Search curation delivers better results

Everything is on the Internet, and that’s the problem. Because everything is there, it makes the one thing you’re looking for hard to find.    It’s somewhat easier if you’re looking for a particular item that’s a paid for business service. Flights and hotels bookings are pretty straightforward and we could all find a flight from London to Paris. However, despite the simplicity of this search, there are numerous aggregators of services. Some show all of the flights, others all of the hotels. Some put both together.

But the sites that attract most views are those that curate the search experience. These sites ask for or understand our requirements. They answer questions like Winter Sun or Short City Breaks.

This is not a common approach in local government, perhaps this is the next area where curation might help the someone find the things they need. A citizen might need to view all the local government services for a family living in a house, or services for a single person living on their own in a flat. This curation should aim to make sure that citizens understand what is available to them.

For older people, this is even more important. Services should be simple to find and in one place, curated for need and provide access to health, social care, voluntary and commercial provision.   They need to be appropriately segmented to keep things simple.  There are plenty of designs for that.  “people that booked A also booked B.”

Should local government only choose to provide answers to citizens needs from their own resources they will fail to access the less costly and sometimes more effective voluntary and commercial services. At BriteLives that’s our mission, put all the services in one place and make them easy to find and book.

Just realised you’re a carer? Three things it’s good to know now.

Lesson 1  – Don’t be passive in any situation, I don’t care how senior they are or what specialist knowledge they have.

Right off the bat I realised I needed to be the decision maker; I felt that there were some occasions when I thought someone else was the decision maker?  This was never the case, at the bedside in a hospital ward, during some social care meeting or just choosing a hairdresser to come to the house; I realised I had to make all of the decisions. That does not mean I did not include my Mother in these decisions, but it became pretty clear all decisions would have to be made by me.

This is particularly the case in healthcare situations. During my Mother’s last stay in Hospital, which should have been a short one, I quickly realised that the ward staff were unable to make any decisions about my Mother. She was not well enough to go home without a care package and no one could decide how big that would be or who should provide it.  So we kept going round and round in circles with me asking their advice.  I found I had to guard against being passive and learnt how to challenge decisions that were or were not being taken.

Lesson 2-  When someone tells you something check both you and they understand what they are saying.

People called me out to the blue and started chatting about my Mother and her needs. This initially seemed like good news.  On at least two occasions I realised that they were not talking about my Mother, some transposition of phone numbers on a list perhaps.  So when I  got one of these calls I did the following:

  • Asked them to identify themselves
  • Got their contact details –  I always did this first. Get their general contact details to and their specific job title.
  • I recorded all of these interactions into an Evernote Notebook; you can, of course, use a paper notebook
  • I confirmed who they thought they were talking about –  I did this through active questions like; “ You wish to discuss Mavis Coulthard with me who’s on Ward XX at the Royal Surrey Hospital?  Is that correct?
  • I would then confirm who they thought they are talking to.
  • Then and only then would I have the conversation
  • Finally, I would confirm the agreed actions back to the caller.

Lesson 3 – Write it all down and keep your eyes and ears open

Don’t rely on your memory, write everything down how ever trivial it might be.  A mobile phone camera is really good at capturing complex meds and forms.   I found that I was often the only person that had all of the information.  The last hospital discharge letter, a list of the latest meds, the name of the intravenous antibiotic Mum was on.  I found that no one seemed to have the right information at the right time.  More of this in another Post.

Once my Mother was discharged from the Royal Surrey Hospital without any medication.  At the time, she was on about 13 different pills.  Fortunately, I had a photo of her medications and the schedule associated with them.  I was able to send this to a local pharmacy and they were able to sort out the mess with some help from my Mother’s GP. Without that intervention, I guess Mum would have been back in Hospital that night.  The healthcare ombudsman has recently published a report into the discharge of older people from hospital.  It does not make good reading.

I found I needed to be aware of the conversations around me and my Mother, I read all of her medical notes, I asked open-ended questions and listened hard to the answers.  I found it easier and easier to challenge the jargon. The NHS loves jargon, three and four letter acronyms abound and I just asked what they meant.  Sometimes not even the user knew what they stood for.

 

Role of Friends and Family

This third blog highlights the things I learnt looking after my Mother during the last few years of her life.

Friends and Family

I thought I was alone in sorting out the increasing complexities of my Mother’s life. Focusing entirely on the needs of my Mother meant that I forgot that she had a loyal and capable group of friends. They had been helping her with all sorts of tasks and running errands for her for years, and I needed to include them in my plans and activities.

Neighbours and their role

Neighbours are as worried as you are. They can often see what you can’t see, the gentle deterioration of Mum’s general health, that fact that she was getting out less and less. I quickly found that neighbours were a great source of information, support and help, I always made sure I dropped in on at least one of them each time I visited Mum. If they had helped in some specific way that week, I might take flowers or a bottle of wine, to thank them for their help. I felt that the key was to reach out early and tell them what was going on.

Is there a Doctor in the Family?

If you’re very lucky, you may have a healthcare professional in your family. I have a relative that had been a GP; he understood ageing and the likely issues my Mother would face. I found that if I carefully noted my Mother’s symptoms and relayed them to him, I could get an understanding of what might be the issue. I cannot tell you why, but when Mum had a urinary tract infection, she would quickly become confused and paranoid. Now some reading this will know the reason, but at no time did any of the healthcare professionals working with us made such a connection. They all seemed too busy and too hurried to encourage our involvement in my Mother’s care. (see my earlier blog about decision making).

Access and Security

On a couple of occasions, someone wanted access to the house. If the key holding neighbour was away, then this could be an issue. I bought a LockMaster key safe and screwed it to the door frame and put my mobile number on it. Then should someone need access I could tell them the code and they could get the key? It meant that neighbours knew they would not have to force entry. Later I learnt that this was a very useful thing, and although no one said it at the time neighbours were worried what would happen if they had to get access quickly, the key safe removed their anxiety.

Top Tips

    • Tell friends and neighbours what is going on as early as possible.
    • Ask neighbours what has been happening, they will be happy to update you.
    • Find someone you can discuss medical issues.
    • Thank neighbours early and often.
    • Use a key safe for house keys.

The Death of my Mother

MumIt may seem an odd thing to Blog about the death of one’s Mother but I have learnt so much in the last two years it seems nonsensical to keep the journey to myself. We all miss Mum a great deal.  As a teacher, she knew the power of knowledge and the empowerment it brought.

Today, in London there are more than 250,000 people in the last five years of their life. In the UK, there are now 11.4 million people aged 65.   There are over 23.2 million people aged 50 years and over, over a third of the total UK population.   The number of people aged 65+ is projected to rise by over 40 per cent in the next 17 years to over 16 million. And most worrying of all, like my Mother, 3.5 million 65+ live alone.

Unless we do something, we are condemning generations of older people to a chaotic and unhappy last few of life. We can all do better!  This is not about service redesign, apps or productivity this is about happiness. So over the next few weeks, I intend to focus on some of the lessons I learnt.

My Mother died just after Christmas 2015; she was 90. She had survived three bouts of cancer, two knee replacements, World War 2 and a career as a teacher.  She was a pillar in her village community, helping the young ones, all in their 70s, access services. In the last few years of her life, she found it harder and harder to make sense of the services she needed. This was not because she was confused, it was mainly the lack of coordination between the service providers.   These providers were public sector, commercial, charity and church organisations. We had to coordinate and manage all of these services, visits and appointments.

So these are the lessons:

  • The five things you should know now
  • Engaging with friends and family
  • Finding Support
  • Allowances
  • Coordination of Services
  • Role of local NHS and Social Services
  • Hospitalisation and Blue Lights
  • Mini Mental Health Assessment
  • The chaos at the heart of the NHS
  • Access and Control