Plan ahead for your place of care

80% of adults have not thought or talked about where they would like to be cared for, if they fell ill or frail, writes Patricia Rickard-Clarke, Chair of Safeguarding Ireland
Plan ahead for your place of care

70% are confused about decision-making and consent protocols when caring for a seriously ill or frail older person.

NEW research commissioned by Safeguarding Ireland has found that 80% of adults have not thought, or talked about, where they would like to be cared for if they became seriously ill or frail.

And just 5% have documented what their place of care preferences are.

Furthermore, 70% are confused about decision-making and consent protocols when caring for a seriously ill or frail older person.

Following the findings, Safeguarding Ireland is encouraging a major change in attitudes and behaviour on sensitive care issues with greater consideration, conversation and recording of wishes on where we would like to be cared for, if we became unable to live independently in the future.

The research, carried out on a nationally representative sample of 1,000 adults using RED C’s omnibus survey, found that just 21% of adults had personally considered where their preferred place of care would be if they were seriously ill or nearing death, just 17% had discussed this with a family member, friend, or other trusted person and only 5% had documented their preference.

Consideration of place of care was higher among older adults (65+), but still just 43% had considered it, 35% had discussed it and 9% had documented their wishes.

When asked if a family member has authority to make decisions for someone who is frail but still has decision-making capacity without their consent, 30% said that yes the family member does have this authority, 28% did not know, and just 40% recognised that the decision continues to lie fully with the person as long as they have decision-making capacity.

The message from Safeguarding Ireland is that the best step to safeguard your future is to think in advance about important future decisions, talk with your most trusted family, friends or professionals and have your wishes clearly recorded.

Patricia Rickard-Clarke, Chairperson of Safeguarding Ireland.
Patricia Rickard-Clarke, Chairperson of Safeguarding Ireland.

That means that if in the future, you do not have the capacity to make decisions, due to age related frailty or serious illness, your choices on where you would like to be cared for, healthcare approaches and finances can be known, considered and respected.

Planning ahead also safeguards against abuse.

The important steps to take are:

1. Appoint a person under an Enduring Power of Attorney

2. Make known where you would like to be cared for

3. Make your healthcare preferences known

4. Plan your Finances Planning Ahead is relevant for all adults, but those most at risk are people with reduced decision — making capacity, age related frailty, a serious illness or a mental or physical disability.

I encourage people to complete the Irish Hospice Foundation’s Think Ahead form, a dedicated planning document, available at www.thinkahead.ie.

Think Ahead is a one-stop planning document in which people can record personal information, emergency contacts, health insurance, medications, culture preferences, religious beliefs, place of care wishes, an Advance Healthcare Directive, resuscitation preferences, organ donation wishes, and financial plans.

Preferences can be updated at any stage. Once completed it is important that trusted family, friends or professionals know where the form is stored. Details on an Enduring Power of Attorney is also available on www.thinkahead.ie.

Think Ahead is an initiative of the Irish Hospice Foundation.

Taking these steps means that family, friends and care professionals can, if needed, know what your wishes and plans are. While it may not always be possible to deliver all of wishes, by being known they can be considered and respected.

We also need a much clearer understanding of people’s rights, decision making-capacity and consent.

The research has confirmed our suspicion that consent for frail older people is often misunderstood.

No-one has authority to make a decision for a person who has decision-making capacity. Their consent is always required. As long as a person has this capacity – where they are cared for is their own decision.

The survey also asked respondents where their preferred place of care would be and this showed a strong preference for home over institutional care. 85% said they would be happy to be cared for at home with the necessary supports, 55% in the home of a family member, 33% in a hospice, 25% in a nursing home and 19% in a hospital.

Safeguarding means living safely, free from abuse of neglect. It means our choices, particularly if we are vulnerable, are clearly heard and respected.

More information at www.safeguardingireland.org.

Safeguarding Ireland Safeguarding Ireland promotes safeguarding of vulnerable adults to protect them from was all forms of abuse by persons, organisations and institutions and develop a national plan for promoting their welfare. The organisation’s main funder is the HSE.

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