26 February 2018

I’m Still Me: a narrative for coordinated support for older people

The Challenge 

The Narrative for person-centred coordinated care, published by National Voices and Think Local Act Personal, in May 2013, provided a common cross system definition of the goals for care integration that was designed to be ‘generic’.

However, it was identified that this approach might exclude some factors in the care of older people that are significant to them, but do not always apply to other groups. The ‘I’m Still Me’ project aimed to address this challenge by empowering older adults to express how they would like their care delivered through the use of ‘I’ statements.

Facing the Challenge 

I’m Still Me was a joint project undertaken by National Voices, Age UK, and UCLPartners to develop a set of narrative statements that describe the way in which older people want high quality coordinated care that supports them.

For this work, we looked particularly at older people who might be vulnerable to sudden deterioration in their health, possibly including crisis or hospital admission. Similar pieces of work with other groups of service users – such as people using mental health services – have resulted in new quite extensive new sets of ‘I’ statements giving their perspectives on their care and support.

With older people, there was a different need. We found that although the statements in the existing Narrative were relevant to older people, many of whom we spoke to were less concerned about the specific type of service provision, and more concerned about the outcomes that matter in relation to living their lives.

The ‘I’ statements were initially drafted by the project steering group around the key themes that emerged from the literature review, survey, interviews, and workshops. The narrative was then reviewed, revised, and verified through further discussion with a group of 74 people from the older population.

The aim of the ‘I’ statements is to help commissioners and providers of health and social care to work together with older people to design the proper care that will achieve the outcomes that matter most to them.

The 'I' Statements are:

  • I can maintain social contact as much as I want
  • I am recognised for what I can do rather than assumptions being made about what I cannot
  • I am supported to be independent
  • I can do activities that are important to me
  • Where appropriate, my family are recognised as being key to my independence and quality of life
  • I can build relationships with people who support me
  • I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes that are important to me
  • Taken together, my care and support help me live the life I want to the best of my ability
  • I can make my own decisions, with advice and support from family, friends, and/or professionals if I want it

UCLPartners Clinical Academic Lead for Population Health, Professor Mike Roberts, said:

“We felt it was vital to ask older people themselves about what was important to them. It was a rewarding experience to hear their stories which enabled us to put their priorities in their care at the centre of how services are commissioned and delivered.”