How to design a care plan that meets all your needs
Care plan design for the elderly
You and your care needs should be at the heart of your care plan design. As you get older, you might need additional care and support to help you live at home for as long as possible. Homecare providers are experienced in providing in-home care for the elderly, offering services designed to meet your care needs. But the process of designing the right care plan does not begin and end with hiring a good home care agency.
A truly person-centred care plan should take a more creative approach to care plan design, one which includes support from other sources, such as family members or services within your local community. Too much care can be as detrimental as too little if it takes away your independence as you come to rely on it. A one-size-fits-all approach can also mean that opportunities to improve your health are missed. Using a care broker like Care Captains to help you plan your care, gives you the chance to take a more holistic approach that offers the right level of care and support for your needs.
In this blog post, we look at what a care plan is, what a care plan includes, and the benefits of using a broker to help design your care plan and keep it under review.
What is a care plan for the elderly?
A care plan is a document that sets out the type of care and support you need, how to provide that support, and who will cover your care costs.
A good care plan will include your goals, such as wanting to stay at home for as long as possible, and your care preferences. It will also incorporate the care that your family members can offer, consider your activities, and days when you may have access to more support.
Why is a care plan important?
Typically, care is needed for one of two reasons; rehabilitation following a hospital stay or maintenance care to help prevent health conditions from worsening.
Following a hospital stay, the care plan you need at home will focus on improving your health and wellbeing as you recover. You might need more care at first, with the amount reducing gradually as your condition improves.
Maintenance care aims to support you with tasks that you start to find difficult. Care is likely to be increased over time as your needs change.
Documenting your needs in a care plan ensures that everyone is on the same page. Everyone involved in your care should know what is expected of them, and you should know what to expect.
How do you get a care plan?
When the time comes to arrange care, your local council will carry out a needs assessment to understand your care needs. The outcome of the assessment will form the basis of your care plan.
You may be offered a telephone or online assessment, but you can ask for a face-to-face meeting if you feel that it would be better for you.
The assessor will try to find out how you manage everyday tasks. They will look at:
– your emotional and social life,
– your skills and abilities,
– your religious and cultural background and your available support network,
– any physical difficulties you may have, or any risk factors,
– any health or housing requirements,
– your needs and wishes, and
– what you would like to happen.
If you are happy for them to do so, the assessor will also talk to other professionals who care for you, such as your GP or nurse, to try and get a complete picture of the support you need.
Thinking about the type of help you feel you need in advance can ensure that the assessment reflects your views. Think about the things you do, or would like to do, each day, week, or month and whether support could make them easier. For example, do you need help to visit your place of worship each week, do you want to visit a family member, or do you have a particular hobby or activity that you would like to pursue?
The council will answer the following three questions to decide whether you are eligible for their help.
– Do you have care and support needs due to a physical or mental condition?
– Do your care and support needs mean that you cannot achieve two or more desired goals or outcomes? (see below)
– Is there, or likely to be, a significant impact on your wellbeing?
The desired goals and outcomes are whether you can:
– Eat properly
– Look after your personal hygiene
– Go to the toilet
– Dress yourself
– Be safe at home
– Keep your home clean and safe
– See family and friends
– Go to work, volunteering, education, or training
– Use services in your area.
‘Not being able to achieve’ an activity means that:
– You need help to do it,
– You find it painful to do it yourself, or it makes you feel distressed or anxious,
– It’s dangerous for you or others,
– It takes you a lot longer than it should.
If you are eligible for care and support, the council will assess your financial means to work out who will pay for the care you need. All this information is included in your care plan.
If your income or capital is above a certain level, you may have to contribute to or cover all your care costs. You can read more about care funding in our blog post here.
If you know your income is too high for you to qualify for council support, a needs assessment is still useful to inform prospective care providers about the kind of help you need. In these circumstances a care broker can help you create a care plan.
If you are self-funding your care, you can arrange support even if your needs do not qualify for council assistance, for example, if you only have difficulty achieving one of the desired goals and outcomes. It could be worth arranging a low level of support if the goal is to improve your health and allow you to stay independent for longer. Similarly, if you suffer from dementia, accessing a small amount of care early on could help you form a relationship with a care provider before your condition worsens.
What should be included in a care plan?
A care plan put together by the council should cover:
– the outcomes you wish to achieve,
– what your assessed needs are,
– which needs your local council can meet and how they will meet them,
– information and advice on how to prevent, reduce, or delay your future social care needs.
Support from the council can come in lots of different forms, such as:
– adaptations or equipment to make your home safer and easier to live in,
– help from home carers or a personal assistant,
– a personal alarm to call for help,
– help to regain your independence and confidence after an illness or injury,
– an opportunity to meet people and socialise, such as at a day centre,
– a permanent place in a care home.
The details of your care plan depend on your circumstances and the help and support you need.
Self-funding allows you to take a more creative approach to your care plan design. A care broker will start by getting to know you and your family’s circumstances. They will help you identify areas that are lacking in your current routine. Setting goals for your wellbeing, such as “I want to be safer in my own home,” or “I want to have a higher quality of life,” encourages you to take a broader look at the care options available to you.
It may be possible to adapt your home or purchase equipment to help with your daily tasks. Members of your family may be able to offer additional care and support to help you meet your goals.
A care broker can also help you access paid-for care more creatively. It is worth remembering that homecare providers are businesses. They aim to sell as many care hours as possible. Some homecare providers set a minimum duration for their visits, which leads to care staff filling their allotted time by carrying out tasks that you could complete yourself.
A good analogy is fitting a stairlift. It might seem like a good idea to buy one when you find that you can only manage half a flight of stairs. Once you have the stairlift, you don’t need to keep trying to climb that half flight of stairs. Within days you find yourself dependent on the stairlift and unable to climb the stairs on your own.
Your care needs are likely to change over time, particularly if your situation worsens, which makes it tempting to plan for a worst-case scenario and acquire plenty of care. As with the stairlift analogy, relying on a higher level of care than you need could achieve the opposite effect and reduce your ability to stay independent for as long as possible.
How often is a care plan reviewed?
Care arranged by your local council must be reviewed within a reasonable time frame, usually within the first three months. This is to make sure that the care is meeting your needs as identified by your needs assessment. Your care plan should then be reviewed at least once a year, or more if your circumstances change.
Self-funded care should also be reviewed so it continues to meet your needs. Many care providers plan reviews in prescribed timescales or review your care plan when your circumstances change, for example, due to illness or changes to your living arrangements.
Unfortunately, annual reviews or inadequate review provisions can see care plans left to run unchanged, resulting in missed opportunities to increase or reduce your care. Care plans should be fluid enough to be reviewed in line with your needs and enable the people fulfilling them to identify when a review is needed.
Family support should also be kept under review. Family members may not notice a gradual increase in your care needs and the support they provide. Including their support in a review of your care plan encourages them to take a step back and assess how your needs have changed.
A care broker can help by overseeing the operation of your care plan and the review process.
An imaginative approach to care planning
When it comes to care planning, it is important to take a person-centred approach. The concept is emerging in health and social care planning in the UK, but best practice can be overtaken by a tick-box exercise, particularly if decisions need making quickly.
Care needs are not static. Health conditions improve and worsen, which affects your ability to do things. The level of support available to you from other sources may also change over time, which can influence how much care you need at home.
When you start to design a care plan with the person needing care at the centre, working out which areas of their life need improvement, considering their goals and wishes and those of their family, you can create an arrangement that offers comfort and support whilst promoting independence.
It is easy to think in hour or half-hour blocks of time, particularly when planning homecare. But doing so misses the opportunity to design a care plan that complements your other activities. You might have more family support available on certain days and need additional assistance, for example with your shopping, on others. Looking at your care needs over a whole week or month, rather than on a day-by-day basis, gives you the chance to design a care plan that supports every aspect of your life. Involving a care broker, in addition to the care provider and your family, can ensure that your care plan is bespoke to you.
Why use Care Captains to design your care plan?
Care Captains will design your care plan to support every aspect of your life, involving your family if you wish, by looking at ways they can support you in addition to paid-for care. We will consider your hobbies, interests, and weekly activities so that your care enhances and improves the things that are most important to you.
We can negotiate with care providers on your behalf to ensure they provide the exact amount of care you need. Sourcing flexible care and reducing your care on the days you need less can also save you money.
Care Captains will provide for your care plan to be reviewed as and when your needs change and support you during formal reviews with your homecare provider so that your care plan continues to meet your goals.
Find out how we can help design the right care plan for you. Call us today on 0345 340 5065 for an informal chat and we’ll take it from there.
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