A quick guide for practitioners supporting people growing older with learning disabilities

 

A future plan is key to providing care and support that can respond to the person’s changing needs as they grow older.

Thinking about the future is an important aspect of person-centred planning, which should aim to build on the person’s strengths and skills, and help them consider what they want most in life as they get older.

Planning for the future helps people with learning disabilities to live healthier and more fulfilled lives for longer.


Person-centred planning for now

Together with the person consider:

  • Changing needs (including health), wishes and capabilities.
  • Encouraging and supporting independence.
  • Activities and any practical support needed to access them, including transport.
  • How they could build and maintain support networks.
  • Information and support needs of family members (including siblings) and carers.
  • Carer’s assessments.
  • Creating a future plan.

Planning for the future: core principles

  • Make sure the planning is led by the person, with their family, carers or advocates involved where appropriate.
  • Involve a practitioner who has a good relationship and communicates well with the person.
  • Include input from practitioners with good knowledge of local resources.
  • Look at the person’s life as a whole, including their hopes and dreams.

Creating a future plan

Together with the person and those most involved in their care and support, make a plan after a discussion about the following areas:

 

Housing

Does this meet the person’s current needs? Can it be adapted for the future?

Health

Does the person have the annual health check for people with a learning disability, as well as the same screening as other older people? Do they know what health changes to expect as they age?

Support network

Who provides emotional and practical help? Are there plans in place for changes such as illness or the death of a carer?

Money and legal issues

Does the person need help to manage their money? Has anyone been appointed to have lasting power of attorney? Is information about wills, trusts or benefits needed?

Crises

What unexpected events might affect the person and their care and support?  What would they want to do and who would they want to involve?

Technology

Could any new developments (such as telehealth) help the person as they grow older?

Making decisions

The person’s capacity to make decisions may change with age. Do they have views and wishes about their future care and support that can be recorded now?

Deprivation of liberty

How can the person be helped to maintain as much choice as possible if future changes to their care and support means they have less freedom?

Giving support

Will the person need to care for others as they get older? How might it affect their health and wellbeing if they do?

End of life

Does the person have any particular wishes, including where they want to be cared for and where they want to die?

Review this plan every year and whenever the person’s needs or circumstances change.


Future housing

Housing is one important part of a future plan. Talking to the person about where they might live as they become older can avoid the need for a sudden move if their circumstances change – for example if their carer becomes ill or dies. 

Together with the person, talk about:

  

Who they will live with, taking account of whether anyone else in the family relies on their support.

 

How they can be active and independent at home – such as doing household tasks, making decisions, planning activities. 

 

Any adjustments that might help them stay in their current home – such as support phone line, telehealth monitoring, and home adaptations. 

If a move is being considered, keep the person fully involved in any decisions and include an advocate or a family member. Once a move has been agreed, start planning it straightaway with the person and those supporting them. This might include visiting their new home, as well as talking about how to keep in touch with those currently supporting them and how to find new sources of support.


This content has been co-produced by NICE and SCIE and is based on NICE’s guideline on Care and support of people growing older with learning disabilities.

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