I am deeply fortunate that in my role as a Private GP I have the opportunity to build longstanding relationships with my patients and their families. This becomes even more relevant during times of illness and has given me the opportunity to understand the dynamics at play when planning care.
It is no secret that being able to afford private care allows one to access a level of individualised care that the state is unlikely to be able to match. That said, having worked both as a GP within the NHS and now privately, I have witnessed varying standards of care in both sectors and for me this reinforces the importance of planning one’s care. In order to best do this you need to appreciate the various options available to you.
In the private sector I know I am deeply fortunate in that I get to know my patients well and spend more time with them and their families over times of illness. This gives me the opportunity to understand the dynamics at play and the real wishes of the patient and wider family – a key factor when planning care.
When you or a loved one are entering a stage in life when care is required, there are ten key things to consider:
1. There are different types of care. Some require nothing more than someone to keep an eye on them, some company and a little help with preparing a meal perhaps. Others need help getting dressed and washing, whilst some require round the clock nursing. Understanding that a variety of help is available at all stages is important. Knowing too that the level of care is likely to change in time so this should form part of the plan.
2. Good care is about maintaining independence. This is key. Facilitating a life that continues to be rewarding and enjoyable while being safe at the same time is the primary goal.
3. Good care is critical for loved ones. Being able to pick up the phone and get an update matters. You may not be able to be there as much as you would like, but knowing that your loved one is in good hands and that you would be alerted were there any concerns is really important
4. Choosing the right carer. This bit is critical. While the vast majority are trustworthy and reliable, having an appropriate ‘vetting’ process to ensure this is key. The relationship is a close one and inevitably often the client can be vulnerable. You or your loved one must feel safe in the carer’s hands and with luck enjoy their company too!
5. Arrange legal planning in good time. Power of attorneys for welfare and wealth are two different pieces of documentation. Should the need arise they ensure that you have arranged for your welfare and financial affairs to be overseen by people you trust. It’s amazing how often this is forgotten about.
6. Don’t overlook a living will. These ensure that should you lose capacity to make decisions regarding your treatment then your wishes will be respected. This often includes clarification on when hospitals should withdraw treatment; for example if it is deemed unlikely you will recover from an illness, such as a major stroke. Many people have strong feeling about this aspect of care and it is well worth giving it some thought.
7. Communication is key. Points 5&6 only work if you talk to your relatives and doctor. Best laid plans can come unstuck if they are not communicated!
8. Death can and should be planned. I’m amazed how often this subject is simply taboo. I understand that it’s a difficult conversation but it’s one that we really should have. Most people want to die at home yet in the UK few people do. They often end up in hospital when plans fall apart as someone becomes unwell. Clearly every situation is different but I do believe that with good communication between the client, the family and the doctor, meeting the hopes and wishes of the client is far more likely.
9. Embrace familiar surroundings. The stress of moving at a late stage in life cannot be overemphasised and clients with good care are far more likely to remain in their homes where they are most at ease. Investing into things such as stair lifts, bath lifts and technology that enables one to remain independent in ones own home is very worthwhile.
10. Consider the needs of family members and other halves. Seeing couples grow old together is a joy. At some stage it is very likely that one of the couple start to require more support and this often falls to the other half. In my experience they tend to do an amazing job however this takes its toll on them over time. It is so important to look after the caring partner in this situation and ensure they have frequent breaks with the support of a professional carer every now and then.
Dr Toby Dean works as a GP at The Sloane Street Surgery in Chelsea, London. A private general practice that aims to provide the best medical care for its patients of all ages. Dr Dean has a particular interest in chronic disease management and disease prevention alongside his role as a general family practitioner.