10 Principles of Care

This text offers an introduction to the many questions we now face about the future of care and its relationship with public services in the UK. It presents no solutions, but may provoke action to address these challenges.

All carers are designers.

They inhabit the margins of society, facing unique and often overwhelming obstacles, and developing their own ways to meet these challenges.

Every day, a single carer may perform hundreds of interventions that make a real difference in the lives of the person they care for. These interventions can be very small - making cups of tea, checking that the person is comfortable, offering a hand to hold or a friendly ear.

The interventions can also be very large - helping someone eat, get dressed, or make decisions about their future.

Each of these interventions is a ‘design decision’ based on their expert knowledge of the person they care for, their needs and wishes, and the resources available to them.

Dieter Rams famously developed the following 10 principles of ‘good design’.

1. Good design is innovative.
2. Good design makes a product useful.
3. Good design is aesthetic.
4. Good design makes a product understandable.
5. Good design is unobtrustive.
6. Good design is honest.
7. Good design is long-lasting.
8. Good design is thorough down to the last detail.
9. Good design is environmentally friendly.
10. Good design is as little design as possible.

Do these same principles apply to carers?

1. Good care is innovative.

Every carer responds to the specific needs of the person they look after. There is no simple template to follow: each person’s requirements are different.

Although carers can share stories and experiences, they each have to deal with unique circumstances. There is no defined ‘pathway’ for carers.

One way to help carers is to empower them to make informed decisions about the care they provide.

2. Good care makes a person (more) useful.

For carers and the people they care for, there is nothing more dispiriting than the feeling that they are no longer productive and useful members of society.

Carers often feel marginalised, their work unrecognised - but they perform an essential role in filling the gaps in health and social care services. They are useful not just to the people they care for, but to everyone.

It is vital that we all recognise and celebrate the value of the work that carers do every day.

3. Good care is beautiful.

Here, ‘beautiful’ seems more appropriate than ‘aesthetic’, which has meanings that are perhaps not relevant to this piece.

Providing care to someone who is sick or infirm goes to the very heart of what it means to be human. To help another person live and die with dignity is an inherently beautiful act.

4. Good care makes a person (more) understandable.

Carers are uniquely placed to act as the voices for people who cannot speak for themselves. They can help everyone - doctors, nurses, social workers, and the local community - to see the human being behind the condition.

5. Good care is unobtrusive, until it has to be.

Carers help people live the lives they want to live. Often, however they need to make difficult decisions which have a significant impact on the lives of the people they look after. To avoid these decisions may cause greater harm. It is a delicate balancing act.

6. Good care is honest.

Carers must be honest with themselves about their own limits. They must look after their own needs and seek out help when they require it.

7. Good care is long-lasting?

Being a carer is often a full-time job. Many carers provide over 90 hours of unpaid care each week.

As life expectancy increases, and the success rates for medical interventions improve, people may be carers for many years, even decades. Their role as ‘carer’ may overwhelm their own identities. Is this a sustainable state of affairs? Do we expect carers to deal with too much for too long?

8. Good care is thorough down to the last detail.

Carers help ensure that nothing is left to chance.

Their in-depth knowledge can help the people they look after get the right level of support tailored to their specific needs, taking into account all the relevant information that could be lost without carers to guard against this.

9. Good care is community friendly.

Carers make a vital contribution to the preservation of local communities, friendships, and family relationships. It is difficult to quantify the value of this, but it cannot be taken for granted. We all rely on carers.

10. Good care is as little care as possible.

Perhaps this answers the questions posed for #7. Carers often make great sacrifices to ensure they can support their loved ones. They may give up work, lose touch with friends, and neglect their own needs to focus on helping others.

We must help carers to live their own lives, achieve their goals, and to keep their identities beyond their roles as carers.