Care homes are no longer the default option for the elderly. In fact, while occupancy rates at nursing homes – which offer specialist care for those with more advanced needs – is remaining stable at around 90 percent, the number of people moving into residential homes is steadily decreasing. There appears to be a growing trend for elderly people who require lower levels of care to remain in their own home – a move which is being praised for helping to significantly improve quality of life.
Many elderly people do not wish to move into a care home, particularly if they live with a spouse, own their own home, or enjoy being a part of the local community. Many also worry about a loss of independence should they move into a residential or nursing home. While care homes can be very beneficial for those with greater needs, there are many advantages to remaining at home, including happiness and emotional wellbeing, and lower care costs There is also a wealth of research which suggests that mortality rates – especially for those with dementia – are actually higher in care homes.
For families considering care in the home for their elderly parents or relatives, it’s important to understand that there’s no one single definition of ‘home care’. It’s a very flexible term that’s used to describe a diverse range of services that all have the same ultimate goal: to enable elderly people to live safely and happily in their own homes, in spite of any health conditions that might make some everyday tasks more challenging. Here are just some of the services available through home care:
Personal Care – This includes providing assistance with washing, bathing, and dressing.
Daily Tasks – This includes providing assistance with shopping, paying bills, or writing letters.
Home Care – This includes providing assistance with food preparation, cooking, and cleaning.
Nursing Care – This includes providing assistance with healthcare, such as changing dressings.
Emotional Care – This includes providing companionship and reducing isolation.
Not only is home care flexible in terms of the services offered to the elderly, but also in terms of how these services are delivered. In the UK, we’re fortunate to have a huge choice in how we deliver care to the elderly at home, with varying options designed to meet individual needs and preferences. Here are some of the most common care options for the elderly who wish to remain in their home:
A common worry is that many elderly people may be accessing care, despite not wanting it, or actually needing it. As we age, a natural loss of bone mass and muscle density means that it can become difficult to move around – it can be painful, frustrating, or even impossible at times. A loss of mobility has many side effects. It can mean that the elderly cannot climb stairs to use the toilet, it can mean they are unable to stand for long periods to cook a meal, and so on. However, these people don’t necessarily require help with personal care, or with meal preparation. With the right support, many are able to complete these tasks independently, and will not need to access formal care.
Stairlifts, wheelchair ramps, bath hoists, and grab rails in the kitchen, bathroom, or bedroom can all provide assistance in the home for those that struggle to care for themselves adequately due to mobility or balance issues. They allow for independent living, while still providing a ‘safety blanket’, and giving elderly people the opportunity to live a ‘normal’ life. There are many different providers out there to consider, but remember to choose only high quality stairlifts and equipment – preferably those that meet the BS EN 81-40:2008 European Safety Standards, to give you total peace of mind.
Informal Home Care
If an elderly person requires a little more assistance than mobility aids can provide – or if they would benefit from regular companionship, you, your family, or your
friends may wish to provide informal care in the home. As an informal carer, you can provide whatever level of support and assistance your parent or relative requires and, of course, there are no fees or charges for this form of home care. It is believed that there are more than 3 million people in the UK currently providing some degree of home care for an elderly parent or relative in the UK – a very challenging, yet very rewarding role.
Being an informal carer for an elderly parent or relative is an unpaid job, but the good news is that the government recognises this form of home care as being a driving force towards keeping home care vacancies for those that need it most. Therefore, you may be entitled to financial assistance if you provide care in the home. Carer’s Credit is available for those providing more than 20 hours of care per week, and Carer’s Allowance is available for those providing more than 35 hours per week. This can help if you choose to take fewer hours at work, or opt to stop working completely.
Care Services & Nursing Services
Care services and nursing services are very similar to the help that would be provided by an informal carer. However, the support and assistance is undertaken by a professional carer. Some may be registered nurses, and be capable of providing higher levels of care including changing wound dressings, monitoring overall healthcare, and arranging for medical services as and when required. Contrary to popular belief, it’s not an ‘either/or’ situation when it comes to informal care and professional services. In fact, many informal carers choose to delegate personal care tasks to formal carers, as it’s usually a much more comfortable situation for the elderly person and their family.
Care services and nursing services in the home are usually provided in one of 3 ways – by a local authority home care service, by a private home care agency, or through a charity. There are advantages to all options. Local authority care may be more cost effective, but services may be limited based on the outcome of an assessment. Agency care offers more flexibility, but costs may be higher. Charity services are often temporary, providing respite care for informal carers. Respite may not be something that you’re interested in, but it can actually be very beneficial, and research shows there’s often a ‘significant improvement in functioning’ of the elderly after a little change of pace.
An alternative to home care and nursing care services is to hire a personal assistant who can provide support in the home and encourage the elderly to live happily and safely in their own surroundings. The advantage of a personal assistant is that the level of support provided will not be based on the results of a healthcare assessment or any other form of overview. Instead, you and your family can request specific services, including those not usually undertaken by the local authority or agencies, such as transport to appointments or companionship during a day out. Unlike with home care agencies, the elderly will be visited by the same carer each day, which can help build trust.
If this is something you and your family are interested in exploring, remember that it may not be the simplest, most straightforward option. With home care agencies, there is the advantage that the Care Quality Commission monitors service quality, and publishes reports – that the public are able to view – which detail the areas where the service excels, and where there’s room for improvement. When hiring a personal assistant, you will need to rely upon references and qualifications alone. You or your elderly parent will also be an employer. This means that you’ll be responsible for meeting the requirements of an employer, including arranging for Employer’s Liability Insurance which is a legal necessity.
24 Hour Care
24 hour care is considered to be a good compromise between home care and care homes. It is designed to meet the needs of elderly people who require a higher level of care but do not wish to move out of their home. 24 hour care is usually provided in one of two ways, depending on which type of arrangement you opt for. If you choose to use an independent agency, or hire a carer privately, you may be able to arrange for live-in care if this is something you’re interested in. Alternatively, if you use a local authority service you will usually find that the carers or nurses take shifts, with regular swap overs throughout the day. 24 hour care provides peace of mind for families.
Adult Placement Schemes
You may not have heard of adult placement schemes, but they are becoming more and more popular. These involve an elderly person either moving in with an approved ‘Shared Lives’ worker, spending daytimes with the worker in their home, or a mixture of daytime visits and overnight stays. The scheme is being praised for encouraging the elderly to remain social and remain a part of the local community, while still receiving the care and support they need. It is also being suggested that the scheme could help to teach the elderly some of the basics of independent living, enabling them to return to their home in the future. You can find out more from the Shared Lives charity.
The first step towards providing care in the home for an elderly parent or relative should be to decide upon the level of care required, and should take into account the preferences of the elderly person and their family. If you’re interested in exploring formal care through the local authority, contact your nearest social services who will be able to arrange to undertake an assessment of needs. If you’re interested in exploring formal care through an independent agency, the NHS have a list of all approved home care agencies nationwide which should be helpful to families.
Post supplied by Harold Rigby, health & lifestyle journalist.