What is complex care?
Understanding complex care
There are many types of care available for older adults depending on their specific needs, and complex care is one that you may need to know more about if you are caring for an older loved one with additional needs. Here, we are taking a closer look at what this is, who it could benefit, how a complex care plan works, how long this type of care lasts, who administers it, and more. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about complex care, we can help.
What is complex care and who is it for?
Complex care is a form of person-centred care for anyone living with a chronic or long-term health condition who requires more help in order to manage their day-to-day symptoms and continue with daily activities. According to the National Institute for Health and Care Excellence, complex care needs may be a result of an illness, a disability, wider life circumstances or a combination of several of these elements, and these can be present from birth or develop later in a person’s life. Any condition that requires a combination of treatments and support could qualify as complex care, and these needs may also fluctuate over time or develop as a person gets older. Complex care needs could be something like:
- A neurological condition that requires nursing care, and/or speech and language therapy (such as epilepsy, a stroke, or dementia)
- Mental health issues that require help for severe symptoms like hallucinations, delusions or suicidal thoughts (such as bipolar disorder or schizophrenia)
- An injury that requires a long recovery, physiotherapy, and help at home
For some people this kind of intense care requires moving into a care home or nursing home, however you can receive this type of care at home if you wish to. You can learn more about this in our guide to the benefits of complex care at home.Severe mental illness, disabilities and intellectual disabilities are all linked with earlier onset of conditions associated with getting older, an increased risk of preventable secondary conditions, and premature mortality – for these reasons, it is important to ensure those with complex care needs receive the support they need to manage any conditions they have, keep them comfortable, and maintain their independence as much as possible. Complex care is different from other types of home care as it often involves some elements of medical or nursing care in order to keep the person healthy and comfortable.
What counts as complex needs?
Some examples of complex needs include:
- Oxygen therapy
- Chronic symptom management (such as constant pain)
- Vital signs monitoring
- Disability assistance (such as help with bathing, walking around the home, etc.)
- Rehabilitation after a life-changing injury
- Feeding tube management
- Catheter care
- Stoma care
- Ventilator care
- Diabetes monitoring
- Severe mental illness care
- Palliative care or end-of-life care
- Needs after major emergencies such as strokes
- Needs after major diagnoses such as organ failure or advanced cancer
These are only a few of the complex care needs someone might experience, but ultimately the aim of complex care (for any condition) is to help anyone dealing with symptoms and additional needs to find the best quality of life possible for them through personalised nursing and medical care. If you are planning to organise complex care for your loved one at home, you may find our guide useful: Complex Care Needs Suitable For Home Care
What is a complex care plan and how does it work?
For anyone receiving care at home, a Care Plan is required to lay out the details of what a person needs, how care will be administered, and who will administer this care. In the case of a complex care plan, this focuses on those with complex care needs and presents a specific, detailed breakdown of every health condition that the person has and what needs to happen in order to care for them.Research finds that those with complex care needs often find interactional issues with their care, where different elements of care that involve their loved ones, caregivers, healthcare professionals and more may lack consistency, clarification and appropriate support. For this reason, a clear and extensive complex care plan is needed to keep everyone involved on the same page. You may find more useful information on this in our guide: Complex Care Management & Care PlanningAccording to the NHS, a care and support plan should include the below elements, and a complex care plan will be similar while being personalised to the individual’s complex needs:
- The person’s diagnoses
- The recommended treatments from medical professionals
- The person’s specific wishes for their care
- How care will be administered
- When care will be administered
- Details of the medical professionals involved in their care
- What the person is able to achieve themselves
- Any home adaptations needed to make the home safe and comfortable (you may find more helpful information in our guide to home adaptations for disabled older people)
- What equipment may be needed to help care for them
- Considerations from family and friends
- Contact numbers for all medical professionals and carers involved in care
- How often respite care may be needed
You can find more information on Care Plans in our guide: All About The Care PlanThe complex care plan should indicate the amount of care that will be needed, which should determine whether an individual will require care workers to visit on a regular basis or whether live-in care will be needed to ensure the person’s safety and comfort at all times. You can find more information about live-in care in our guide: What Is Live-in Care?
How is a complex care plan developed?
Developing a complex Care Plan requires input from a number of people, so it may be slightly more difficult to create than other Care Plans. As with all care needs, the first step is often a Care Needs Assessment. This is to evaluate the person in their home and find out exactly what they need to feel safe and comfortable in their own space, and have all of their needs met effectively. When complex needs are involved, the regional medical professionals (GPs or nurses) in charge of the person’s care may provide input at this stage to ensure the assessment takes note of certain elements of their condition(s). From there, a complex Care Plan will be developed with further input from everyone who might be involved in care. As well as observing the person at home, the Care Needs Assessment will take into account things like their daily activities, health conditions, mobility needs, personal preferences and more. They will also speak to family members or caregivers, clarify what the medical recommendations are, and provide a rough overview of the next steps. The complex Care Plan will then be sent to the person and their caregivers or family members for their feedback. In the UK, the NHS and local councils prioritise person-centred care, so you and your loved one can be highly involved in the creation of their Care Plan. When you receive the Care Plan, there are usually contact details for the best person to get in touch with if you have questions or concerns about the Care Plan or care. If you do have any questions or feel changes need to be made, don’t be afraid to reach out to them to discuss this.
How long does complex care last?
Complex care can last for as long as it is needed, because the care will be bespoke to the person’s individual situation. For some, they may be returning home from hospital and need complex care while they heal from a surgery or injury, which could present a clearer pathway for recovery. For others, they could be battling a difficult chronic illness that does not have an exact end date. Also, some may have been living with a condition since birth, and therefore will require ongoing support. Whether a person needs a few weeks of home care visits to help with specific tasks, or they need 24/7 live-in care to help them manage their additional needs, there are options for everyone.If you are paying for complex care yourself, you may be keen to understand exactly how long this will last so you can budget for the future, however it can be difficult to gauge this. You may find more useful information in some of our other guides:
Who administers complex care?
Some elements of complex care will need to be administered by a trained nurse or a medical professional, but not all. Complex care is typically provided by a combination of specialist carers who can cover all of the individual needs of the person, alongside full-time carers who will assist with more general care, while coordinating other professionals visiting the home. Any care workers involved in complex care will need specialist training in the person’s specific health needs in order to effectively help them. For example, at Home Instead, our Care Professionals undergo specialist training to ensure they are equipped to help with the needs of the person they are caring for. We keep our team up to date on the latest care training, with workshops covering everything from general guidance on medication and manual handling, to safeguarding and basic life support, to specialist training in things like Parkinson’s, diabetes, catheter care, dementia care, and end-of-life care. Our matching service ensures all our clients are paired with the perfect Care Professional for them, who has undergone the specialist training needed to effectively look after the person in their care. If you are currently looking to put home complex care in place for a loved one, or are curious about the possibility of arranging live-in care, our award-winning home care at Home Instead could offer you the bespoke, person-centred care you need to complement the complex care you currently receive from medical professionals. Feel free to reach out to the Home Instead team to discuss your needs and allow us to create a personalised package to support you.