Caring for older people
The realisation that your loved one (or perhaps yourself) is no longer able to live independently is painful. The person who was once able to look after themselves and others now needs care themselves. Finding the right type of support for you or your loved one (daily help in the current home: live in carer: care home) can feel really difficult. The information is often confused, contradictory and hard to find, and negotiating legalities and finances is the last thing most of us feel able to do when faced with such a life changing event.
Sheffield Churches Council for Community Care used to offer the Placement Support Scheme which aimed to guide people through this difficult time and help them identify the most suitable accommodation for their loved one. Unfortunately, funding restraints means we are no longer able to provide this service, so, we thought it was time we collated our knowledge into one easy to consume article. There are links to helpful charities and to the appropriate pages of the Sheffield City Council website (if you are outside Sheffield, your local council should have similar areas on their website).
Help to stay at home for longer
Let's start with services that could help your loved one stay in their own home for as long as possible; these could include some adaptations like handrails on the stairs, grab rails and perching stools for the shower, walking frames and even possibly intercom systems for the front door. The first step is to call the First Contact Team on 0114 2734908 and chat to a member of staff. You will need to apply to the council for a home assessment there is a referral form on the page. You can also access Community Support Workers who may be able to assist in sourcing help and information that could enable your loved one to stay at home longer. They are usually based in GP surgeries and you need to call 0114 2057120 to initiate a referral.
When it's time to consider a care home
If you have reached the point where moving into a care home is the only viable option, then there are many things to consider. One of the most important is how the care will be paid for. You may also (if you haven't already done so) need to look at applying for a Lasting Power of Attorney (both financial and health). This is particularly relevant in the case of Dementia- without this it may be difficult to organise your loved one's finances and continuing care.
There are somewhat complicated calculations involving the amount of capital (which may include property) that the person moving into care has, and we would recommend speaking to an Independant Financial Adviser. Anyone deemed to have capital above the prescribed limits is known as a 'self-funder' and may make their own arrangements directly with a home.
For those under the threshold, Sheffield City Council may contribute a maximum of £463 per week. Very few care homes have fees at that level and therefore it may be necessary for a relative or friend to pay 'top up fees' (As an example, weekly fees for a resident living with dementia, residing at a care home run by Sheffcare, the charity which took over the running of homes formerly operated by the council runs to nearly £600 per week).
Types of care homes
Effectively there are two kinds of care home - 'a residential home' and 'a nursing home'. A residential home provides 24hr care which includes personal care (like bathing, dressing and using the toilet) along with all meals, laundry etc. A nursing home provides the same BUT with 24hr nursing provision - a particularly important consideration if your relative is suffering from a condition requiring more intensive support.
It is important to note that your loved one may qualify to have their nursing needs paid for under the NHS Continuing Care Scheme. However, as you may expect, the assessment process is complex! Take a look at the the Beacon website or call 0345 548 0300 for help and guidance.
How to find a care home
There are several web based resources that will help you narrow your choices. We would suggest you make a list of top requirements and use these to indentify 5 or 6 potentials. For example:
- Location - near to where they currently live (for familarity) or nearer to family (makes visiting easier)?
- Own or shared bathing facilities?
- Modern or older style building?
- Are there gardens?
- What communal spaces are there?
Use websites such as www.carehome.co.uk and www.careuk.com to find potential homes. Sheffield City Council have now produced a very useful document entitled "A Guide to Residential and Nursing Care in Sheffield" which you can download for free by clicking on the link. The booklet covers everything from support at home to a list of care homes in the area and their contact details.
All care homes in the UK have to be registered by the Care Quality Commission and it is worth visiting the website www.cqc.org.uk to check a homes latest inspection.
Personal referrals are also useful, so ask friends, family and colleagues if they have any recommendations.
Once you have shortlisted it is usually helpful to visit each of the homes. No care home should ever turn away a visitor, but some will be more welcoming and helpful than others! Sometimes what seemed perfect on paper will just "feel" wrong when you visit. It may be unscientific, but you are ultimately the best judge of what will be right for you or your loved one.
Here are a few things you might like to think about;
- Ensure you are able to view a typical room and the shared areas.
- What is the interaction like between residents and carers?
- Do the residents appear well cared for and happy?
- What sort of activities are they able to do?
- Are the visiting times restricted? if so why?
- Can residents bring in their own furniture - a favourite chair for example?
- Are they able to eat in their rooms if they prefer?
Many homes will encourage a prospective resident to visit for a day, perhaps have lunch and join in any activities. Some will offer a trial period of up to 4 weeks. Use that opportunity if it is offered.
The care home is selected and all the arrangements made....in some ways that is the easy part because now comes the reality of actually moving in. Make sure everything is done calmly and quietly. If at all possible, see if you can get personal possessions like photos, pictures, ornaments and bed dressings into the room before your relative is moved in. This will help the room immediately feel more homely and familiar.
The home should have appointed a staff member to oversee the moving in and they should be on hand to ease the settling in process. See if you can stay for lunch or simply tea and biscuits, talk positively about the new surroundings and ensure that your relative doesn't feel abandoned. The staff know how to best do this and may ask you to leave to get them settled in.
There is no doubt that the transition into care can be almost as hard on a family as on the new resident; there will be feelings of guilt (he/she looked after us, why couldn't we do the same?) and also the worry that the home won't be right, the relative will be miserable etc.
The best thing to do is remind yourself that your loved one is now SAFE and CARED FOR 24/7 - something you would be unable to do yourself.
When you visit try and be positive and upbeat and get involved in enjoyable activities you know they enjoy; play some music, have a little dance, look at photo albums etc.
We hope we've cast a little light on the whole care process- it can be scary and upsetting admitting that you or loved one need care....but it's important to remember that it's all about your loved one's safety.
Here are a few more wesites (in addition to the ones linked to in this article) which you may find helpful.