‘What is really important to me?’
This question is central to integrated assessment and goal setting. Taking time to understand the individual, including their history, beliefs and circumstances, will help to answer this question and,equally importantly, it will help to understand the personal context and meaning of the answer. This question should be revisited regularly throughout the individual’s journey of frailty because evidence shows that a person’s answer may change along the way, as their condition progresses or their personal priorities change.
‘What would I like to be able to do?’
Sometimes the answer to the question “what is really important to me” may translate directly into potential supported self-care goals. However, in other cases it may help to understand how to support the things that are most important to the person by asking the question “What would I like to be able to do?”
There are different types of goals. In the case of older people with frailty this may be a maintenance goal (“what would I like to be able to keep doing?”) or a recovery goal (“what would I like to be able to get back to doing?”) or a new goal (“I would like to do something new”). Furthermore, goals can be set in different areas of a person’s life, across any of the domains of frailty. Example goals include:
- Being able to wash and dress independently;
- Being able to get in and out of bed independently;
- Being able to make own dinner;
- Being able to join a local support group;
- Being able to meet up with family and friends;
- Being able to go to the park, and walk the dog;
- Being able to get back home;
- Being able to talk to someone “about how I feel”;
- Not being so lonely;
- Being able to learn more “about my Alzheimer’s”;
- Being able to eat a healthier diet;
- Being able to do more exercise.
‘What is helping me and what is getting in the way?’
Goal setting needs to be realistic and action orientated. Supporting the individual to think about “What is helping me and what is getting in the way?” and considering all the domains of frailty is an approach to generating opportunities for change
It helps to develop a shared understanding of a person’s sources of resilience and vulnerabilities, and the achievability of the goal. Setting appropriate and manageable goals can make a positive contribution to an individual’s motivation; therefore it may be necessary to encourage the individual to reconsider their goal if it seems unrealistic, or to extend it if it seems under ambitious.