Maslow’s five-tier model can be applied to any stage of life, including later life. In this framework, Maslow describes that while we all have a constant range of needs, our physiological and safety needs prevail over those for love, self-esteem, and then self-actualisation – in that order. As such, we ensure that these physical and safety needs are met first and foremost, before moving on to enhance wellbeing by addressing one’s sense of attachment and belonging.
Meeting the needs of someone in their older years can require a very specialised approach. The risk with older adults, especially those who live with conditions such as dementia, is that only the lower levels of their needs are met, as the further up the tiers you go, the more the level of skill required to satisfy the individual’s needs increases.
This is where Plan with Care can help families, friends, solicitors – and, most importantly, the individuals themselves. Maslow’s model reflects the way we work and, specifically, our ‘three E’ approach – ensure, enhance, exceed.
First, we ensure the right care is in place to meet physiological and safety needs. Then, we enhance quality of life by looking after social and emotional wellbeing to promote love and belonging and bolster esteem. And, finally, we use creative approaches to exceed expectations where we can, pushing into the self-actualisation tier. This combined and progressive approach leads to us achieving outcomes never thought possible, and a more enjoyable life – not only for the older people themselves but for the people who care for them.
Beyond this, the hierarchy not only helps us meet the current needs of an individual, but also helps us predict what those needs might be in the future. Just because one stage of the model has been fulfilled in a certain moment, doesn’t mean that it won’t need to be revisited at another point in time as needs change, so we move freely between the stages to always ensure the very best quality of tailored care for each individual.
Let’s delve a little deeper into the different tiers of the model...
Physiological and safety needs
Needs at the lower end of the pyramid revolve primarily around having a safe place to live with sufficient food, water and clothes. Family and professional carers usually provide the majority of the support needed here, depending on where the person is living. While these needs may seem basic, meeting them is not always as simple as it sounds. For example, a person with dementia may be distressed at having support with personal hygiene, but be at risk of serious conditions such as skin infections if they go too long without being clean and dry. This is a common challenge in dementia care, with best practice offering a range of interventions that involve improving the bathroom environment (making it less threatening, more homely, removing hoists and/or introducing favourite music and aromatherapy), changing the materials and methods used for washing, ensuring the right time of day and person, alongside an in-depth analysis of distress triggers for risk reduction. So we often provide oversight, and bring in specialists where needed to ensure that these needs are fulfilled to the optimum level to provide a solid foundation for us to then build upon in order to enhance quality of life. This can involve us ensuring the correct level of care is in place and facilitating services that may be necessary, such as mobility solutions at home, nutritionists, aphasia specialists and so on. Once we are happy that everything is in place that should be, we move up to the next tier.
Love and belonging needs
Once our Care and Wellbeing Consultant is satisfied that physiological and safety needs are being well met, we can then move on to enhancing quality of life and bringing in a bit of sparkle. It’s all very well making sure someone is up, washed and dressed. But what are they up, washed and dressed for? What has that person got to look forward to in their day?
We do this in a range of ways, all tailored to the individual. We work with families to help them understand how they can keep a meaningful connection with their loved ones even when dealing with dementia or other conditions. For example, we show them strategies for meaningful engagement and communication such as word, sound, touch, pictorial and object cues. You can read more about one example of touch in our blog ‘The Power of Touch’. Once we’ve found out what makes the individual feel a sense of love and belonging, we look at how it can be implemented in daily routines to enhance wellbeing as a whole, and therefore quality of life.
Esteem needs
From here, we look at solutions that can build on self-esteem, giving the individual a feeling of self, status, and that they can still contribute to life. A creative companion can be the perfect solution here – a dedicated person to spend time with the older person, really drilling down into what makes them happy and fulfilled, what gives them a sense of achievement and validation. This could include reminiscing about the past and what they achieved in their younger years, but we also look to enable new achievements and experiences. Our approach could start with simply talking, looking at old photos, having a walk around the garden or listening to music. It could lead to planting flowers or playing a few notes on a piano. Or, where circumstances allow, it could progress to trips out to a garden centre, outings to musical concerts, or even the person giving a small piano recital themself. The key thing here is that it’s personalised and each person is treated as the individual they are.
Self-actualisation needs
By fulfilling the esteem section of the pyramid, we then have the opportunity to push even further up to the self-actualisation tier. We all know that not every day is going to be the best day ever, but it’s crucial that we experience stand-out moments that help define who we are, and give us joy, purpose and drive to carry on through the day-to-day. The activities that do this for our clients will depend on their passions and interests (and how they can be adapted to meet frailty levels), but we have gone as far as enabling clients to star in their own movie (with dementia specialist actors), which created amazing moments for all concerned!
We’d like to raise an important final point: people can be hesitant to engage services that provide the extra care that fulfils the upper tiers of Maslow’s Pyramid, and this is often due to finances. But, in fact, 90% of spend goes into the care at the bottom of the pyramid – for the physiological and safety needs. The rest can be achieved by adding in that little bit extra. Obviously, everyone wants older people to flourish and be cared for in the best way possible – whether they are family, friends or people you are responsible for as a care home manager or solicitor. But time, resources and skills are often in short supply, which leaves you with a feeling of frustration and overwhelm. Family members often have children, partners and jobs they also need to give their care and attention to (let alone themselves!), and solicitors must find the balance between fulfilling their duty to spend their client’s money in their best interests, yet be mindful not to spend too much. This is where we want to help – to help take the pressure off you by ensuring, enhancing and exceeding the type of care you never thought possible.
Get in touch with us today if you’d like to know more about how we can support you, your loved ones or the people you are responsible for.