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  • Robin Tthomson

Fixing social care?

Updated: Nov 26, 2020

Discussions about reforming social care often begin with money – how much will it cost? And then structures – do we need something like the NHS? Or more care homes? Or…?


But let’s begin with people. What exactly is our aim?

Many agree that the basic question is this: how can we enable those that need care and support – now and in the future – to live the lives they want to lead? How can they live a full life in every dimension – physical, social, spiritual, emotional, with freedom of relationships and choices?


If that is our aim, what care will enable it? And who can best provide it? There will be a range of answers, depending on people’s situations. But all will need to be person-centred and relational, responding to people’s needs rather than fitting them into a system.


And most of the care, as at present, will best be given by voluntary caregivers – family and friends. They can’t be replaced.


BUT they need support. They can’t do it on their own or they will be overwhelmed, as many currently are. The role for the ‘professionals’ becomes clear: it is to provide the resources for those who need care and support, and for their caregivers, so that together they can enable them to live the lives they want.


Resources include the full range of social and health care, according to people’s needs, integrated rather than divided, as they often are at present. In other words, we need integrated teams that combine medical and social resources, while also being relational and accessible.


This applies whether people are living ‘at home’ or ‘in a care home’; with voluntary caregivers or paid carers as well. In every case the focus is on working with the persons and the caregivers. The integrated team brings them the resources they need to go on living their lives well.


This model works for all of us at any age but is essential for older people and those living with dementia or other chronic illness.


Do teams like this exist? And how do they function? We benefitted greatly from this kind of team and later learned of other models. They do exist, but not nearly enough of them. To multiply them will require some radical changes in the present system. Read more here about ‘Changing the system and building your support team’.



Read more about the team that worked for us in ‘Person-centred care: models that work’ here.

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