The Four Phases of Care for Older People

Phase One

Due to better living conditions and better healthcare, life expectation is increasing and as a result the number of elderly people who are living alone is also rising. 

Loneliness is the result for hundreds of thousands of older people and this brings it's own problems of depression, anxiety, lack of confidence in ones own ability to manage and often is the reason for personal decline.

The phase of elderly care that is required at this time in a person's life is social care. Contact with other people from just having a conversation with another person to having a visit, an outing or just a phone call to make all the difference.

It is regretted that day centres are closing, that sons and daughters of most families have to work and during the day many communities are empty. It is unfortunate that village stores and post offices have closed and milk, paper, bread, meat, fish, etc. deliveries have almost ceased. 

Phase One care is simple, it is just about making contact with an older person on a regular basis.

Phase Two

It may be physical decline is beginning to show, a little less mobility, small signs of confusion, anxiety about becoming older, loosing a spouse or partner all can move a person to a slightly lesser state of independence than previously.

Phase Two of care needs to be offered to support the older person at this stage. Phase Two care is preventative care which has been shown through the ages to enable independence to be kept for longer. Usually at this phase it is domestic support that can make a difference. Help with the heavier domestic work, changing the bed linen, pushing the bin down the drive, helping with shopping, looking for obstacles which might result in a fall and keeping an eye out for changes in a person's lifestyle that may indicate a problem e.g. food not being eaten, clothes looking grubby, letters on the mat several days old, etc.

The Home Helps of the fifty years ago carried out this role and if they were they in place today for our older generation, there would be less hospital visits, admissions and accidents in the home. 

Phase Three

When an older person's dependency increases to a time when domestic support is not enough, it may be because physical decline necessitates help with personal care tasks or reduced mental powers mean that another person has to take responsibility for some of that person's health and safety then longer term decisions have to be made. Decisions to ensure that although independence may be reduced, what independence can be prolonged should be encouraged.

Usually at this phase, appropriate help needs to come into a person's home or a move to a care home can be the answer.

Either decision should only be made after considerable enquiries have been made by the family or advocates of the older person and where possible with the older person themselves as they move into this new era of their lives. Looking at either option as a 'solution' is unacceptable.

Phase Four

Palliative care is the last stage in our lives and one which should be as free from anxiety as is possible. Soothing, calming care, pain free all delivered in a kind, dignified manner. 

Care should be offered with time. Time if needed with the elderly person themselves, their families, time to listen, to offer support and compassion.

Care homes and care organisations need flexible working processes to perform in this arena appropriately and the importance of this phase in a person's life should not be downgraded as 'inevitable' in  a working week.

Looking at the Four Phases above, they are a generalisation. It does not matter how many care training courses are developed, what ever care legislation or standards are made statutory, without the very basic need to offer appropriate care from Phase One, the cost both financially and in misery will continue to rise.

We have to embrace the 'new world' of an aging population and we should all take note.

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