity.
An older person may prefer to remain at home, but that preference becomes difficult to realise if intensive community support is unavailable. A family may want daytime support rather than residential placement, but geography can determine whether such provision exists. A disabled person may prefer community living but still require accessible housing, personal assistance and transport.
Türkiye's Twelfth Development Plan recognises this wider service-design issue. It gives priority to home and family-based care and proposes expansion of support and daytime services while also seeking greater standardisation and quality within social services.
This direction matters because person-centred care cannot operate through individual plans alone. It requires a sufficiently diverse care system.
Choice may concern:
- remaining at home or considering another living arrangement;
- the timing and organisation of everyday support;
- which personal goals receive priority;
- family involvement and the boundaries of that involvement;
- social, cultural and community activities that remain important; and
- how acceptable risks are balanced against independence.
Not every preference can be met. Resources, safety, eligibility and service availability create legitimate constraints. Person-centred practice requires those constraints to be transparent rather than converting whatever the system can currently provide into an assumption about what the person needs.
Operational scenario: the difference between a care task and a life outcome
A 78-year-old woman in Bursa experiences reduced mobility after a fall. She lives alone in an apartment close to shops, neighbours and a daughter who visits several times each week. Assessment identifies difficulties with bathing, meal preparation and leaving the building.
A service-centred response could translate those needs directly into tasks: personal care, meals and household assistance.
A person-centred conversation identifies something different. Her strongest concern is losing the ability to leave home. She has attended the same local social group for years and regards that routine as central to remaining independent. She is willing to accept help with bathing but wants rehabilitation and mobility support prioritised because being able to reach the street matters more to her than having additional domestic tasks completed for her.
The resulting support plan therefore combines necessary assistance with restorative goals. Her daughter is involved with consent, but family availability is not treated as unlimited. Progress is reviewed against function and participation as well as completion of care tasks.
The distinction is operationally important. Both approaches may provide the same number of service contacts. Only one is organised around the outcome the woman values.
Organizations examining comparable planning decisions can use the Positive Risk Enablement Planner to structure discussions about goals, protective factors, autonomy and proportionate risk. It does not determine Turkish eligibility or care decisions, but it can help prevent safety considerations from automatically displacing the person's priorities.
Autonomy should not disappear when dependency increases
One of the most important tests of person-centred care is what happens when somebody requires extensive assistance.
Physical dependency is easily confused with inability to make decisions. A person who needs help dressing, eating or transferring may still be entirely capable of deciding how those activities should be organised. Someone who communicates slowly may understand decisions fully. A person with cognitive impairment may retain preferences and abilities even where some decisions require additional support.
Türkiye's Law on Persons with Disabilities states that disabled people should be able to live independently in the community on an equal basis with others and should not be compelled into a particular living arrangement. It also provides for community-based support, including individual support services, and requires care to take account of biological, physical, psychological, social, cultural and spiritual needs.
Those principles are highly relevant to long-term care.
Autonomy does not mean leaving people unsupported. It means ensuring that assistance increases the person's ability to direct life wherever possible rather than transferring control unnecessarily to professionals or relatives.
This connects with wider rights, consent and decision-making. The practical question is not simply whether a signature exists. It is whether information was understandable, whether communication support was provided, whether the person had a genuine opportunity to express a preference and whether disagreement was taken seriously.
Family involvement needs partnership rather than substitution
Family relationships are fundamental to care in Türkiye. Relatives provide substantial practical, emotional and financial support and often know the person's history, routines and preferences better than formal services do.
Person-centred care should use that knowledge.
It should not automatically assume that the family's preference is the individual's preference.
The distinction can become difficult when dependency is high. Families may be anxious about falls, medication, wandering or living alone. Their concerns may be well founded. They may also carry significant caregiving responsibility and understandably seek arrangements they can sustain.
A genuinely individualised process therefore needs to consider the person and the family without collapsing them into a single unit.
Where the person can express their own wishes, those wishes should remain visible. Where communication or cognition makes decision-making more complex, professionals should explore how the person's values, past preferences and current responses can inform support.
Caregiver needs also require their own assessment. Asking a daughter whether she can continue providing daily support is different from assuming she will do so because she is family.
This is particularly important in a system where informal care has historically carried a substantial proportion of long-term support. Person-centred planning that depends on invisible, unlimited family labour is neither fully individualised nor sustainable.
Operational scenario: family concern and an older person's wish to remain at home
An 84-year-old man in Ankara has early dementia, diabetes and reduced balance. His two adult children believe he should enter residential care after leaving the front door open overnight. He wants to remain in the apartment where he has lived for three decades.
A binary discussion creates an immediate conflict: family safety versus personal choice.
A stronger assessment examines the actual pattern of risk. Professionals consider cognition, mobility, medication, nutrition, home environment, social contact and the circumstances surrounding the door incident. His children explain the support they currently provide and what they can realistically continue.
The resulting plan might include more structured family contact, health follow-up, environmental changes, support with medication and additional community or home-based assistance where available. The incident is monitored rather than ignored.
Residential care remains a possible future option if needs change, but one event does not automatically determine the person's long-term living arrangement.
The important point is not that remaining at home is always preferable. It is that the decision should emerge from the individual's wishes, actual risks, available support and continuing review rather than from a generic assumption that greater dependency requires greater institutional control.
Person-centred care needs assessment that sees the whole person
Türkiye's long-term-care architecture has historically involved different assessment routes across health and social services. WHO's country work has identified fragmentation, absence of standardised needs assessment across the whole long-term-care system and unclear care pathways.
This matters because people rarely experience needs in institutional categories.
An older person's difficulty preparing food may relate to arthritis, poor vision, income, kitchen accessibility, cognition or caregiver absence. Treating only the medical condition may leave the practical problem unchanged. Providing meals without examining function may remove an opportunity for rehabilitation.
WHO's Integrated Care for Older People approach offers a useful international reference point because it connects physical and mental capacity, functional ability, health conditions, social support and environmental circumstances with personalised care planning. The framework is not a Turkish entitlement model and should not be presented as one. Its principle is nevertheless relevant: assessment should identify what combination of factors is preventing somebody from living the life they value.
For Türkiye, stronger person-centred assessment would also help connect the different parts of the system. A person's health needs, social-support needs, family circumstances and functional goals should inform one another even where different organisations remain responsible for delivery.
Workforce practice determines whether plans become personalised care
Person-centred care cannot be implemented through documentation alone.
A worker who has ten minutes to complete a task, limited information about the person and no discretion over timing may struggle to personalise support regardless of what the care plan says. Conversely, skilled workers who know somebody well can often preserve autonomy through small decisions that never appear in national policy.
These include asking before assisting, supporting somebody to complete part of a task independently, recognising non-verbal preference, adapting routines, understanding cultural practices and noticing when a person's goals have changed.
This makes staff competence and training assurance part of person-centred care.
Training needs to include more than technical care tasks. Workers require communication skills, understanding of rights and consent, dementia capability, awareness of disability, risk judgement and confidence in involving people in decisions.
Supervision should reinforce the same expectations. If organisational performance is judged almost entirely through task completion, staff will naturally prioritise tasks. If reviews also examine independence, participation, satisfaction and whether individual goals are progressing, person-centred behaviour becomes more visible and more valuable.
Individual plans need to change when people's lives change
A care plan is only person-centred while it reflects the person who is currently receiving support.
Needs can change gradually through ageing or chronic illness, suddenly after hospital admission or positively through rehabilitation. Family circumstances change too. A caregiver may become ill, return to employment or move away. Someone who initially resists support may become more comfortable with it. Another person may regain abilities and need less assistance.
The 2026 nursing-home regulation explicitly provides for individual care plans to be reviewed when required and revised according to changing need. That principle is important beyond residential care.
Review should ask more than whether existing services are still being delivered.
It should consider whether the person's goals remain the same, whether support is achieving them, whether independence has increased or declined, whether new risks have emerged and whether family involvement remains sustainable.
This creates a practical connection with practice validation and assessment. A plan should be treated as a working hypothesis about what support will help, not a permanent administrative record.
Where review shows little progress, the response should not automatically be to increase the amount of the same intervention. The service may need to reconsider whether the approach, environment or underlying assessment is correct.
Residential care can remain individual even within a shared institution
Residential settings inevitably operate collectively. Meals, staffing, medication processes, activities and building routines require organisation. The challenge is preventing operational efficiency from determining every resident's day.
Türkiye's 2026 residential regulation provides a stronger formal basis for individualised care by requiring a specific care plan for each person and multidisciplinary input across health, nutrition, social services and physiotherapy. It also establishes coordination and case-discussion structures within facilities.
The operational opportunity is to use those structures to personalise everyday life rather than merely coordinate professional tasks.
A resident's preferences may concern when they wake, what they eat, religious or cultural practice, privacy, friendships, family contact, meaningful activity or how much assistance they want. Some choices appear small from an organisational perspective but are central to dignity.
Person-centred residential care also means retaining capability. Completing every task for somebody because it is quicker can gradually increase dependency. Rehabilitation, movement and participation should therefore be connected with ordinary routines rather than treated as specialist activities occurring elsewhere.
The strongest test is whether a facility can explain who the person is beyond their diagnoses and care requirements.
This is closely related to reablement and restorative approaches: support should preserve or rebuild what people can do wherever realistic, rather than organising care solely around deficits.
Operational scenario: individualising life inside a nursing home
An 81-year-old retired teacher moves into a Ministry nursing home after increasing frailty makes living alone difficult. His assessment identifies assistance with bathing, medication oversight and support with mobility. A technically sound individual care plan could be built around those requirements.
Early conversations reveal that his strongest concern is not personal care. He has spent most of adult life reading, teaching and discussing history and fears that residential care will reduce his identity to being an "elderly resident."
The social-service team incorporates his interests into planning. He is supported to continue visiting the facility library, participates in activities he actually values rather than being assigned generic recreation and, where appropriate, contributes informally to reading or discussion activities with other residents. Physiotherapy goals are connected to maintaining enough mobility to reach the spaces he wants to use.
His health and personal-care needs remain fully addressed. They simply do not define the whole plan.
Review then considers not only falls, medication and physical dependency but participation and satisfaction. If his mobility declines, the objective becomes adapting how he accesses valued activities rather than automatically accepting their loss.
This is person-centred care in operational terms: professional disciplines use their expertise around the person's life rather than organising the person's life around professional disciplines.
Risk enablement is different from abandoning safety
Person-centred care becomes most difficult when an individual's preference conflicts with professional or family concern.
An older person wants to continue cooking despite reduced vision. A resident wants to walk outside despite a history of falls. A disabled adult wants to travel independently. A person with dementia rejects a routine that staff consider safer.
Risk cannot simply be ignored in the name of autonomy. Services have legitimate duties to protect people from foreseeable harm.
Equally, eliminating every possible risk can eliminate ordinary life.
A proportionate approach asks what the person wants to achieve, what specific harm is foreseeable, how likely and serious it is, what strengths or safeguards already exist and whether the activity can be supported more safely without removing it altogether.
This principle is particularly important for people whose dependency makes others more likely to make decisions on their behalf.
It also provides a bridge between person-centred care and safeguarding. Safeguarding protects people from abuse, neglect and exploitation; it should not be used as a general justification for unnecessary restriction.
Services examining this balance need governance capable of distinguishing responsible positive risk-taking from unsafe practice. Decisions should be reasoned, reviewed and proportionate to the individual rather than based on blanket organisational rules.
Technology can increase control or quietly take it away
Digital health, remote support, sensors, electronic care records and assistive technologies can strengthen individualised care in Türkiye as digital infrastructure develops.
The potential benefits are substantial. Technology can support medication routines, communication, emergency response and remote access to expertise. Shared information can reduce the need for people to repeat their story to different services. Assistive technologies can increase independence for people with sensory, physical or cognitive impairments.
Technology becomes person-centred only when the benefit is defined from the user's perspective.
A sensor installed to reassure relatives may feel intrusive to the person being monitored. A digital appointment system may improve efficiency while excluding somebody who cannot use it. An algorithm may identify risk but know nothing about why a particular activity matters to the individual.
This is where digital exclusion and access intersects with person-centred practice.
Consent, accessibility, privacy and alternatives matter. Technology should increase the person's control over life rather than simply increasing institutional visibility over the person.
Organizations considering similar changes can use the Digital Transformation, AI and Cybersecurity Readiness Assessment to examine governance, workforce and implementation readiness. It does not assess compliance with Turkish law, but it can help structure the question that matters operationally: whether digital change improves care without weakening accessibility, privacy or human judgement.
Person-centred care has a geographic dimension
The meaning of choice differs between Istanbul, Ankara or İzmir and smaller towns or rural areas where fewer formal services may be available.
Türkiye's geography creates practical variation in access to specialist health care, social services, community support and formal care provision. Family networks can compensate for some gaps, but relying on family availability can itself create inequality.
A person-centred system therefore needs to distinguish between a genuine preference and an option selected because nothing else is available.
If a rural older person "chooses" family care because no realistic community alternative exists, recording that as preference can conceal unmet need. Conversely, assuming that a rural location is inherently disadvantageous can overlook strong local relationships and the person's desire to remain within their community.
The appropriate response is not to impose identical services everywhere. It is to understand what outcomes people need and design viable ways of supporting them across different contexts.
Mobile services, stronger primary-care links, municipal support, transport solutions and appropriate digital provision may all contribute. This connects person-centred care with the wider challenge of rural and underserved communities.
Equity does not require identical delivery. It requires geography not to determine unnecessarily whether somebody can retain independence, dignity and meaningful choice.
Operational scenario: individualised support in a rural district
A 69-year-old man with a physical disability lives with his wife in a village in Central Anatolia. He requires assistance with several daily activities but wants to remain near relatives, neighbours and land that his family has worked for decades. His adult children live in another province.
A narrow service assessment might identify residential placement as the most administratively straightforward response if needs increase.
A person-centred assessment begins with his preference to remain in the community and then tests whether that outcome can be supported safely and sustainably. His wife's caregiving capacity is assessed separately rather than assumed. Health needs are connected with primary and home-health services where applicable, while social-service and local support options are considered alongside environmental barriers.
Technology may help with communication or remote clinical contact, but it is not treated as a substitute for hands-on assistance. Transport and access to periodic specialist assessment become part of the plan because geographical isolation can undermine otherwise viable home support.
If remaining at home eventually becomes unsustainable, the decision is revisited transparently with the couple. The original preference is not treated as an irrevocable instruction, nor is rurality automatically treated as a reason to remove the person from the community.
The scenario illustrates why individualisation requires system flexibility. The outcome is defined first; services then examine how closely available resources can support it.
Funding structures influence how much personalisation is possible
Person-centred care also has a financial dimension.
Türkiye does not currently operate one unified long-term-care funding system. Health care, social assistance, home-care support, public residential services, municipal provision, private purchasing and unpaid family care interact in different ways.
That fragmentation can affect individual choice because eligibility and funding rules often determine which form of support is realistically available.
Home Care Assistance, for example, provides financial support where disability-related dependency and household eligibility conditions are met, but a cash benefit does not by itself create a complete personalised care market. Residential care has its own eligibility and charging arrangements. Health services address clinical needs through separate structures.
The Twelfth Development Plan's direction towards diversified social-service models, stronger home and family support and improved quality is therefore relevant to personalisation.
Over time, financing reform needs to consider not only how much long-term care costs but whether resources follow needs flexibly enough to support different outcomes.
The objective is not unlimited individual purchasing power. Public systems require boundaries. The stronger principle is that funding categories should not create avoidable fragmentation in a person's support.
Quality measurement needs to ask whether life improved
Person-centred care changes what counts as evidence of quality.
Traditional indicators remain important. Services need to know whether medication is managed safely, falls occur, staffing is adequate, complaints are addressed and required care is delivered.
Those measures do not reveal whether support is achieving what matters to the individual.
A more balanced evidence set might examine:
- whether the person's stated goals are documented and reviewed;
- whether functional ability has been maintained or improved where possible;
- whether people participate in decisions about their support;
- whether restrictions have increased or decreased;
- whether community participation and relationships are being maintained;
- whether the individual reports that support respects preferences and dignity; and
- whether family involvement remains appropriate and sustainable.
Some outcomes are difficult to aggregate. That does not make them unimportant.
A national or provincial system still needs comparable indicators, but services also need qualitative evidence capable of showing what changed in individual lives.
The Quality Dashboard Builder can help organisations considering comparable questions structure a balanced set of indicators. It is not a Turkish quality framework; its relevance lies in helping leaders combine safety and operational measures with outcomes rather than assuming activity alone demonstrates person-centred quality.
Governance determines whether the person's voice reaches decision-makers
Individualised care can easily remain confined to frontline relationships while strategic decisions continue to be made entirely through capacity, cost and activity data.
Person-centred governance closes that gap.
Facility managers need to know whether individual care plans are meaningful and reviewed. Provincial leaders need to understand whether service gaps are repeatedly preventing preferred outcomes. National policy needs evidence about whether home, community and residential models are supporting independence as intended.
Complaints and feedback are part of that evidence. So are recurring requests that cannot be met.
If many people want daytime support but available provision is predominantly residential, that pattern is strategic information. If families repeatedly report that service timing makes employment impossible, the problem is not simply individual dissatisfaction. If care plans consistently identify community participation goals that cannot be delivered because transport is inaccessible, planning needs to see the connection.
This is why outcomes frameworks and indicators should extend beyond service activity.
Governance becomes person-centred when individual experience can influence organisational improvement, local service planning and ultimately national policy direction.
Person-centred care is a system capability, not a professional attitude
Respectful professionals are essential, but person-centred care cannot depend entirely on individual goodwill.
The system around them has to make personalised practice possible.
Assessment needs to capture goals and strengths. Care plans need enough flexibility to respond. Workers need skills and time. Information needs to move between services. Funding needs to support more than one care model. Quality systems need to measure outcomes that matter to people. Leadership needs to act when recurring service constraints prevent meaningful choice.
Türkiye's current policy direction provides several building blocks. The disability-rights framework emphasises independent community living. The Twelfth Development Plan prioritises diversified, higher-quality social services and greater home and family-based support. The 2026 residential regulation embeds individual care planning more explicitly within Ministry facilities. WHO's work on Türkiye has simultaneously highlighted the fragmentation that can prevent those elements from operating as one coherent long-term-care pathway. [oai_citation:0‡Ministry of Family and Social Services](https://www.aile.gov.tr/eyhgm/mevzuat/ulusal-mevzuat/kanunlar/engelliler-hakkinda-kanun/?utm_source=chatgpt.com)
The next stage is therefore less about adding another statement of principle and more about aligning operating systems around it.
Organizations exploring that alignment can use the Governance Maturity Assessment to examine how responsibility, evidence and improvement are structured. It does not determine Turkish policy or regulatory compliance, but it can help leaders test whether stated person-centred ambitions are reflected in operational accountability.
International learning should focus on principles rather than imported structures
Many countries are trying to make long-term care more person-centred, but the institutional mechanisms differ considerably. Personal budgets, individual funding, statutory care planning, care coordinators and consumer-directed models operate within legal and financial arrangements that cannot simply be transferred into Türkiye.
The more useful international lessons are underlying principles.
Assessment should see the whole person. Goals should influence the support plan. People should participate in decisions. Families should be partners without automatically replacing the individual's voice. Risk should be managed proportionately. Plans should change when circumstances change. Quality should include outcomes experienced by the person.
WHO's current long-term-care work places person-centredness at the core of an integrated continuum, while its 2025 ICOPE guidance describes personalised care planning as part of a pathway from assessment through implementation and monitoring. [oai_citation:1‡World Health Organization](https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/ageing-and-health/integrated-continuum-of-long-term-care/providing-access-to-long-term-care-for-older-people?utm_source=chatgpt.com)
Türkiye can adapt these principles through its own ministries, provincial structures, health system, municipalities, family networks and provider landscape.
The objective is not to make Turkish long-term care resemble another country's system. It is to make the existing and emerging system increasingly responsive to the people it exists to support.
Conclusion
Person-centred care in Türkiye is becoming more important as long-term support expands beyond an assumption that families alone will absorb increasing dependency. The country's disability-rights framework, policy direction towards community and home-based support, and newer residential-care requirements for individual care planning provide meaningful foundations. The strategic task is to ensure that individualisation reaches beyond documentation.
That requires services to understand what people value, not only what tasks they cannot perform. Choice must be connected with realistic service alternatives. Autonomy should remain visible as dependency increases. Family knowledge should strengthen planning without automatically replacing the person's voice. Workers need the competence and organisational flexibility to translate preferences into everyday practice, while quality systems need to examine independence, participation and lived outcomes alongside safety and service activity.
Implementation will remain shaped by Türkiye's geography, funding arrangements, workforce capacity and the division of responsibility between health and social services. Those constraints are real. Person-centred care does not remove them; it makes their consequences visible.
The strongest future direction is therefore to connect individual care planning with system planning. When repeated unmet preferences inform service development, when changing goals alter support, and when governance asks whether people are living lives they value rather than merely receiving prescribed interventions, person-centredness becomes more than a care philosophy. It becomes an operating principle for a more responsive long-term-care system.