Establishing an effective care plan

First impressions are everything. Whether you’re a professional or family member, when it comes to caring for the elderly, introducing a plan that is well thought through can help to ease any concerns they may have about letting go of some independence.

While daily tasks are likely to become challenging as your loved one gets older, they needn’t struggle through this alone. Good, dependable care can mean the difference between them being able to stay in the comfort of their own house or having to move away from the home they know so well.

In fact, having a helping hand can allow older people to lead an independent lifestyle long into their golden years. The cornerstone of effective assistance lies in establishing a care plan that considers their choices and works to provide them with a safe, happy routine for as long as possible.

Discover our tips to building a care plan that works for everyone.

Care can be a difficult topic to broach, especially if your older friend shows resistance when caring comes up in conversation. No one wants to feel as if they’re vulnerable or that they need to rely on the help of their cohorts and family, but if you tackle the subject openly and objectively, always ensuring that their concerns are listened to, you should be able to reach a place where they are willing to accept your support and help.

Involving your loved one in every step of the decision making will give them comfort in knowing that they’ve raised any queries and had their say in finding a system to move forward with. Remember, the main priority of the caregiver is to help their ‘patient’ manage their chosen lifestyle, stepping in to offer assistance when need be.

The care plan should be a guide that both parties can refer to, offering their decisions primarily, with solutions that can be acted upon should these choices become harmful to them. With a little consulting, the care plan can be an effective tool for improving their quality of life as they get older as well as maintaining a happy relationship between you. 

Once you have established that avoiding care is no longer feasible and your elderly friend has agreed to accept this help, your focus should turn to making care work on a day-to-day basis.

Practicalities first, you should consider what health complaints your friend may have and how you’ll both manage this. If there’s a medical condition, it’s worth speaking to health advisors about their options at home. Try to learn as much as you can about the issues and what treatment is available. For example, those with limited mobility could benefit from installing a stair lift to move with greater ease around their home. Whereas, someone suffering with chronic bronchitis would need more medical attention and you should ask their doctor for guidance. You may also need to know about prescriptions and how often these will need replenishing.

On the subject of well-being, does your loved one have adequate health insurance or can the NHS provide the healthcare they need? These are questions to ask when establishing your care plan.

Likewise, you should identify any opportunities available locally. Community resources could include care training for you or any day centres or services where your friend can go to meet people and have a change of scenery for a morning. They say that it takes a village to raise a child, but what about caring for the elderly? Well, you’re bound to have friends who have older parents or know of someone in a similar position, why not share your experience and learn from their advice? Gathering all this useful feedback can help to assemble a care plan that avoids others’ past mistakes and if nothing else, this group can act as a support network when you could do with letting off some steam.

Managing the options from healthcare providers and support and social services is crucial in ensuring that your loved one receives the monitoring and interaction that they need to lead a content lifestyle.  Care To Be Different, for example, is a specialist information resource about NHS Continuing Healthcare funding, showing families how to apply for this specific funding stream.

Under the Care Act 2014, local authorities have a duty to confirm that the elderly have access to NHS Continuing Healthcare funding where needed and that the application for this has been properly considered in each individual case. The fund is for people who receive full-time care and who meet a certain level of care requirement. Eligibility for NHS Continuing Healthcare funding is not related to the patient’s finances or assets, it’s about their care needs only.

Care To Be Different explains this in their NHS Continuing Healthcare FAQs: “At Care To Be Different we have heard from hundreds of families over the years whose relatives have been misled into paying for care – simply because their relatives had some savings and/or a house.

“As we’ve seen, this is not what should be considered first. It’s a person’s care needs that should always be considered first – through an assessment for NHS Continuing Healthcare.”

Before you get down to the nitty gritty of your care plan, the following points can help you to develop a clear idea of what their needs are and what solutions you can help to instigate:

1.    Start by observing them in their environment at home to determine what a normal daily routine would be for them. You can make note of any tasks that you feel they could benefit from some help with and where some jobs should be avoided completely. While a walk in bath or shower can help those who struggle to bathe, without these facilities you could be concerned about their safety when in the bathroom alone. 

2.    Discuss your findings and draw up a list of tasks that you both agree require help. You can always modify and add to these later but removing these initial barriers is important for their personal safety. 

3.    Develop some short-term goals that you can both tackle together. Perhaps your relative would like to be able to go out more but moving around is a challenge. Take it slowly but do try to work towards this. Having ambitions that your loved one can focus on is a way of promoting their dignity and independence as they continue to want to achieve these goals. 

4.    Anticipate how their living arrangements may need to change. Whether this is achieved through assistive bars and mobility equipment or simply removing any obstacles that could be hazardous, knowing what might need to change ahead of time can help to eliminate health and safety risks.

Paul from HealthComms adds: “It’s important to remember the purpose of the care plan, too often it becomes focused on the document itself and not the patient.  A good care plan will be focused on Patient outcomes and continually revisited update to reflect the patient’s condition.”

HealthComms is a software company providing tools to support the care of individuals in the home. While they do not construct care plans they can facilitate their use on their software. Assistive technology is one way in which elderly people can be safer in the home without being solely reliant on a caregiver.

The TrackToMe, for instance, uses GPS tracking to enable a one touch system that alerts the person’s friends and family that they need help through email, SMS texts and via HealthComms Control Tower product. In an emergency the elderly person can touch the button to notify their chosen responders, who can use this software to locate the person immediately saving precious time when it’s most vital.

Paul reminds us, when planning care: “I would also suggest that it is important to look beyond measurable data, and consider well-being in the process.”

As we get older it’s important to ensure that our affairs are in order, ensuring that all legal decisions and documents are in place. As care provider, you can help your relative work through the technical jargon in all this paperwork and leave them feeling assured that their wishes will be followed later.

Likewise, this organising should extend to a set of instructions that can help you express their choices when they can’t for themselves. Make sure you have on hand your loved one’s vital information so that you can provide a full medical history to any healthcare advisors who may require it. Keep these details with copies of their health insurance and policies and note down any medication they are currently on and the dosage for this.

If they haven’t already, you should help them prepare plans in the case of disability deciding who will have responsibility as power of attorney in their financial and healthcare matters.

STEP is the worldwide professional association for those advising families across generations. “We promote best practice, professional integrity and education to our members.

“Our members help families plan for their futures: from drafting a will or advising family businesses, to helping international families and protecting vulnerable family members,” they explain.

Entering our golden years isn’t without complication and sadly many of us will experience the loss of our physical or mental capacity. In this scenario, it’s important to ensure that we’ve tied up all loose ends early to avoid complication later should the worst happen.

When it comes to creating an effective financial care plan, STEP has the following advice:

•    Make a will, and keep it up to date if their circumstances change, particularly in the event of a birth or death in the family. Otherwise the rules of intestacy will apply, and their estate may not go to the people they want it to, especially in cases of second marriage and stepfamilies. An experienced legal professional will adhere to proper will-writing practice, and also advise them on recent developments. Any STEP member engaged in will writing is obliged to adhere to STEP’s Will Code and can display the logo on their website and promotional materials.

•    Make a Lasting Power of Attorney (LPA), to enable someone else to act as their legal agent if they lose mental capacity. Keep in mind this may take six months to complete, including registering it with the Office of the Public Guardian. An LPA will remain in place for the rest of their lifetime and does not have to be used if they are able to look after their own financial affairs.

•    Confirm how their home is registered at the Land Registry – if it is in a partner’s sole name and they lose mental or physical capacity, they will have to go to court in order to access their share.

•    Check how their bank accounts are registered – again, if it’s in a partner’s sole name and they lose mental or physical capacity, they will have to go to court in order to access their share.

•    Consider a care-home annuity policy – it is a one-off premium that is calculated on their life expectancy and will cover their care home bill for life. There are only a few care-home annuity providers in England & Wales, so you may need to ask your legal advisor for further details; however you should be able to get a free quotation.

Planning for old age can be an emotional experience but if handled delicately and with respect for your elderly friend, it can bring about a sense of relief knowing that everything is organised and the future is taken care of.

Remember, the resulting care plan needs to be discussed and delivered upon to create a routine and later life plan that everyone can adopt.

Image Credit: Hugo Chlsholm (flickr.com)