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In our last blog we talked about starting the conversation about care. We understand that these conversations can be difficult, and emotions need to be recognised. While it is not possible to separate emotion from the practicalities, being prepared with knowledge of what care options are available can help to focus the conversation.
Carers have told us that having conversations about care helps them understand that while for some the ideal scenario would perhaps be to stay together at home, they recognise that a time may come when a care home is needed.
Sometimes people living with dementia might be in denial about their condition and not recognise that they will need care at some point. Others may feel that, by remaining at home, they would become a burden to their family. Carers, despite being worn down, often feel a sense of guilt when discussing care options but being a carer for a person living with dementia is hard and these feelings are totally normal.
Any decision around care must consider what is best both for the person living with dementia and also for the carer. Acknowledging that sometimes employing carers or moving to a care home is the right option allows the family to continue the conversation, discuss why the decision was made and adapt to a new way of life where they can still experience good times together.
When we speak about care it does not automatically mean moving from independence into a care home. In some cases, perhaps after a fall or illness requiring hospitalisation, moving straight to a care home is the right step. However, for some people, care can be introduced gradually as symptoms progress, this might be to support independence if they are unable to manage daily tasks alone or to maintain safety.
Types of Care Services for a Person Living with Dementia
There are various types of care options available and who requires what will depend on their individual circumstances. Researching and understanding the different options is important before having a conversation around care. This blog will identify some of the stages of care and services available, but remember, a Wayfinder at Sage House is always available to discuss these options in greater depth to support you to decide what is best for you and your situation. The Wayfinders are also able to offer guidance around care funding available. Some people may meet the criteria for local authority support, some may qualify for NHS funded nursing care whilst others will need to self-fund their care. Attendance allowance is a non-means tested benefit which many people living with dementia are entitled to and which can be used towards care costs.
First Steps
Many people living with dementia are able to remain at home independently for a significant length of time post-diagnosis. Sometimes just a small amount of support can enable a person to remain at home for a greater length of time. Equally, if the carer has access to additional support, then they can be able to continue caring for their loved one at home for longer. Some of the care options at this initial stage could be:
A cleaner
A gardener
Support with bills and administrative jobs through a personal assistant
A food delivery service
Meals on wheels
Support for Social Isolation
For people living alone it is really important to prevent social isolation as this can negatively impact cognitive symptoms. Some options to reduce this are through:
Sage House - activities, Chatter Tables, Wayfinders, support groups
Local volunteer community groups
Befriending organisations
Day centres
Employing a companion carer through a care agency
Domiciliary Care
This can be sourced privately or through a care agency, which may be preferable in terms of legalities, insurance and cover if a carer is sick or on annual leave. A care plan is drawn up to meet the needs of the individual which could mean a few visits a week or daily care calls. The calls could be once, twice or multiple times a day, ranging from a 15-minute medication call, an hour’s personal care with a shower or a call of a few hours for companionship. A carer can support with many things including:
Meal preparation
Medication
Personal care including washing, dressing and assistance toileting
Companion care calls
Live-in Care
Sometimes if a person has a high level of need with daily living tasks and needs supervision for safety but does not want to move to a residential home then a live in carer may be suitable. The person would need to have a spare bedroom and suitable facilities as well as finance available as it is less likely to be funded by adult social care.
Respite Care
This option allows the person living with dementia to experience life in a residential setting or care home for a short period whilst their partner has a much needed break from caring duties. Sometimes this is a good stepping stone before a move to permanent residential or nursing care and can identify the type of home that will best meet the person’s needs.
Residential or Nursing Care
If care needs become too difficult to manage at home, then a residential or nursing care home may be a suitable option. Always ensure that the home is registered for dementia care. Some homes may also have specialist secure dementia units which can manage additional needs associated with advanced dementia.
The main difference between the two is that a nursing home will always have a qualified nurse on-site to provide a higher level of medical care. It is important to consider that while there may be no nursing needs at the point of moving to a care home this may be required further down the line. This potentially might mean a move to an alternative care home and changes to the environment can be detrimental for people living with dementia. Some homes are residential but have a nursing wing or floor which means a person may need to move rooms but would still be in the same home which can be a significant advantage. At the end of the day, it is important to find somewhere which can meet your needs and which feels right for you and the person you care for.
Speak to a Wayfinder at Sage House for further support around care options as well as guidance around funding for care, accessing local authority support and how financial assessments are undertaken. Call 01243 888691 or email info@dementiasupport.org.uk