It’s horrible to think about our parents and elder relatives losing their independence and needing care one day. But it is something that most of us will invariably have to face.
Talking about future care is a conversation that many families put off, which leaves them scrambling to make difficult care decisions ‘in the dark’ during a health crisis.
But what if we approached care planning with the same foresight we give to other major life events? What if we made the time to understand and plan for care before it’s urgently needed?
Fred Lloyd George, co-founder of boutique live-in care company Hamilton George Care, knows firsthand the difference early planning can make. In a recent conversation with us, Fred shared his insights and advice on some of the misconceptions and challenges around eldercare, how it’s changing, and how families can navigate this delicate terrain with more confidence and clarity.
Here’s what he had to say.
Families need to understand that social services and the NHS don’t operate together
“One common misconception is that the NHS directly provides social care services, and we often hear from families asking how to contact the NHS for this type of support. In reality, social care is a local authority matter. While the NHS can provide guidance and assist with assessments, the actual responsibility for delivering social care falls on local authorities. This means that if you’re looking for support with social care, it’s essential to know which local authority is responsible for your area, understand their policies, and be aware of the funding options available.”
Demand for social care is growing
“Another important point to recognise is that local authorities have limited resources. Many people assume that social services are being unfair or restrictive, but the reality is that demand for social care is growing and funds need to be carefully allocated to ensure that those most in need, particularly those with lower-income, receive adequate care. This often creates a political challenge around how resources are distributed, but it’s important for people to understand that the constraints are financial, not personal.”
Families often make rushed, high-cost care decisions
“One of the biggest challenges families face when arranging care for their parents and elder relatives is the pressure to make urgent, costly decisions in a short amount of time, often following a diagnosis or hospital discharge. In these rushed situations, children often arrange expensive care solutions without fully involving their parents. I often compare this scenario to suddenly realising you need transportation and, without considering your options, buying a Porsche rather than checking if there is bus or a train. Hurried decisions like this can lead to care plans that may not align with what your parent truly wants, leaving them feeling as if their independence has been taken away at a moment when they’re already struggling to cope with a difficult diagnosis or lifestyle change.
Another challenge with care decisions involves understanding the level of care required, particularly with progressive conditions like motor neuron disease, where the need for intensive support is inevitable, but the timeline is uncertain.”
Early discussions about care preferences make a big difference
“Too often, we see families reaching out in moments of crisis, needing immediate solutions after something unexpected has happened to a loved one. This urgency can make decisions more stressful, less thoughtful, and not necessarily aligned with what the person receiving care wants.
As a response to this, we’ve developed a consulting service to give families a chance to have a relaxed, pressure-free conversation about care, even if they don’t anticipate needing it for many years.
Legal tools like a power of attorney and a will are vital for ensuring that your parent’s wishes are clear and followed. Including specific instructions about care preferences and funding in these documents allows families to act on those decisions when the time comes, avoiding confusion and maintaining a sense of control for the person receiving care.”
Live-in care is changing the traditional care model
“One of the biggest misconceptions about live-in care is the belief that it simply isn’t an option. Traditionally, in countries like the UK and Australia, care has followed a predictable path: family and community would support an elderly person at home for as long as possible, but once full-time care became necessary, the next step would be a move to a care home. This model has shaped how we think about care in the UK for decades. However, live-in care is an increasingly viable alternative, allowing people to remain in their own homes even as they require full-time or end-of-life care. Advances in technology, such as video calling, have also made it easier for health professionals to remotely oversee care, ensuring higher standards and rapid assessments, something that was far more difficult just a couple of decades ago.”
Staying in a familiar environment can be better value
“While care, in general, is expensive, live-in care isn’t significantly more costly than moving into a care home or nursing facility. In fact, the personalised, one-on-one attention that live-in care provides can make it a better value for families looking to keep their loved ones at home. Additionally, staying in a familiar environment has been shown to benefit conditions like dementia, delaying the impact of cognitive decline by maintaining a stable routine in a familiar environment, close to friends and family. While many care homes offer excellent care, and still play an important role especially for those with more complex needs, live-in care is now a feasible alternative for more people who prefer to stay at home.”
Home care is moving towards a more holistic model
“In the past, care companies often focused primarily on the medical conditions of individuals. While addressing medical conditions is essential, it should be just the baseline of what care entails.
Today, families are seeking more comprehensive support that enhances the quality of life for both the individual receiving care and their families. Caregivers are increasingly helping to coordinate various aspects of a person’s life – from organising medical appointments and social outings, reconnecting with friends and family, or even traveling with clients. Quality care goes beyond basic medical support. It’s about layering in additional services that drive real value and enrich the lives of those receiving care. This holistic approach is where the future of home care is headed.”
Speak to multiple providers when choosing care
“For families starting this journey, referrals from those who have navigated similar situations can be incredibly valuable. Around 65% of our new families at Hamilton George come to us through word-of-mouth recommendations. If you’re searching online, remember that larger companies tend to dominate search results due to their marketing budgets, but smaller agencies often offer unique and personalised care options. Every company operates differently, with varying sizes and philosophies around care, so it’s important to speak with multiple providers. Think about what your parent or elder relative needs beyond personal care, medication management and the basics you would expect. It’s equally important to consider how the carer will offer companionship and enrichment to help your parent stay engaged and maintain their independence for as long as possible.”
More about Fred: Fred served as an infantry officer in the army for seven years before transitioning into care. Prior to co-founding Hamilton George Care, Fred began his care career at the home care tech start-up Elder, and then worked for NHS Digital during the COVID-19 pandemic.
