In our last post, we talked about three distinct silos of care, which necessarily interact as our circumstances change. In this post we explore well-being to discover what it means and how it fits into our model of care.
There are many definitions of well-being. Most link it to happiness, psychological health and quality of life. In fact the NHS has a well-being self-assessment which allows you to see how happy you are. Click here for more details. We agree that happiness and quality of life are important factors in maintaining a state of well-being.
The Westcott Definition
When we talk about well-being in the context of integrating care we mean maintaining, or improving, quality of life. Well-being is, in essence, the steady-state norm without the need for an acute intervention from the health and social care systems. Restoring a state of well-being, even if it is different from before, should be the goal of any health and social care intervention.
That's not to say that well-being is always separate and distinct from health and social care. For example, someone with a chronic condition, like high blood pressure, may maintain a state of well-being by taking medication regularly. This would stave off the need for an acute medical intervention for as long as possible. Like those on chronic medication, someone who is receiving support in a care home is able to maintain their quality of life and well-being because they are receiving that support. For others, maintaining well-being might include choices about diet, exercise, smoking and even in engaging in complementary therapies.
Who Pays for my Well-Being?
The short answer is: you do. However, funding within the care model is extremely complex and depends upon numerous factors such as the nature of your condition, your personal circumstances and so on. One might argue, therefore, that the real answer is probably: it depends, and there are some blurred lines.
Under Westcott's model of care, healthcare and soical care are accounted for separately. Therefore medical and social care costs associated with maintaining quality of life, such as those described above, would fall outside of the scope of well-being. All other costs are entirely within the discretion of the user and are therefore their own responsibility. Governments, charities and other organisations only step in to fund well-being, e.g. through benefits and aid, when basic needs, such as food and shelter, are not being met and/or those in need of them are unable to afford to meet them. The debate as to what constitutes a "basic need" and where the line for assistance should be drawn is one which is soaked in philosphical, political and moral aspirations. For our purposes though, the individual is resposnible for paying for their own well-being.
How Does Well-Being Fit into an Integrated Care System?
The purpose of well-being is to stave off the need for a health or social care intervention for as long as possible. Once a health and/or social care intervention is necessary, their purpose is to re-establish a level of well-being as rapidly as possible.
By way of example. A lady has a chronic condition. She is not ill. Rather she is able to live a good quality of life by making sensible choices around her diet, seeking out complementary therapies to relieve stress and taking medication and visiting her doctors regularly to keep her condition at bay. However, every-so-often her condition flares up and makes her ill, i.e. she is unable to function as she would wish to because of her condition. She is no longer well and requires medical attention: a healthcare intervention. In our model, she moves out of well-being and into healthcare. Doctors treat the flare up and acute symptoms. When the lady is better she is discharged: the healthcare intervention no longer adds anything. However, the nature of her condition means she still needs some time to recover and is unable to do everything she had been able to do beforehand ,such as live at home by herself safely. This is where a social care intervention might might be necessary. She now receives support at home to help her with certain tasks such as getting up in the morning and going to bed at night. If this support is necessary on a permanent basis it becomes the new norm and she moves back into a state of well-being where the focus is on living her life the way she wants to and is able to. It is about maximising the quality of her life within the constraints of her condition.
The key is to be able to indentify the right care at the right time to meet specific needs. By doing so a high level of well-being and quality of life can be achieved and maintained.
There are many definitions of well-being. Most link it to happiness, psychological health and quality of life. In fact the NHS has a well-being self-assessment which allows you to see how happy you are. Click here for more details. We agree that happiness and quality of life are important factors in maintaining a state of well-being.
The Westcott Definition
When we talk about well-being in the context of integrating care we mean maintaining, or improving, quality of life. Well-being is, in essence, the steady-state norm without the need for an acute intervention from the health and social care systems. Restoring a state of well-being, even if it is different from before, should be the goal of any health and social care intervention.
That's not to say that well-being is always separate and distinct from health and social care. For example, someone with a chronic condition, like high blood pressure, may maintain a state of well-being by taking medication regularly. This would stave off the need for an acute medical intervention for as long as possible. Like those on chronic medication, someone who is receiving support in a care home is able to maintain their quality of life and well-being because they are receiving that support. For others, maintaining well-being might include choices about diet, exercise, smoking and even in engaging in complementary therapies.
Who Pays for my Well-Being?
The short answer is: you do. However, funding within the care model is extremely complex and depends upon numerous factors such as the nature of your condition, your personal circumstances and so on. One might argue, therefore, that the real answer is probably: it depends, and there are some blurred lines.
Under Westcott's model of care, healthcare and soical care are accounted for separately. Therefore medical and social care costs associated with maintaining quality of life, such as those described above, would fall outside of the scope of well-being. All other costs are entirely within the discretion of the user and are therefore their own responsibility. Governments, charities and other organisations only step in to fund well-being, e.g. through benefits and aid, when basic needs, such as food and shelter, are not being met and/or those in need of them are unable to afford to meet them. The debate as to what constitutes a "basic need" and where the line for assistance should be drawn is one which is soaked in philosphical, political and moral aspirations. For our purposes though, the individual is resposnible for paying for their own well-being.
How Does Well-Being Fit into an Integrated Care System?
The purpose of well-being is to stave off the need for a health or social care intervention for as long as possible. Once a health and/or social care intervention is necessary, their purpose is to re-establish a level of well-being as rapidly as possible.
By way of example. A lady has a chronic condition. She is not ill. Rather she is able to live a good quality of life by making sensible choices around her diet, seeking out complementary therapies to relieve stress and taking medication and visiting her doctors regularly to keep her condition at bay. However, every-so-often her condition flares up and makes her ill, i.e. she is unable to function as she would wish to because of her condition. She is no longer well and requires medical attention: a healthcare intervention. In our model, she moves out of well-being and into healthcare. Doctors treat the flare up and acute symptoms. When the lady is better she is discharged: the healthcare intervention no longer adds anything. However, the nature of her condition means she still needs some time to recover and is unable to do everything she had been able to do beforehand ,such as live at home by herself safely. This is where a social care intervention might might be necessary. She now receives support at home to help her with certain tasks such as getting up in the morning and going to bed at night. If this support is necessary on a permanent basis it becomes the new norm and she moves back into a state of well-being where the focus is on living her life the way she wants to and is able to. It is about maximising the quality of her life within the constraints of her condition.
The key is to be able to indentify the right care at the right time to meet specific needs. By doing so a high level of well-being and quality of life can be achieved and maintained.