When 82-year-old Hannah Murray from Leeds had to stay in hospital recently, she was very worried about her kitten, Oscar, who is just a few weeks old. This might not seem like a problem that should occupy social support services, but for Hannah it was one of a number of things causing her great anxiety.
The British Red Cross (BRC) arranged for a cattery to take Oscar for a few days, and when she left hospital, arranged for a box of food to be sent home with her as she didn’t feel confident going out alone after her hospital stay.
This is no quick fix. Hannah’s long-term goals are to regain the confidence to go out and do her own shopping, join a local neighbourhood network, which organises activities and support networks for older residents, and find a new flat to move into. Jane, her support worker, has also helped Hannah to clean her fridge, make a doctor’s appointment and has accompanied her to a hospital visit.
Hannah is one of approximately 50 people in Leeds, primarily older and living alone, that BRC is supporting upon discharge from hospital. A team of committed staff and volunteers support patients at St James’s hospital and Leeds General Infirmary to settle into life back at home.
The BRC approach is all about goal setting and people directing their own support, explains policy and advocacy manager, Chloë Carter. The top three goals approach centres on a two-way conversation between workers and the individual. This means that the person is at the centre of the support planning.
By finding out what people really want to achieve, resource is focused in the right place, says Sharon Dhesi, inclusion manager: “A service coordinator I was talking to recently said that because they are concentrating on the things that really matter, it makes the service more efficient. Their energy isn’t being taken doing things that are well meaning but won’t make a difference to the person they’re supporting.”
Dhesi speaks of one lady who wanted to go into town: “She didn’t want to walk into town for shopping, her son did that. She was lonely. But she couldn’t leave her flat because she was embarrassed because she hadn’t had her hair done – it wasn’t about telling her what groups there are in her area as she already had a social network. Having the initial conversation is so important because it brings all that out. For her it was a practical task that was keeping her indoors but it was all about social connectivity in the end.”
BRC services are provided for a specified period of time and focus on preventing, reducing or delaying a person’s need, thus enabling people to lead lives they have chosen and value, and live independently for longer. Voluntary sector organisations can not only provide this support, but are ideally placed to do so, says Carter: “Being able to give someone the time it might take to achieve a goal requires support which is flexible. We might do someone’s shopping one time, go with them the next time, and so on.”
Carter adds: “Sometimes we are signposting on to another service within the community and setting that up with them. So we might go with them to the first art class or community group and make sure everything is running OK, but more importantly make sure that they’re confident about returning when we’re no longer with them.”
Though, understandably, the goals can vary wildly, Carter says there’s a common context: “It’s usually about regaining confidence and skills. We can see that a small majority are focused on improving ability to manage day-to-day activities. The others are quite spread.” For example, she says: “There are quite a few around managing finances. We thought the focus might be on the finances themselves but the focus is often on the paperwork. One lady described it as the elephant in the room. She simply couldn’t come to terms with the enormous pile of paperwork that awaited her on her return from hospital.”
To this end, the BRC has submitted to the Department of Health’s consultation on the new eligibility criteria within the Care Act, using data gleaned from its top three goals approach to inform them what older people really want. “In the Department of Health’s understanding of what care tasks are, paperwork and finances had been missed,” says Carter. “We were able to give them tangible examples of why it’s really very important and the sort of support people need.”
“Ultimately, this is about moving away from filling out forms to having a conversation with someone that gives them the ability to decide what they want from our service,” says Dhesi. “It’s about us taking a holistic view of people’s needs and agreeing together what will help that person recover from their crisis, regain their independence, increase their resilience and ideally prevent them from ending up in hospital.”
Content on this page is paid for and produced to a brief agreed with British Red Cross, one of the sponsors of the Guardian Ageing Population series.
