What is the difference between person-centred care and person-led care?
I attended a webinar earlier this week that has really stayed with me. It got me thinking—not just about how we deliver care in our own Local Help My Way network, where the client or their advocate must lead support, but about something bigger. About empowerment, autonomy, and what it really means to support someone to live their life, rather than care for them.
As some of you may know, I worked in care for around 18 months through an agency while I began training as a midwife in the NHS. Like many in health and social care, my learning was grounded in person-centred care. The idea that the individual should be at the heart of everything we do, and the familiar phrase, “no decision about me without me.”
Person-centred care was an important shift away from patriarchy in the NHS. It asks us to listen, to understand someone’s life, their preferences, their identity, and to use that understanding to shape care. It reminds us that people are more than tasks or diagnoses. However, even when we are person-centred, there remains an unspoken dynamic: we are still the ones delivering the care. We gather information, interpret it, and shape support around what we think is best. The person is at the centre, but the system and decision-making often still sit around them, and we are in control, not them.
Person-led care feels different. It’s not just about placing the person at the centre. It’s about placing them in the lead. Our role shifts from doing for to enabling with. From organising care to supporting people in organising their own lives in ways that matter to them. It’s a subtle shift in language, but a significant power shift.
In a person-led approach, decisions are directed by clients, with support if needed. Even risk is viewed differently, not something to remove, but something to navigate together, recognising that taking risks is part of living a meaningful life. It also changes how we think about identity. Person-centred care often looks to the past and who someone has been. Person-led care recognises that identity continues to evolve even through chronic illness or disability. People still have goals, preferences, and things they want to achieve. They are not just being supported—they are still becoming.
Language plays a big part in this, too. The words we use can shape how we see people. Talking about “delivering care” or someone “refusing care” can position them as passive or problematic. Shifting to language around supporting, enabling, and working alongside encourages a more equal, respectful relationship. Indeed, the more I reflect on it, the more I see person-led care as a mindset rather than just a model. It asks us to step back, to share power, and to trust that people are the experts in their own lives.
That isn’t always easy. There will always be tensions between safety and autonomy, between systems and individual choice. But if we are serious about empowering our clients to live better lives for longer at home, it’s a shift worth making and worth us learning to sit with those tensions.
For me, this has been a reminder that good care isn’t just about what we do—it’s about how we see the person in front of us.
Not as someone to be cared for.
But as someone who is still living, still choosing, still leading.
And our role is to walk alongside them.
With thanks to David Wilson-Wynne, Dementia Care Specialist for a really great webinar.
