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Care in the home
With the right care and support, staying at home becomes a lot easier – there’s no need to go it alone.
If an older person can live safely at home but finds it hard to carry out personal-care routines or manage the house, they might need some outside help. This could be a few hours a week, a few hours a day or full time.
Creating a care plan
Start by discussing with your relative what they want. Ask how often and at what times they want help, and with what tasks. Consider how much they can afford to pay, and whether different people might be needed for various tasks, such as cleaning or mowing the lawn. This will help you start to get a clear idea of what's needed.
Personal care can include help with:
● getting out of bed
● washing and dressing
● using the bathroom
● picking up prescriptions and pensions
● giving medication
● preparing drinks and meals
● getting settled for the evening
Other jobs around the home that an older person may need help with include:
● managing household bills
● dog walking
● general home maintenance.
If your relative needs extra help at home, the next step will be to get a needs assessment Needs assessmentUsed by local authority social services to decide the type of care and support needed by someone from their local authority. This might result in a formal care plan, with recommendations about adapting the home to their needs or getting practical support, or advice on looking for a residential or nursing home.
Contact your relative’s GP or their local authority’s social services to request a needs assessment.
Who will provide the care?
If someone is assessed as having eligible needs, local authorities have to offer suitable services, such as personal care or preparing meals. But they are unlikely to help directly with household tasks, except when it’s part of a more complex care arrangement.
It’s possible that you will need to look at other sources of help, such as:
- home care agencies
- non-profit organisations, such as the Royal Voluntary Service or Age UK
- hiring private individuals
- support from family, friends and neighbours.
If you’re considering using an agency, make sure they’re a member of the UK Homecare Association. Ask companies what types of care they’re registered to provide. They should also be able to show you a statement of purpose, their price list and a sample contract detailing roles and responsibilities.
Which? Later Life Care has a directory of care homes, home care agencies, nursing homes and local support groups for carers and people living with dementia.
Live-in care Live-in careWhen a careworker lives in their client's home is an increasingly popular alternative to moving into a care home, as it allows people to stay in their own home. It’s particularly valuable if someone needs help with:
- personal care
- taking medication
- cooking and housework
- support to manage risks such as falls
- trips out, such as to the doctor or hairdresser.
Such care gives relatives and friends peace of mind because they know someone is there to help if there’s a problem. It can be more cost-effective for a couple if both need care, as they will pay once for a live-in carer, rather than for two care-home places.
However, it can be difficult to find the right careworker or care team with the proper training, and it isn’t cheap – although fees can often be lower than the price of a care home.
You can organise live-in care privately (in which case you or your relative carry all the responsibilities of an employer) or via an agency. The carer must have their own bedroom, breaks and time off. If your relative needs round-the-clock care on a daily basis, this will be provided by more than one carer.
Home care – also called domiciliary care – allows older people to stay in their own homes for longer and in contact with their local community. It is mostly provided by agencies, and usually costs far less than moving into a residential care home or nursing home.
The carers are not around 24/7, so your relative may also need back-ups, such as an alarm system or a fall detector (see the section on Comfort and security at home). Most carers come through an agency, so the personnel and timing arrangements can change.
Day care and respite
There are other ways of supporting someone in their own home:
- Day-care centres or clubs are usually run by councils or local charities, such as Age UK. Your relative can attend regularly – usually one or two days a week – to socialise and take part in activities.
- Your relative may be able to go into residential care for a short period if their main carer is unavailable, or if they are ill and require specialist care. For example, if they are recovering from an operation or need end-of-life care.
- NHS intermediate care is free care and support at home, or in a care home, for up to six weeks following a stay in hospital or to prevent admission to hospital.
For more information on home care, read all our articles on Which? Later Life Care.