Developing a decision aid for older people who pay for social care

Making informed decisions about social care in later life can be challenging and emotional, particularly for self-funders who organise and pay for care, often with little or no statutory support. Decision aids can guide complex decision making by bringing together information and associated risks and benefits. This project aimed to create such a resource to support self-funders in navigating social care planning and funding. A prototype decision aid, Care Confidence, was co-designed with involvement of self-funders, carers and professionals, including care providers, information and advice services, later life advisers and others whom self-funders approach for information. The methods, adapted from design of patient decision aids in clinical settings, involved scoping and consultation, development workshops, and iterative testing and modification. This paper discusses the application of these methods in relation to the striking complexities of decision making in social care, particularly for self-funders. The resulting digital decision aid provides information on care options and funding strategies, as well as generating a user-centred action plan that empowers self-funders and their supporters to make confident, informed decisions about care. The development of this unique decision aid contributes to improving the evidence-informed support available to self-funders in England. In relation to accessibility, Care Confidence would benefit from further research to address language and digital exclusion of self-funders and scope to implement the resource in adult social care and third sector providers.