Later life is too often overshadowed by needless suffering, says Chris Gage. In response, he has co-founded Plan with Care, which offers a highly personalised, fully managed holistic care and wellbeing service.
Our belief is that vulnerable older people can thrive rather than languish in later life, whatever the circumstances. I am one of the founders – along with Nathan Harris – of Plan with Care, which was born from our personal and professional experience of seeing later life overshadowed by needless suffering time and time again.
Both of us have seen older members of our families enter the stage of life where more care is needed. My background as founder of Ladder to the Moon means that I have led creative quality improvement in care for over a decade, while Nathan has a background improving access to high quality financial planning. Between us, we have a holistic view of how later life can play out.
Sadly, for many, later life often involves a drop in the quality of life – quite a drastic drop. We believe that, on the contrary, older adults should have access to the best care and life experience, particularly when living with conditions such as dementia.
But this requires a lot of creativity to devise care and wellbeing plans that are fully tailored to individuals. Unfortunately, due to time and resource constraints, this is often beyond the remit of care homes or in-home care organisations, and often too overwhelming for families to tackle on their own.
What we offer
Plan with Care is intended to solve these problems. We offer individuals, and more normally those who have legal responsibility for them, a highly personalised, fully managed holistic care and wellbeing service. It’s an unusual combination. Rather than directly providing care services, we carry out an in-depth assessment, strategise and create a plan to manage all aspects of a client’s wellbeing, including their emotional, physical and environmental needs.
For some clients this is quite light touch and is a matter of making recommendations that the family implements themselves with our support in the background. For others, we are more actively involved and once we get sign-off on the plan, we then go about making it happen. Our promise is to constantly monitor wellbeing and strive for improvement.
We call it the “three E” approach:
- ensure the right care is in place
- enhance quality of life
- exceed expectations where possible.
This approach is in line with Maslow’s hierarchy of needs. In this framework, Maslow describes how, while we all have a constant range of needs, our physiological and safety needs prevail over those for love, self-esteem and then self-actualisation – in that order. As such, we ensure that these physical and safety needs are met first and foremost, before moving on to enhance wellbeing by addressing the person’s sense of attachment and belonging. Finally, we try to help the individual achieve self-actualisation through meaningful creativity.
Care and wellbeing plans
Our dedicated care and wellbeing consultants take time to understand the passions and goals of each individual before putting in place a person-centred care and wellbeing plan that will make them feel safe, cared for, valued and able to express their personality. The plan contains some or all of the components I am about to describe.
Creative Companions can spend time with the people we support, doing activities they will enjoy. These can include anything from gardening, music and outings to simply just offering company and talking about their family. It fully depends on the person’s wishes and their circumstances.
This part of our service is invaluable not only for the person we support, but their families and friends too. It provides reassurance that their loved one is being looked after in a way that is tailored to them, offering extra comfort if they live far away and cannot visit on a regular basis themselves.
We establish what specialist needs are present and facilitate the appropriate services, from nutritionists, dysphagia (swallowing) specialists and mobility solutions to moving individuals from poor quality care and supporting families and their loved ones at end of life.
Care home or care at home?
Everyone should have the right to stay at home for as long as they wish. A care and wellbeing plan can be implemented wherever the individual chooses to live. We advise on what measures to take to make a home setting as safe, comfortable and enriching as possible.
Good financial forecasting is intrinsic to ensuring sustainable best quality care and is a key part of our planning. To achieve financial clarity so we can plan properly, we can offer integrated financial planning from trusted partners if needed. But often families already have a financial plan, and simply let us know their circumstances.
Whichever way, the main aim is to avoid the traumatic situation where vulnerable people can no longer pay care fees later in life and end up having to move. So we create care and wellbeing plans in line with funds that are available. Where funds are more limited, we implement changes that have the biggest impact. Simply rearranging a room so that the person has a better view benefits wellbeing all day, every day.
Our care and wellbeing membership is designed for long-term support. We look at what care needs are now, what they are likely to be in three years, 10 years and beyond. This way, crises are avoided because changes in needs are planned for. We review this at least every six months to ensure the best quality of support. Membership costs £100 per month.
Challenges we face
The heart of the challenge we face is that people don’t see the importance of properly investing in vulnerable older people living well.
Quality of life is often marred by low ambition for the person and a lack of awareness and knowledge of what is actually possible.
People think getting a good care provider in place is enough. But it often isn’t as providers can be overstretched; even if good intentions are there, money and skills may not be. Care providers we work with always value our partnership with them, even if they have good provision to start with, as there is always something extra that can be done to improve someone’s quality of life.
An additional challenge is fighting the myth that private companies in the care sector are just in it for the profit. For example, we recently recruited Neil Hunt as a care and wellbeing consultant, who has 28 years of experience as a social worker for Kent County Council, where he worked in a variety of roles such as safeguarding for people living with dementia and as a senior practitioner in community older people’s teams and hospital teams. He clearly explains this challenge:
There is a certain dichotomy that exists between the statutory and private care sectors – that the private companies are the big bad wolf that are out to make a profit from people’s circumstances. But there is a genuineness about Plan with Care that shows that they are driven to do the best for the people they are supporting. Their ethos is that the individual is at the heart of everything they do.
Case study: Carole
Six months ago, Carole Jones was introduced to Plan with Care as a client by her attorney for property and finance with a view to improving her wellbeing.
Carole is a highly sociable, friendly lady with a strong character, who used to live next door to the Lawns care home in mid Kent, where she has recently moved in. She was actively part of their community for many years and helped out in many ways on a voluntary basis. She knew the staff well and always talked about how comfortable she was as a volunteer there.
Due to some cognitive decline and possible depression, signs of self neglect were reaching a critical point when Carole decided it would be best that she move into the care home. But after moving in it was clear she was struggling to adapt to care home life. While she clearly articulated a desire to be active in all senses of the word, she was holding back. Staff reported that she tended not to join in activities, and would often have a cross word towards fellow residents, which was highly out of character for her.
When we drilled down into what was causing Carole’s distress, it transpired that a large part of the issue was a reluctance to admit to the outside world that instead of hosting tea parties in her own garden for residents, she herself was now a resident.
Working alongside the care home, we have facilitated a day-long dementia specialist drama intervention used for relationship-building, and sourced, trained and inducted a Creative Companion for Carole.
This has completely transformed Carole’s mood, outlook and wellbeing. On the day of our six-month review, her confident, humourous personality had returned.
*Resident’s and care home’s names have been anonymised
Carole continues to have very good physical health, In addition, the risks of skin degradation and UTIs are now reduced as she is regularly accepting support with her personal hygiene.
Carole has gone from being at high risk of social isolation and depression, to the returning of her old self – the life and soul of the party! With her Creative Companion she is gardening again, going out regularly in the locality and chatting with people she used to know, as well as exploring the garden centres, shops and countryside.
Her general day-to-day demeanour has shifted from closed and cautious to welcoming, friendly and full of cheeky humour. On the day of the wellbeing review, she welcomed me into the lounge, patted the seat next to her, and “held court” with me and the other residents. She also made sure I got a cup of tea, proudly showed me the trees that she had planted in the home’s front garden and laughed at her obsession with the tennis at Wimbledon.
She has now made two good friends with others who live in care homes – catalysed in part by the Ladder to the Moon relationship-building drama intervention – and one of these recently joined Carole and her Creative Companion for her 90th birthday celebrations at the local pub.
Carole has come to express her comfort with the staff, residents and environment once again. Now that she is becoming an active gardener again, her body language exudes a confident sense of ownership.
We will continue to manage her care and wellbeing over the next six months and supervise her Creative Companion as part of her care and wellbeing membership. Plans include focusing on local gardening, fashion events, musicals and tennis tournaments, all designed to support her to thrive.
For further information, go to www.planwithcare.co.uk or phone 01303 764576.
Chris Gage is co-founder at Plan with Care.