“Care for the Wise” – a missional entrepreneurship project idea

by a CMS diploma student

Introduction

I attended the “Make Good” module in the second year of my Diploma in Theology, Ministry and Mission on the CMS Pioneer undergraduate programme. The module is an introduction to social and missional enterprise and its relevance in mission. It’s a residential week that enables you, with the guidance of experienced practitioners, to take an idea from conception to the initial stages of a business plan.

Society tries to anaesthetise against the many problems that exist. In her book Who Do We Choose to Be?,¹ Margaret Wheatley states that we need to acknowledge the pain and suffering in the world, the disparities in wealth, status and quality of life, and be prepared to serve. However, we can often feel paralysed when we stop to look at these things, and feel we are unable to make a difference. This module, in fact this whole programme, not only gives us permission to dream, but equips us to “do”. We have the creative ability and innovative ideas to solve most problems, but moving from passion to action is something we often find hard. The following is a presentation of a project that I think can solve a very real problem.

My project is called “Care of the Wise” and seeks to provide holistic care to older people in their own homes. The vision, however, is much greater than just providing a care service and is summarised in the following mission statement: Transforming the way we view and support older people, their families and the caring profession in the UK.

What is the problem I want to solve?

Two years ago, I started work as a chaplain in a large retirement community and care home that has a reputation as a leader in care. Despite this, I have been shocked at the poor quality of life experienced by residents. Their bodily needs are met but little attention is given to their mental and spiritual wellbeing. It is also evident that the training for staff who care for those living with dementia focuses on reacting to difficulties rather than the wellbeing of the residents. Through my work I have found it possible to tap into the spiritual side of those with advanced dementia and see the beauty within. I believe that deep wisdom resides in these people that can be accessed through holistic care.

In addition, I have seen the inequalities present in the working conditions of care staff in care homes. Members of the executive team earn large salaries and work office hours whereas the care staff work long shifts at antisocial hours, many of them earning less than the “real living wage”.² There appears to be few prospects for career progression, and it is recognised that professional carers suffer from a lack of status and recognition.³

It is widely and regularly reported that there is a crisis in social care provision in the UK. The situation is likely to deteriorate even further as the number of over-85s is predicted to treble in the next 30 years.⁴

There is also an overall lack of practical and emotional support for families and unpaid carers in the UK; it has been reported that unpaid carers are some of the most isolated and loneliest people in Britain.⁵

Those who work in the caring profession are among the lowest paid, many not even receiving the “real living wage”, with poor employment conditions and few prospects for career progression. Care professionals generally suffer from a lack of status and recognition in this country.

In contrast to many African and Asian communities, Western society has come to see older people as a “problem” rather than an “asset”. Our solution to the “problem” seems to be to hand older people over to residential care homes, where they are separated from their families, communities and younger generations, and become “unseen” by much of the population. I think our society as a whole is poorer for losing the voice of our older people (the wise) in our communities.

My response

My idea is to set up an innovative care-at-home business that not only approaches the care of the older person in a holistic way – body, mind and spirit – but also provides support to all those intimately connected to the older person – their families, friends and care professionals. When thinking about the idea, I was struck by the “three-ness” of the holistic idea; it reminded me of the Trinity and I sketched the following diagrams based on the Celtic symbol of the Trinity:

The aim of the service would be to enable the older person to stay in their own home for as long as possible, to the benefit of all (the older person, their family and carers, their community and wider society), but then to ease the transition to a care home if necessary.

The care-at-home service would have the following innovative features:

• Bespoke solution for each individual and their family.
• Care to be provided by professionals specially selected and trained in an innovative approach to dementia care, the “Understanding Dementia” approach,⁶ as well as pastoral and spiritual care.
• Training to be provided to the family/unpaid carers.
• Practical, emotional and spiritual support for the family – providing respite, advice, signposting to support and community networks.
• The older elderly person and their family would be encouraged to participate in and contribute to all-age community events.
• Professional carers to receive fair pay and employment contracts, equal pay for all employees (carers and managers), high quality specialised and ongoing training, opportunities for career progression.

What will success look like for my project?

How often do we really ask this question? And what is “success” anyway? In capitalist terms success is often measured as profit; in church terms it’s often “bums on seats”. However, there are other ways to think about success. If I set up a community café to address loneliness, how would I know if it was successful? Would it be people smiling, laughing, chatting together and coming back? When we really think about the goals of our project, we can easily start to think about what success might look like.

To know what success looks like, we must first ask what impact we want to make.

My project seeks to impact on four sets of people:

Firstly, the older person themselves. I would seek to see a greater wellbeing in body, mind and spirit – less stress, calmer, happier, improved mental and spiritual health. For them to experience improved relationships with family and community, and consequentially an improved quality of life. That they would be encouraged to recognise and exercise their gifts.

And in terms of care that they would be to stay at home for longer, and have a less stressful transition to care home (if that becomes necessary).

The second set is their families/unpaid carers. It would be my intention for this group to feel supported through training and practical help; to experience improved relationship with their loved one, and, with help, find “the beauty within”; in their position of “unpaid carer” that they would have improved mental and spiritual health, less anxiety and stress, and have an improved quality of life through connecting with their friends and community, expanding social life.

Thirdly, the professional carers. This group would undergo a rigorous selection process to find those with a strong vocation and commitment to the project’s mission statement. They would experience a high employee satisfaction and feel that they are contributing to the transformation of the care sector. This would, in part, achieved by improved pay and employment conditions, ongoing specialist training in understanding dementia and pastoral and spiritual care, as well as active and ongoing professional development and support.

The project would also aim to impact the wider sector, and society in general. Older people will be more visible in their communities: a growing awareness of the wisdom held by our older people, as well as interest from others wanting to replicate the business model.

This would also include an aim to be active in appealing to local and government to make change to policy to improve the care of older people, the support of their families, and raise the status of those in the caring professions.

How will I measure my impact?

In their book Measuring and Improving Social Impacts, Marc Epstein and Kristi Yuthas stress the importance of measuring impact, not only to provide proof for stakeholders, but also to confirm the beliefs of those running the project that it is making a positive difference.⁷ They describe three approaches to monitoring and evaluation of effective organisations: “While formative evaluation is recommended for improving an approach, and summative evaluation for validating it, developmental evaluation is used for creating innovative approaches to social problems.”⁸ This makes it an ideal approach for my project that seeks to create a new service but wishes to refine the approach as strengths and weaknesses are uncovered.

From the outset, it will be made clear to everyone involved that this project is a prototype for a new model of caring for older people, and that development evaluation will be necessary throughout.

A preliminary review of research on evaluating the effectiveness of similar projects appears to indicate that the most common type of evaluation tools are questionnaires and semi-structured interviews of the various parties involved, both before and at regular intervals (3–6 months) throughout the evaluation period.⁹ My proposal involves deeper thought into what it means to flourish as the older person, the family member and the caring professional, in addition to thinking about the impact the project might have on the sector and society in general.

Who will I collaborate with?

One of the things we learned on the Make Good module is it is better to collaborate than not. There are a few reasons why this is a good idea, most of which are about sharing. There are often many like-minded projects, or at least projects in the same arena, in this case “care of older people”, who share very similar goals and objective, and invariably seek the same impact. Through collaborating with these organisations, we can share resources, people and knowledge, which inevitably leads to more innovation, efficient processes, increased success and improved communication.

For this project my main partner for this project will be Shirley Pearce of the Understanding Dementia charity. Shirley has developed an innovative training method for professional carers and families of people living with dementia that focuses on the person’s feelings and wellbeing. Trainees report improved client outcomes, reduced behavioural issues and increased job satisfaction.¹⁰

As this project is a prototype for transforming the way we care for older people, it is important that links with several research institutions are fostered before the project begins (e.g. UK Dementia Research Institute, Dementia UK, Australian National Ageing Research Institute).

Is my project mission or enterprise, or can it be both?

Mission, according to Christopher Wright in The Mission of God, may be defined as follows: “Fundamentally, our mission (if it is biblically informed and validated) means our committed participation as God’s people, at God’s invitation and command, in God’s own mission within the history of God’s world for the redemption of God’s creation.”¹¹

So, what is God’s mission? God’s mission is often summarised in the key biblical commands that are called the Creation Mandate, the Great Commandment, the Holistic Commitment and the Great Commission.¹² Johnson argues that these four commands relate our mission as God’s people to our everyday working lives as follows:

1. The Creation/Stewardship mandate (Gen 1:28–30; 2:5, 15, 19–20). In the beginning God made humans to work and care for all creation in partnership with him. Work is therefore a form and vehicle of mission.
2. The Great Commandment (Matt 22:37–40). “God mandated, allowed and privileged us to love our neighbours through our work by providing the products, services, encouragement and support they need to live life, even abundant life.”¹³
3. The Holistic Commitment (Matt. 25:31–46). “Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me” (v. 40b). Jesus is calling us to “love people holistically in their real needs”.¹⁴
4. The Great Commission (Matt. 28:18–20; Acts 1:8; Luke 24:47–48; John 15:26–27). We are called “to minister holistically to hurting people in the name and love of Jesus, bringing them the gospel by word and deed”.¹⁵

Johnson argues that in today’s world where the marketplace affects virtually every person in the world, mission initiatives that are carried out through the business sphere perhaps have “the highest potential for effecting sustainable, transformational, holistic kingdom impact to a hurting world”.¹⁶

Business by its very nature relies on enterprise. “Enterprise is the mainspring of business”¹⁷ according to Richard Higginson in his book Faith, Hope & the Global Economy. He goes on to say that “The global economy never stands still… it is by undertaking new ventures, trying out new products, services and processes, and refining what currently exists in search of something better, that progress is made”.¹⁸

Firstly, my project seeks to transform the way our society sees older people – from a “problem” to seeing them with “new eyes” as valuable assets to society.

Secondly, my project seeks to challenge the notion that older people need to be sent to residential care homes at the first sign of dementia or physical frailty. In general, it has been shown that the wellbeing of older people is much greater if they can stay in their own homes for as long as possible.¹⁹

Thirdly, my project will “attempt to re-imagine the practice of business”²⁰ by challenging the concept that financial reward is the only incentive for good performance and that managerial roles should attract higher status and pay. It is the intention that all employees and owners of the business will be paid the same hourly rate, whatever their role, so that vocation and service are prioritised over financial performance as the main drivers of the business.

Fourthly, “Care for the Wise” seeks to be a true platform for holistic mission in line with other businesses run by “Business as Mission” (BAM) entrepreneurs, as described by the Lausanne Committee.²¹

Johnson describes holistic mission as “showing the love of Jesus to people in need by ministering to each of them as a whole human being and trying to address all of their needs and pain”.²² This means meeting their “spiritual needs for eternal wellbeing… their emotional need for inner well-being… their physical needs for outer well-being”. My project aims to not only provide holistic care to older people but also their families and their professional carers so that everyone is involved in building and receiving from a “Kingdom” community.

Finally, “Care of the Wise” seeks to contribute to the advancement of God’s kingdom in each of the following main areas identified by Higginson and Robertshaw in A Voice to be Heard:²³

1. Making the World a Better Place: by improving the quality of life for older people, their families and carers in the UK.
2. Embodying Christian Values: by modelling an equitable way of doing business where the contributions of every employee are equally valued.
3. Witnessing by Word: by demonstrating the importance of spiritual care.
4. Charitable Giving: by putting any profits back into the business to fund research and training for the benefit of society at large.

To conclude, in an ANVIL article, Shannon Hopkins writes: “At the root of missional entrepreneurship is the belief that another world is possible. In the Lord’s prayer, when Jesus prays ‘Thy kingdom come, on earth as it is in heaven,’ (Matt. 6:10) Jesus is not referencing the afterlife but is offering a vision of the transformation of the earth.”²⁴

“Care of the Wise” is an attempt to bring transformation, not only the way we care for older people, but how society sees their intrinsic value as our “wise ones”.

More from this issue

Notes

1. Margaret J. Wheatley, Who Do We Choose to Be? Facing Reality, Claiming Leadership, Restoring Sanity (Oakland, CA: Berrett-Koehler, 2023). ↩︎
2. “What is the real Living Wage?” Living Wage Foundation, https://www.livingwage.org.uk/what-real-living-wage . ↩︎
3. “Adult Social Care: Ninth Report of Session 2016–17,” House of Commons Communities and Local Government Committee (House of Commons, 27 March 2017), 37, https://publications.parliament.uk/pa/cm201617/cmselect/cmcomloc/1103/1103.pdf, accessed 30 January 2022. ↩︎
4. “Challenges of an Ageing Population – Age UK report,” Age UK, 22 April 2013, https://www.ageuk.org.uk/latest-press/archive/vision-and-imagination-critical-to-meet-challenges-of-ageing-population/, accessed 30 January 2022. ↩︎
5. Carers UK, “Alarming Numbers of People Feel Isolated and Lonely as a Result of Caring for their Loved Ones – Carers UK,” Carersuk.Org, 2015, https://www.carersuk.org/news-and-campaigns/press-release-rss/4702-alarming-numbers-of-people-feel-isolated-and-lonely-as-a-result-of-caring-for-their-loved-ones, accessed 30 January 2022 (no longer available). ↩︎
6. Shirley Pearce, “About Understanding Dementia,” Understanding Dementia, July 2021, https://understandingdementia.co.uk/credits/, accessed 30 January 2022. ↩︎
7. Marc J. Epstein and Kristi Yuthas, Measuring and Improving Social Impacts: A Guide for Nonprofits, Companies and Impact Investors (Abingdon: Taylor and Francis, 2017), https://www.perlego.com/book/1548574/measuring-and-improving-social-impacts-pdf, ch. 7, accessed 30 January 2022. ↩︎
8. Ibid., ch. 7. ↩︎
9. Rhonda Riachi, “Person-centred communication in dementia care: a qualitative study of the use of the SPECAL® method by care workers in the UK,” Journal of Social Work Practice 32, no. 3 (2018), 303–21. ↩︎
10. Shirley Pearce, “Turning a crisis into an opportunity: taking dementia training online,” The Journal of Dementia Care, 31, no. 6 (2023), 23–24. ↩︎
11. Christopher J. H. Wright, The Mission of God: Unlocking The Bible’s Grand Narrative (IVP, 2020), Introduction, https://www.perlego.com/book/1470298/the-mission-of-god-pdf, accessed 30 January 2022. ↩︎
12. Richard Higginson, “Mission and Entrepreneurship,” ANVIL 33, no.1 (2017), 17, https://churchmissionsociety.org/wp-content/uploads/2022/05/Church-Mission-Society-Anvil-Volume-33-Issue-1-Apr-2017.pdf; C. Neal Johnson, Business as Mission: A Comprehensive Guide to Theory and Practice (Downers Grove, IL: IVP Academic, 2011), 155. ↩︎
13. Johnson, Business as Mission, 155. ↩︎
14. Ibid.; NRSV. ↩︎
15. Ibid., 156. ↩︎
16. Ibid., 22. ↩︎
17. Richard Higginson, Faith, Hope & the Global Economy (IVP, 2012), ch. 1, https://www.perlego.com/book/1470677/faith-hope-the-global-economy-pdf, accessed 30 January 2022. ↩︎
18. Ibid. ↩︎
19. Briony Dow and Anita Goh, “PITCH Perfect for Home Care Workers,” Australian Journal Of Dementia Care 8, no. 4 (2019), 12–13, https://www.anandaagedcare.com.au/wp-content/uploads/2019/08/Issue-44-Aug-Sep-2019-1.pdf, accessed 30 January 2022. ↩︎
20. Mark Sampson, “The Promise (and Peril) of Missional Entrepreneurship,” ANVIL 33, no. 1 (2017), 5, https://churchmissionsociety.org/wp-content/uploads/2022/05/Church-Mission-Society-Anvil-Volume-33-Issue-1-Apr-2017.pdf . ↩︎
21. Mats Tunehag, Wayne McGee and Josie Plummer, “Business As Mission: Lausanne Occasional Paper No. 59,” in 2004 Forum For World Evangelization (Lausanne Committee for World Evangelization, 2004), pt. 1, sect. 1, https://www.lausanne.org/wp-content/uploads/2007/06/LOP59_IG30.pdf, accessed 30 January 2022. ↩︎
22. Johnson, Business as Mission, 41–42. ↩︎
23. Richard Higginson and Kina Robertshaw, A Voice to Be Heard (IVP, 2017), ch. 6, https://www.perlego.com/book/1470412/a-voice-to-be-heard-pdf, accessed 30 January 2022. ↩︎
24. Shannon Hopkins, “Experimenting at the Crossroads of Business, Church and Culture,” ANVIL 33, no. 1 (2017), 14, https://churchmissionsociety.org/wp-content/uploads/2022/05/Church-Mission-Society-Anvil-Volume-33-Issue-1-Apr-2017.pdf. ↩︎