Abstract

Background: Most long-term care systems (social care) for older people rely on some non-governmental funding to supplement state provision. In England, perhaps a quarter of homecare delivery is funded privately by individuals known as self-funders. Older self-funders (65 years+) and their families face significant challenges in finding and choosing their care, with many left to "go it alone'. Lack of care navigation support leaves people making some very important decisions that they have not considered before, often at quite a troubling time of their lives, leading to poorer long-term outcomes.

Objectives: This study examined what sort of help older self-funders and their families want when navigating care. It aims to understand their preferences for support in navigating community social care and the different approaches taken when making decisions.

Methods: This study conducted an experiment of preferences for hypothetical "care navigation services" (like a travel agents, but for social care). A discrete choice experiment (DCE) questionnaire was completed by 182 people. Follow-up in-depth qualitative interviews were undertaken with 37 people to ask how they approached decisions about care.

Results: Not all people looked for care in the same way and they had different preferences when choosing care. Generally, most self-funders were willing to pay for help with "navigating' the care system rather than being left to "go it alone'. They also valued what navigation support was on offer, more than how it was provided. Information about quality, and help to "think things through', were the most important features of navigation support. A typology is being developed to explore different decision-making styles when navigating social care.

Conclusions: The study demonstrates the potential demand and likely take-up of navigation support if it is made available to people who pay privately for care. Findings will be presented at a series of action planning workshop (with key national and local stakeholders and people with lived experience in navigating care) to specify mechanisms for achieving impact. Potentially, the typology could be used by front-line staff in local government to identify self-funders who are most "at risk' of being left to go it alone. These people might benefit from additional navigational support in making key decisions about their care, leading to improved long-term outcomes.

Slides