With increasing numbers of people living longer, the way we care for each other needs to change. We certainly all deserve better – and people who will be old enough to need care in the future will the very people who are bound to radically re-engineer them. After all, we are the Baby-boomers.
The statistics show that in the last 30 years, the number of centenarians in the UK has increased fivefold and this growth is likely to continue looking ahead. Unfortunately, the typical care home model hasn’t really changed to reflect these changes. Not unlike pensions, the average care home is still based on concepts developed over a hundred years ago – and in my experience, so is the décor! I suspect that a shift is inevitable –and on its way – that will reflect the changing needs of these new, older people and deliver a contemporary version.
Again and again, I hear my peer group say that what they want is small communities for groups of (preferably like-minded) people – that support them to go on living full, vibrant lives. It usually goes like this, “what we should all do is buy a big old house and get some staff in who can look after us and where we can all live together” – they may or may not acknowledge that this is almost the model of the 60s hippy communes that they are describing.
Unfortunately, it fails to acknowledge that many people have chronic and other old age diseases and problems and this might mean that they may will be be prevented from having the continuing friendships they seek to achieve.
The Eden Alternative in the US is an interesting model, where households of seven to ten older people live, supported by trained care workers who provide a range of housekeeping and personal care assistance and activities. In conventional long-term care, it is the carers who are in the spotlight all the time, but the Eden Alternative say that it is the older people who are the stars. It would be unthinkable in most care homes here, but it is they and their families who become the active and involved decision-makers. The role of the staff there is to support and assist people in ways that allow them to be involved in running the household, from cooking to budgeting and maintain their independence for as log as possible.
Simply doing a better job under the standard model is unlikely to get us where we need to go. It's better for people to live in a place that's about wellbeing, empowerment, growth and development than one that's about decline, disability and death.
Our attitudes towards older people affects how they feel about themselves. It isn’t rocket science – treat them as disabled and this is how they will eventually see themselves. Enable them to play an important part in the way their home environment runs – as they will have done all their lives, after all – can help them remain positive, independent, involved and happy.
It's our relationships with those around us, the connection and sense of belonging we feel, that counts. We need to stop seeing older people in care environments almost as ‘patients’ but instead, acknowledge and respect the fact that they are experienced, growing and developing human beings.
We are cowed by an array of ‘risk’ factors. Why? Perhaps it’s partly because the way we have always done things, actually carries high risks. One of the key questions I suggest people ask themselves about their possible future care is this:
If you like being outdoors sometimes and were choosing – or having a care home chosen for you on your behalf as an older person – would you want to live in the one that offers a ‘one size fits all’ model; that won’t let you go outside and enjoy the fresh air and the garden whenever you want, just because you might have a fall?
Or the one that says “this is as far as possible a ‘home from home’ for people who live here, where people can come and go outside whenever they want to, because we respect the fact that this home is not their prison and we have made the garden as interesting – and as safe as possible.” I certainly know which one I’d choose.
Or if you enjoy cooking, would you want a care home to be chosen that won't let you, or one that encourages you to keep doing it as far as possible and even actively encourages your participation?
I believe that change is coming and that the changes can be accomplished without spending going through the roof, because at its heart, it’s all about attitudes and culture and quality of life. Good care-giving means making people’s lives as rich and as meaningful as possible, central to its ethos. After all, if a life is worth living, it needs to be lived well.
We need to understand that the tasks with which so many care homes seem to be so often obsessed by, should be a given, and make our quality of life – and that means relationships – the epi-centre of care.