Allowing an individual with dementia to continue living in their own home is beneficial as it allows them to maintain a comparatively independent lifestyle within the comfort and security of familiar surroundings. However, for the family and friends of someone living with dementia, providing appropriate care themselves whenever it is needed can be physically, mentally and emotionally challenging. With no formal training of caring for a person with dementia, a partner, family member or friend who adopts the role of primary carer may be subjected to levels of stress which can be harmful to their own health.
Under a system of hourly care, the individual living with dementia remains in their own home and is visited periodically by a professional carer who understands their requirements and can provide additional support with a range of personal care or domestic duties. The frequency of visits might vary from once or twice each day to once a week depending upon the needs of the person with dementia.
Hourly care can be beneficial in the early stages of dementia but as circumstances change it becomes more difficult to determine the best time for a carer to visit and the frequency of those visits. The family of the person with dementia must consider what might happen during the periods when the carer is not present; fires, accidents, unattended wandering, not eating properly, exposure to financial abuse or burglary and general safety are all potential concerns.
A live-in carer is a trained and qualified care professional who will reside in the home of the person living with dementia for anything up to seven days each week. Live-in care for dementia is an excellent option as it means that a carer is always on hand to assist and safeguard a person with dementia and provide valuable companionship. Family and friends have the reassurance that their loved one is receiving the care and support the need as and when they need it, and that the risk of accidents is minimal.
Those considering live-in care for a partner or relative with dementia should be aware that there are numerous providers, each of which may differ in the quality of care that they provide. Time should be taken to choose a live-in care provider which not only offers the standards of care you require but which is also well-established, is regulated by the Care Quality Commission (CQC) and ideally a member of the United Kingdom Home Care Association (UKHCA), and which can also supply excellent testimonials and references.
There are many care homes of widely varying quality which cater for people with dementia and which offer a comfortable and safe living environment staffed by suitably trained and qualified carers. It should be borne in mind that care homes do not generally employ qualified medics; when medical assistance is needed it is usually called in from external sources which may be on standby for emergencies.
Unlike live-in care, residence in a care home may diminish the freedom and independence of the person in care and can be somewhat ‘institutionalised’. If seeking a care home for a loved one with dementia is your preferred option, it should be noted that is a wide diversity of care homes to choose from some of which may offer higher standards of care and living conditions than others. As with choosing a live-in carer (above) when considering care homes it is essential to select from those which are well-established, reputable and officially accredited.
In addition to the everyday support and assistance and comfortable, secure living accommodation provided by a care home, a nursing home provides on-site medical care. Generally this means that a qualified nurse is present and on-duty 24 hours a day and this can be beneficial for people in the later stages of dementia who may require continuing medical care.
In all other respects, the experience of a person with dementia living in a nursing home will be comparable to that of living in a care home and the same recommendations apply when selecting the best nursing home for your loved one.
A report commissioned by the Alzheimer’s Society (‘Counting the cost: Caring for people with dementia on hospital wards’) which examined the impact of dementia care upon NHS hospitals throughout the UK found that people with dementia fill up to a quarter of all available hospital beds at any given time.
A hospital is not an appropriate option for dementia care provision; the report found that “the longer people with dementia are in hospital, the worse the effect on the symptoms of dementia and physical health” further noting that extended hospitalisation contributed to increased confusion and loss of independence in people with dementia. It was also found that the nursing care provided is not specific to the needs of dementia patients and that medical staff had a general lack of understanding of dementia, its symptoms and how best to manage them.
Furthermore, the long-term hospitalisation of people with dementia represents a significant drain on NHS resources which could be better used elsewhere. The Alzheimer’s Society’s report concluded that “supporting people with dementia to leave hospital one week sooner than they currently do could result in savings of at least £80 million a year.
A hospice is a specialist residential home typically staffed by medical practitioners, counsellors, carers and volunteers and is suitable for people in the final stages of dementia. Hospices provide individual one-to-one care and assistance to people with dementia and usually offer a tranquil and calming environment. There is no charge for hospice care in the UK but residence can only be obtained via a GP’s referral.