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Advanced stages of dementia

Looking for care? Call us on 0800 1234 567

Oustanding dementia care in the comfort of your own home

We know how worrying and stressful it can be when faced with the reality that a loved one is living with the advanced stages of dementia and are struggling to cope alone. Watching someone close whose life is impacted by the varying symptoms presented by advanced stages of dementia can be upsetting. Many family carers will feel guilty that they themselves are struggling to cope and provide the care and support their loved one needs. Where can I get the best care? How can my loved one continue to enjoy life? How can I better manage their changing needs? These are some of the questions you may have asked yourself.

Familiar surroundings provide much-needed comfort and reassurance

 

At The Good Care Group, we know receiving care in the comfort, safety and familiarity of your own home has far reaching benefits in improving overall health and wellbeing for a person living with dementia. Moving at any stage in life can be disruptive and stressful. When an individual is living with the advanced stages of dementia the process of moving to a care home, away from their much-loved home full of its treasured possessions and memories can be really heart-wrenching and daunting, affecting their ability to live well with dementia. We know that staying at home and receiving compassionate, one-to-one care from a highly trained and well-matched professional carer improves quality of life and health outcomes for an individual living with advanced stages of dementia. Our personalised approach to providing high-quality dementia care, with a fully managed and flexible service that families can rely on is setting the standards in live-in care.

"My father has dementia and was in a care home, very unhappy. I watched him decline with much sadness. The move back home with a live-in carer from The Good Care Group has been seamless. He is now visibly happier and relaxed. It is so much nicer for the family to visit him at home once again."

- Mrs S Anderson

Advanced symptoms of dementia

 

As people move through their dementia journey to the advanced stages of dementia, they will experience an increase in their symptoms and are likely to have significant memory loss and cognitive difficulties.

People in the advanced stages of dementia become increasingly frail and depend more on other people for support. As dementia progresses and causes changes to the person's brain, they may struggle to do many of the things they used to.

However, even in the advanced stages the person may experience moments of lucidity (being aware of their situation) and they are always aware of how they are feeling, even if they don’t quite know what made them feel that way.

The person's reactions are likely to be influenced by their environment and how they feel. For example, they may react more positively if they are in a familiar environment or one where they feel comfortable.

People in the advanced stages of dementia often experience problems with the following:

  • memory
  • concentration, planning and orientation
  • communication
  • mobility
  • eating and weight loss
  • toilet problems and incontinence
  • changes in behaviour

Memory in the advanced stages of dementia

 

By the time the person reaches the late stages of dementia, they are likely to have significant memory loss and cognitive difficulties. Recent memories may be lost completely (for example, what they had for breakfast or when they last saw a friend) and they may only be able to access parts of past memories.

The person may believe they are living in an earlier time period from their life (for example, when they were at school). This can mean they say things and behave in ways that do not make sense to those around them. The person may also confuse those around them for someone else (for example, thinking their partner is their mother or father).

The person's emotions are always related to how they're currently seeing their situation - for instance, they might become distressed because they believe they need to go and collect their children from school but they are being prevented from doing this.

The person may no longer be able to recognise themselves in the mirror, or recognise other people such as their partner, friends and family.

The person may become upset when looking at themselves in the mirror or think there are strangers in the house. It can be extremely difficult when someone with advanced stages of dementia is not able to remember their own family or close friends. Don't take this personally. This memory loss is caused by the progression of the dementia.

Even if the person with dementia is not able to place someone they are still likely to experience feelings they associate with that person. For example, they may still be prompted when they see someone familiar to feel safe and happy around them. Keeping in touch with the people they know where possible will help them to continue to have these positive feelings and enjoy their company.

Specialist dementia care at home provided by expert carers

 

We have been innovating dementia care for over 10 years. All our professional carers are trained in how to care with someone living with advanced stages of dementia and use a range of best practice techniques proven to provide reassurance, reduce anxiety and calm behaviours, whilst reducing the need to use anti-psychotic drugs used widely in many care home settings.

This means the person with dementia can live well, despite the challenges dementia can present, with the gentle encouragement and compassionate care provided by our dementia carers. The high-quality care provided by our dementia carers has seen a 66% reduction in the use of antipsychotic medications compared with the average care home.

Our collaborative approach to working with leading medical experts, academic bodies and leading charities ensure our care is of the very highest standards. Our work with the Contented Dementia Trust to introduce the SPECAL approach helps us to understand and discover what is important to the person living with dementia, enabling us to develop a meaningful programme of care that bridges the gap between the present and the past.

We recognise that feelings become increasingly significant to the person living with dementia, and that intact memories from the past become increasingly useful as a replacement for recent lost facts.

We use the SPECAL approach to:

  • Bridge the gap between the person’s past and their activities of daily life in the present.
  • Develop communication strategies that enable the person with dementia to communicate in ways which make sense to everyone who has contact with them.
  • Promote emotional well-being and protect from anxiety and worry.

We adopt a blended approach to delivery of dementia care at home, led and supported by our own Consultant Admiral Nurse. The support from an Admiral Nurse, working with leading dementia charity, Dementia UK means we can offer unrivalled levels of emotional and practical support based on best practice dementia care to those living with dementia and their families.

All of our professional carers are trained in how to care for those living with dementia and our management team complete a higher-level dementia care training programme. It does not stop there. Our care teams receive on-going coaching, mentoring and support based on latest thinking and research that ensure they have the knowledge, skills and aptitude to deliver positive dementia care.

"I have supported a lady living with dementia for over eight months. When I first met her, she had very high levels of anxiety and repetitiveness, which only heightened her anxiety. Using the SPECAL approach and delving into her past, I discovered many things I could do for her that triggered positive memories. She had a passion for music and books, so I found out what her favourites were and arranged for audio books to be delivered, which gave her something to focus on. She was also a dog lover and owned a dog all her life. I arranged for the local animal shelter to visit once a week with a rescue dog – these little things really helped to reduce her anxiety and promoted calm. Using the photograph album analogy, I was able to build a picture of how she saw the world and I encouraged her to talk about these events in her life, listening attentively and never interrupting or asking direct questions. After only a short time caring for my client, she was able to reduce her reliance on anti-psychotic medication and experienced significant improvements in her overall health and wellbeing."

- G Hume, Professional Carer

Meet our experts

Our approach to dementia care at home is developed and led by our in-house team of clinical experts. Working closely with leading dementia charity Dementia UK, uniquely we have our very own full-time Consultant Admiral Nurse, Dr Jane Pritchard. With our in-house Occupational Therapist, Jackie Cooper they both offer practical and emotional support to our clients and their families at what can be a very difficult time. We adopt a multidisciplinary approach to our dementia care service working alongside healthcare professionals to ensure positive outcomes for all our clients. This means they can stay safely and happily at home with the right support and equipment to get the most out of their life.

Personalised care delivered with dignity and respect

Dignity and respect are at the forefront of everything we do and is so important during the advanced stages of the condition. Our highly trained carers work closely with those living with dementia to learn about their past, personality and preferences. Whether it is helping with social activities or simply listening, they take the time to understand the person being cared for and look for ways to enhance their quality of life in a way that respects their choices and preferences.

What does our service include for those with advanced stages of dementia?

 

Specialist nurse-led care

Importantly for those living with dementia, we are able to provide nurse-led care if and when it is needed. Our professional carers are trained to monitor and identify any changes in your health, responding appropriately and avoiding any unnecessary hospital admissions. As part of our commitment to delivering a high-quality home care service, we monitor and measure health outcomes to ensure we continually improve the care we provide.

Managing and administering medications

Our professional carers are trained in medications management and use an electronic medications system to ensure all medications are managed proactively and effectively. They will also collect prescriptions from the pharmacy.

Ensuring safe mobility in and around the home

Our in-house Occupational Therapist, Jackie Cooper will review of a person’s overall ‘function’ to address how they can safely navigate around their home. She will then provide expert guidance and advice as to what equipment can improve safe movement and mobility around the home, whilst minimising falls. Jackie is well placed to provide advice and recommendations as to any home adaptations that may make life easier. She will continue to review a person’s on-going function to keep them well and safe at home as their cognitive function deteriorates as the condition progresses.

Companionship as and when you need it

Our carers will provide companionship whilst ensuring your privacy is respected. We ensure that a perfectly matched carer shares similar values and interests as you to make life interesting, stimulating and enjoyable, whilst being there for you to support your emotional and psychological needs.

Providing discreet and sensitive personal care

This can include the task-orientated aspects of caring for someone, like bathing and getting dressed, but also those that promote self-esteem, like having your nails maintained, or your hair styled.

Planning and cooking meals

Meals will be planned and cooked according to your choice, preferences and nutritional needs, all served at a time that suits you.

Facilitating social arrangements in the home

Your carer will ensure you can invite friends over for socialisation and celebrations, providing the support you need to enjoy yourself and not worry about organising anything.

Trips and visits out of the home in your local community

Our carers know how important it is to ensure you can continue to do as much you wish and that you remain connected to your local community – whether that is a stroll round the local park or attending clubs or groups in the local area or visiting friends, or those shops you always have.

Domestic tasks

This includes cleaning of all rooms and vacuuming throughout to keep your house to the standards of cleanliness and tidiness you always have.

Caring for your much-loved pet

Carers will happily support looking after your pet, including taking dogs for regular walks.

Our approach to late stages of dementia

 

Dementia in all forms is a progressive condition and by the time it reaches the advanced stages of dementia it is very likely that you will need round-the-clock support. During this stage the person living with dementia is likely to have become extremely frail, with severe memory loss and may well have trouble with communicating, eating and even swallowing. They may also spend long periods of time inactive and become prone to infections.

Communication is key at this stage. All our carers are trained to have meaningful interactions with those they are caring for when speech is limited – eye contact, gestures or shared experiences all provide ways to make a connection.

Listening to a piece of music together can help someone feel safe, connected and loved.

During late stage dementia more specialist medical care may be needed. At The Good Care Group our care teams are supported by leading clinical experts in the field of dementia care who guide our approach. Carers can draw on the expertise of our in-house Consultant Admiral Nurse, Dr Jane Pritchard and our dedicated Occupational Therapist, Jackie Cooper. Carers proactively use techniques required for safe moving, pre-empting medical issues, identifying infections that reduce medical admission. For many our care is life changing with fewer falls, less infections and reliance on antipsychotic drugs.

Dementia live-in care, short term care or respite care

We provide specialist dementia care at home as either 24 hour live-in care, as a short term care arrangement or as respite care no matter where you are in your dementia journey.

With a full time, live-in care arrangement a professional carer will live with you in your home providing around the clock care and support, focused on improving your health and wellbeing, whilst enhancing the quality of your life. There are many benefits of 24 hour care, not least that the carer will truly get to know you as a person, not just your care needs but they will be on hand to support you to live life the way you wish, with as much independence as possible.

Respite care or a short term arrangement provide an opportunity for a family carer to take a much needed break from caring for someone living with advanced stages of dementia, or for you to try live-in care for the first time to see how live-in care works and whether it is the right choice for you in the future.

Why choose The Good Care Group for dementia care?

We have been providing high quality dementia care to many families across the country for over 10 years. At the heart of our dementia care is enabling people to live well in their own home with the medical care and support they need from a carefully well-matched, trained professional carer who provides a better quality of life for those receiving care, whilst families receive a fully managed and regulated service that they can trust and rely on.

There are many other compelling reasons to receiving dementia care from The Good Care Group:

 

A perfectly matched care team

A live-in care arrangement usually involves two carers working on a two-week rotation. They will be carefully matched working with you and your family to ensure they are able to meet not just your care and support needs, but are closely aligned with how you wish to live your life, sharing common interests, personalities and backgrounds. In the rare situation, the match does not work out we will happily work with you and your family to find the care team that does.

Expertly trained care teams

Our industry leading training programme completed by our care teams has been created with leading charities and clinical experts and goes well beyond industry standards. This enables our professional carers to support a range of conditions affecting older people, including complex conditions that require more monitoring, care and support. From training, through probation, into placement and beyond our carers never stop learning new skills that ensure they can deliver the quality care our clients should expect, whilst finding new ways to further enhance the level of care they provide.

Clinical care developed and supported by experts in their field

Supported by our specialist in house Consultant Admiral nurse, Dr Jane Pritchard and our central senior management team, some of whom are nursing professionals our professional care teams can support people with nurse-led care in the comfort of their own home. All our professional cares are qualified to manage and administer medications, and support with several complex medical interventions.

We understand that medical care can require equipment and other adaptations to the home. Our dedicated Occupational Therapist (OT), Jackie Cooper will not only liaise with doctors, district nurses and NHS OT’s and physiotherapists, she is also on hand to be able to conduct a thorough OT assessment to facilitate fast and discharge from hospital if required and will co-ordinate any requirement for equipment, so you can get home as quickly as possible to be cared for comfortable in familiar surroundings with all the care you need. These specialists ensure our professional carers are focused on and supported to deliver a holistic and multi-disciplinary approach to caring for your loved one.

Innovating care delivery through technology

Unlike any other live-in home care provider in the UK, we have invested in creating our own market-leading technology to further enhance our service. Through the development of an online community for our clients, their families and our professional carers, we are proactive and responsive to emerging issues, whilst enabling the softer social benefits that technology brings. The secure platform is focused on ensuring our carers are equipped to effectively deliver the high-quality care our clients should expect, whilst delivering improvements in health outcomes. Our families can access important information about the care of their loved one, providing a reassuring window into the care they are receiving.

Our professional carers use a dedicated community through a Chromebook to complete daily care records, update care plans, monitor nutrition and hydration and manage medications proactively with safety features ensuring accurate administration. This allows us to effectively monitor the health outcomes of our client’s care, so we can prevent and respond to incidents and ensure the very highest quality of care is always provided. The online community also allows our professional carers to network, support each other and share best practice, whilst facilitating a connection which is so important for a remote workforce.

For families who may live some distance away from their loved one, they can access care plans, care records and a calendar of events as and when they wish, offering much-needed peace of mind. We are proud that this community offers families a transparent and immediate insight into our service. The technology also provides families with reassurance that any cash handled by our carers is being managed safely and accurately, whilst enabling them to manage practical arrangements, such as food shopping remotely. They can also connect with our other clients’ families who may well be in a similar situation as themselves, so they can share their care experiences and support one another.

Our professional carers will utilise the technology for their clients’ socialisation and enjoyment – everything from video calls with family members so they feel connected, online shopping to general web browsing.

Improving health outcomes

At The Good Care Group every decision is driven by delivering improved health outcomes for our clients. Through our dedicated and committed approach to providing high quality care to our clients and the use of our market-leading digital technology, we see significant improvements in our clients’ overall health and wellbeing every year.

Unique to the live-in home care market, the technology enables us to digitally monitor health outcomes allowing us to effectively predict risk and shape the care we provide. We know, for example that urinary tract infections (UTI’s) are one of the leading causes of hospital admissions for our clients, so we equip our carers with handheld testing kits to proactively monitor our clients for infections. We then benchmark our data to demonstrate how effective our care is in improving the quality of our client’s lives in the context of other types of care provision, for example care homes.

Our health measures are focused on achieving the following:

  • Promoting wellbeing, independence and enjoyment
  • Reducing behaviours that challenge through implementation of psychosocial techniques
  • Reducing and eliminating antipsychotic drug use
  • Promoting excellence in nutrition and hydration
  • Reducing and preventing falls in the home
  • Reducing hospital admissions and re-admission
  • Reducing UTI’s and chest infections
  • Reducing carer stress

We are proud to be transforming health outcomes for those who require care at home. In 2019 our care teams achieved the following outcomes for those they cared for:

Unrivalled falls prevention programmes

In England alone, 30% of people over the age of 65 fall at least once a year and for those 80 and over it is 50%. By comparison, only 7% of our clients aged 65 and over fell at least once, and that was only 6% for those aged 80 or over.

Our clients are seven times less likely to suffer a serious injury as a result of a fall than residents living in a residential care home. This is a result of our quality one-to-one care, which just cannot be achieved in even the very best care home, and our effective personalised falls management programmes.

Working with our in-house Occupational Therapist, we identify clients who are ‘frequent fallers’ and through an intensive and personalised approach to falls management these clients experienced 47% fewer falls from being in our care.

Reducing urinary tract infections (UTI’s)

Through enhanced training and the use of our market-leading digital technology, our professional carers can perform urinalysis tests. This means they can provide accurate and timely information to GP’s, enabling a quick diagnosis and treatment. 82% of our clients were diagnosed in 2019 using urinalysis kits, and through the introduction of testing we were able to reduce emergency interventions involving a 999 call or ambulance call out by a staggering 63%. We have also achieved a 22% reduction in overall UTI related hospital admissions.

A specialist pathway for palliative care at home

For those with a life-limiting illness or a terminal condition, most of us given the choice would wish to end our days in the comfort of our own home. However, the percentage of people in the general population who can do that is as low as 16%. By comparison, our approach to one-to-one palliative care at home has enabled 77% of our clients to pass away in the place they love most – their own home.

Effective pressure sore management

Our high-quality home care provided by dedicated and professional carers has seen a staggering reduction in pressure sores in those we care for when compared to both hospital and care home settings. Our clients are nine times less likely to acquire a pressure sore than they are in a care home and three times less likely than in hospital.

Proactive monitoring of chest infections

Our partnership with an award-winning technology provider, Feebris has seen us reduce hospital admissions for those with respiratory problems by 28%. Our carers use handheld medical devices to detect early signs of illness, such as chest infections enabling timely intervention to avoid unnecessary hospital admissions.

Efficient management of medications

Our digital technology is used proactively to effectively support safe administration of medications, which has seen error rates of 3% compared to a 22% error rate in care home settings.

Reducing the use of antipsychotic medication for those living with dementia

The use of antipsychotic medication to treat dementia symptoms has been increasingly challenged over the last ten years, as they have been shown to be harmful for people living with dementia and are at times prescribed unnecessarily. Through our approach to professional and specialist one-to-one care for those living with dementia, our clients are four times less likely to be prescribed antipsychotic medication than residents of care homes.

Peace of mind and reassurance

Rated ‘Outstanding’ by the Care Quality Commission (CQC)

The Good Care Group is the only live-in care provider in the UK to achieve an ‘Outstanding’ rating by CQC across all five categories – safe, effective, caring, responsive and well-led. We know this provides families with peace of mind that their loved one is receiving the best possible care.

A fully managed and regulated respite care service

We provide a fully managed and regulated home care respite service which offers families reassurance at a time they need it most. Unlike introduction agencies who are not regulated by CQC, all our professional carers are directly employed and managed by us. We ensure they are supervised by an experienced manager and supported by clinical experts – 24 hours a day, 7 days a week.

Local teams with national coverage

We operate nationwide with a local approach to management of our teams near you. Each dedicated care manager has as small portfolio of clients to support, enabling the care team to provide a tailored one-to-one approach with the highest levels of monitoring and support.

What is included in our service?

Our highly personalised dementia care service includes:

  • Full assessment before care starts
  • Bespoke and flexible care plan developed with input from the family and other healthcare professionals
  • Matching of the most suitable care team to meet the holistic needs of our clients
  • Dedicated care team led by an expert regional care manager
  • Meal planning and household tasks
  • Social activities and lifestyle enhancement
  • Specialist support and expertise - 24 hours a day, 7 days a week
  • Access to clinical expertise and medical support

Costs of our dementia care

The cost of care for people living with dementia is typically in line with – and sometimes less than – what you would pay for residential care, with the added benefit of receiving one-to-one tailored care for the person living with dementia, which cannot be achieved in a care home. There is even greater value if you are a couple and one or both of you are living with dementia. A care home would charge double for two packages of care, whereas there is only a nominal extra cost if you both receive care at home at the same address. Devastatingly for couples, where one of you is living with dementia and the other is not, most care homes would have to separate you to give you the care you need.

The cost of receiving care at home is typically higher for those living with dementia and other neurological conditions as it is a specialist care at home service. It is worth considering however that live-in care is often cheaper than the total cost of domiciliary care for people living with dementia. When a person is receiving hourly care, provided by a domiciliary care provider it is likely that you will be charged extras for additional services to support the person’s dementia needs on top of the cost of a carer visiting. These extras add up and can become costly over time. The total cost to provide hourly care to someone living with high or complex needs can sometimes exceed the price of an inclusive live-in care service.

Useful resources

To support you and your family we have created a useful Dementia Care Guide which provides you with information and advice on how to provide person-centred dementia care following a diagnosis of dementia. There is also a number of dementia charities across the UK who provide families with help, advice and support when they need it most, including Dementia UK and the Alzheimer’s Society.

EARLY STAGE

 

Download our Outstanding live-in care for early stage dementia brochure

Download PDF

MID-STAGE

 

Download our Outstanding live-in care for mid-stage dementia brochure

Download PDF

LATE STAGE

 

Download our Outstanding live-in care for late stage dementia brochure

Download PDF

Talk to us about your dementia care needs

Our friendly and experienced team is here to help you and your family make sense of the options available to you. Call us today – we will help you every step of the way.