Care in your own home: do you know about the range of options available?

Julie Wainwright

By Julie Wainwright, manager of Midland care and support advice service

We speak to hundreds of people every month who are looking for help and advice on care options. One of the major themes we have seen recently is this: people contact us because they are worried an elderly relative isn’t managing in their own home. They ask us about care homes because they recognise their relative isn’t coping and things may need to change. There is also, commonly, strong emotions about the idea of a move into a care home: guilt, worries about how the relative might adjust, concerns about how it would be funded. We often say: have you thought about a package of care in your relative’s own home? It is notable that often the answer to this question is – no.

Why is this? Most people know someone who has moved into a care home, or are aware of a care home which is near to their home. The agencies who provide packages of care for people living in their own home are lower profile and lesser known. It follows that there is also less awareness of what packages of care in your own home can be. For example, in many cases, it now costs slightly less to have live-in care in your own home than equivalent weekly fees in a nursing home. Live-in care involves having a carer living in your own home to provide 24-hour care and support, seven days a week. Often, two carers share responsibilities and between them, offer 24/7 support. Live-in care can be a very good option if a couple wants to continue living together but one person needs high levels of nursing care. Having the support of professional carers allows family members to focus on their relationships, while nursing and personal care tasks are fulfilled by professional carers. Live-in care is also an option people are turning to if they live in rural areas and want to stay in their own home: it can be very difficult to find carers willing and able to travel long distances to provide parts of a package of care at home. Having live-in care can be a solution to the challenge of organising care in remote areas with long travel times.

Sometimes, when people ask about care homes, they are really concerned about something else. For example, we often speak to people who are worried about an elderly parent living alone. They tell us: we both work full-time and we try our best to visit Mum or Dad, but they are lonely and spend too much time alone. Many people are not aware of all the different options available. Care agencies can take elderly people out to go shopping, take them to participate in clubs and activities and provide companionship, such as visiting and supporting them to play board games or undertake a craft. Care services offer much beyond meals, washing and dressing.

We can advise you on funding for care in your own home, explain the rules and regulations and how to organise a care needs assessment. If you are self-funding (paying for your own care), although this will have financial implications, it does mean you will have a wide choice of services. We can help by identifying what is available in your area and organising a package of care for you if you wish. Our advice and support is completely free to the families and individuals using our service and we have been helping people choose and arrange care for more than 20 years.

Should you consider live-in care? What are the advantages and disadvantages?

One care option which has been growing rapidly in recent years is live-in care. This involves the carer (or a team of two) living in your home to provide support on a 24- hour basis, seven days a week. The major advantage of live-in care is of course enabling the individual to continue to live in their own home with support at all times. Home life is maintained as far as possible: pets can be kept, for example and helping to look after pets can be part of the support provided by live-in carers.

Live-in care may be a particularly good option if an elderly couple need full-time care and support. The costs of live-in care are likely to be comparable or even a little less than the fees of two people moving into a care home. Live-in care is also being increasingly considered in rural areas: if carers have to travel long distances to reach people, it is difficult to find people for these roles. To drive 20 or 30 miles for a session of one hour or less with an individual is sometimes not viable, whereas with live-in care, carers will be prepared to travel much longer distances and thus the resource of potential carers becomes much larger.

Many live-in carers have specialist training in dementia, Parkinson’s, stroke and multiple sclerosis care and having live-in carers allows for great continuity and mutual understanding. There is often a benefit for the whole family as relatives are released from the demanding, time-consuming demands of day to day care and can focus on social and emotional support.

Of course, the success of a live-in care arrangement is highly dependent upon the relationship between the individual (or couple) and carer. It is important to carefully consider how you feel about the living arrangements and how well it will work to have a person who is not a family member permanently resident in the house. The needs of the carer must be carefully considered; they will be working but equally, while resident, your home will become their home. Some arrangements involve two carers rotating with each other to provide 24/7 support, others involve a main carer with others brought in to support and allow the main carer to have breaks.

Although the upheaval of moving from your own home into a care home is very significant, people often benefit from the social interaction and programme of activities available. Live-in care needs to consider and support the hobbies and activities the individual is engaged in and enable them to continue; it is important to guard against social isolation. An isolated individual supported by an isolated live-in carer is not likely to be a successful solution.

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