“Rubber gloves.”
“What about them?”
“You can put them on the list, can’t stand them.”
Mr Jones is on a roll now.
In 2014, we landed our alternative lifestyle “on his street” and as you might well imagine for someone in their late 70s at the time, we may as well have been aliens. But little by little, stern looks and eyerolls became questions. Questions became conversations over the gate, and conversations over the gate became conversations over a cup of tea.
He is my dear friend, and whilst I do still get frequent eyerolls and warnings about ruining my knees with all the running I do, behind that – I know – is love.
Aside from us, there isn’t much day to day support around him. He keeps himself to himself and remains active as best he can, but some days are harder and slower than others. We talk often about the house and its upkeep which I know to be a source of worry. Those who know me will know my toolbox rivals that of most qualified tradespeople and odd jobs and decorating I can do, but we both know that in time, some difficult conversations will be needed, and difficult decisions made.
This breaks my heart.
But today, we’re having some fun with this and making a Wish List. Well, it’s more a “What Mr Jones Can’t Stand” list but I think if you read it carefully, it’s a Wish List.
I notice that some of the care and support options we talk about seem to trigger some less than desirable visualisations; I can tell by the ‘over-glasses expressions’ he gives me. The rubber gloves comment came about when discussing homecare and how he thinks this would feel. As we talk, I can see that the more traditional solutions still so frequently offered fill him with nothing but dread. I understand that he’s seeing a model that’s predominantly medical in its approach. Largely restrictive and risk averse, and almost stifling rather than empowering; promoting his independence for as long as safely possible.
“So what would you want? If things change, and we need to have a chat about what next. What’s important to you?”
I don’t think that Mr Jones has been asked that question in a long time.
“Somewhere, I think, that feels like home.”
“What would it look like?”
“Well like this, but smaller – obviously. [You can hear the eye-roll, can’t you?] You could come whenever you want. Noone would just be bursting in on me with things I need to do and times for everything. And I can’t stand the smell of Jays Fluid.”
I smile at this because I can’t either, and also because I can’t remember the last time I saw it in a cleaning aisle anywhere.
“I think I would like a little dog. And to still do my tomatoes.”
His tomato plants are out of this world every summer.
“And to get out and about when I want. And to siarad Cymreag.”
This means to speak Welsh.
“I think if you lot could just sort all that out, getting old wouldn’t feel half as bad!”
By you lot, he means us lot. All of us who are committed to the sector, and to working as tirelessly as we need to ensure we’re delivering the best possible outcomes for people in the places and ways most important to them.
I wonder how often people are meaningfully asked what’s really important to them as they get older.
When we think about modernising care and support solutions, as professionals we can often jump straight to thinking about sizeable capital programmes, large-scale investment and perhaps trickier programmes of asset rationalisation as enablers of change.
Costs and resources are raised as barriers to progression, but through trusted collaboration and well-considered strategic investment those barriers are very easily removed. Often they are artificial to begin with. And if anything, the return on investment should far outweigh the arguments at least in relation to ‘test and learn’ approaches that help shift creative thinking into tangible options.
We have seen some truly inspiring examples of alternative care and support models in adult social care emerge over the past few years. Extra care villages, co-housing communities, advances in technology and AI to name but a few. These examples highlight some of the ways in which community is created around an individual, but through our micro as well as macro commissioning practices we can also create community in-reach as another powerful mechanism that enables people to remain in their homes for as long as is possible.
At the other end of the scale, we have also seen some truly inspiring ways in which the micro-provider market has been enabled to grow, the voluntary community sector integrated into homecare provision, and increasingly woven throughout hospital discharge pathways. Real examples of partners thinking outside of the box together and pushing hard against barriers to progress. There is significant evidence to show that even the smallest and low cost changes such as these can have the greatest impact on delivery model quality and outcomes for individuals.
As Mr Jones has so beautifully articulated without even knowing it, it’s more often the little things that really make somewhere feel like home. And we know we simply cannot underestimate the impact that feeling at home has on our long-term health and wellbeing. Thank you, Mr Jones. For both your Wish List which I will keep with me, and for your permission to share snippets of our conversation in the hope that it inspires “us lot” to keep asking questions, listening, learning and moving the sector forwards.