When you, a relative or a loved one develops dementia, it can be a distressing and troubling time for everyone involved. Unfortunately dementia is a condition that steadily worsens over time, with no current cure.
Eventually, for someone with dementia, the best thing to do to keep them healthy, happy and safe is to move them into a care home where they can get round-the-clock care and support they need.
In this article, Lottie looks at when someone with dementia should go into a care home and how to make the transition as easy as possible.
Dementia is a degenerative health condition that affects the brain and its functions. Dementia might start off with early symptoms including:
- Memory loss
- Difficulty concentrating
- Mood swings
- Difficulty finding the right words
- Difficulty with tasks that involve organising
- Repeating words or questions
Symptoms are usually mild to start with and gradually get worse over time, so it can take a while to notice. There are also different types of dementia, the most common being Alzheimer’s, which can affect people in different ways, depending on the part of the brain that is affected.
Although lots of people develop dementia in old age, it isn’t a normal part of growing old, so if you do notice the above signs in yourself or someone else, it’s best to get a formal diagnosis from a GP.
Your GP can conduct tests to rule out other potential problems, advise on the type of dementia you likely have and help you make a plan of action for managing your condition going forwards.
Living at home with dementia
Those in the early stages of dementia can often stay living at home, especially if they have family, friends or carers to visit daily and provide support.
However, as the condition progresses, you may notice that your loved one starts to find it too difficult to live independently and they are at risk of injury.
These are a few of the things that can happen to someone with dementia who lives alone:
- Wandering out of the house and getting lost
- Causing a fire through leaving gas on or leaving lit cigarettes
- Vulnerability to strangers or scammers
- Falling over and being unable to get help
- Social isolation and loneliness
When is the Right Time?
At first, you might be able to manage some of the risks associated with dementia, but as the condition worsens, things usually change.
For example, the person’s dementia may start causing more problems than before, you or their carer find that you are no longer able to meet their care needs, or they might have an accident that requires hospital admission as part of the condition.
If you are unsure whether your loved one needs to go into a home, it can be helpful to write a list of your loved one’s needs and whether you are able to adequately meet them – if you find that there are a lot of items on the list where you don’t feel you can provide proper care and support, it’s probably the right time to start looking at your options.
Sadly, as dementia can only get worse, the person’s condition declines, their care needs increase and there will ultimately come a time when you have to make a decision about their future, which may be moving them into a care home.
In the beginning they may only require help with daily living tasks or personal care but dementia can progress quickly so it is important to choose a care home or nursing home that can provide the required level of care. This may include having a qualified nurse available to look after your loved one or even a full time carer as the dementia progresses.
Who makes the decision?
When making the decision to put someone into a care home, it’s important to involve all parties. Ideally it should be the decision of the person going into the care home.
Even if the person in question does not have the mental capacity to be involved in the decision making process about the move, you should still involve them and make them feel valued and considered. Where possible, do offer them choices to give them a feeling of control – and always be positive and upbeat.
This can be a really difficult and upsetting time for everyone, so it’s important not to rush conversations, allow all family members enough time to come to terms with the move and put proper plans in place to reassure the person that they will be well looked after.
If the family member in question lacks the mental capacity to know what is in their best interests or is unable to communicate, getting advice and support from a personal welfare deputy or a Lasting Power of Attorney, or LPA, can help you to make important decisions for them.
A Health and Welfare LPA allows you to decide when your loved one should move into a care home.
With a Property and Financial Affairs LPA in place, you will also have the legal power to make financial decisions for your loved one and pay for their care.
If the person with dementia doesn’t have an attorney, the decision should be made by health and social care professionals and friends and family close to the person.
Benefits of moving into a care home
There are many benefits to moving into a care home. Some of the most common include:
Improved quality of life
There are so many amazing care homes out there that promise to give residents a high quality of life, through socialising with staff and residents, joining in daily activities and taking care of mindfulness and wellbeing.
Many elderly people experience social isolation and loneliness, so often moving into a care home gives them a new lease of life, lets them rediscover old hobbies and try out new ones.
24-hour care and supervision
People with dementia are prone to confusion and wandering, which can make life difficult when they live alone. In a care home, staff are on-hand 24/7 to monitor and supervise residents, prevent them from wandering off and into potentially dangerous situations.
Staff will have been given specific training to support people with dementia, giving you the peace of mind that your loved one is safe and sound at all times.
Getting the right therapy and medication
When your loved one goes into a care home, you can rest assured that they will be given all the medication they need and special therapeutic techniques that can help them to manage their dementia, such as specialist sensory equipment made specifically for dementia patients.
Reduced stress for you
Although it’s normal to feel sad or guilty about moving your loved one into a home, it’s also important to consider what is best for you as their carer – as well as any other people involved.
Caring for someone with dementia is an uphill battle that only becomes more challenging the longer time goes on and the physical and mental strain can take its toll.
Finding a good care home relieves this stress and pressure and gives you more time to spend with your loved one as their relative and friend, rather than their carer.
Choosing the right care home for someone with dementia
There are plenty of wonderful care homes in the UK that can support people with dementia, so you’re really spoilt for choice! The first thing you’ll need to do is request a needs assessment from your local authority.
This will analyse your loved one’s condition and provide recommendations on the type and level of care they need, as well as conducting a financial assessment to look at care home costs and funding options.
When your loved one has been assessed, most care homes will visit your relative either at home or in hospital or invite them to the home for a visit if possible.
While at the home, talk to the staff, the care home manager and other residents to get a feel for the home. What are the facilities like? Are there activities especially for those with dementia? Will your loved one be able to decorate their own room to make it more familiar?
Above all, it should be left to your loved one to choose the home that feels right for them, but let them know that you are there to provide support and advice along the way.
Specialist dementia care homes
As well as residential care homes that can support residents living with dementia, there are also many care homes and nursing homes that specialise in dementia care, palliative care and end of life care, that have dedicated dementia units for residents with Alzheimer’s and other types of dementia.
These units typically include special dementia equipment, such as sensory rooms, reminiscence rooms, memory cafés, special lighting and doors and more. Residents with dementia can enjoy comfortable and secure long-term stays here, without the risk of getting lost or injuring themselves.
Care home costs
As part of the financial assessment, your local council will advise whether you or your loved one can self-fund (cover all costs), or whether you need assistance from the local authority, the NHS or a registered charity.
Care homes that provide or specialise in dementia care, do tend to be more expensive than residential care homes – this is due to several factors, such as staff needing to be available round-the-clock and the need for specific staff training.
If you plan the move in advance, you’ll have plenty of time to work out what you can and can’t afford and apply for support and funding if available.
Advice for the move
Even if you’ve planned the move to the best of your abilities, the day itself and the run-up to it can be tough.
Your loved one may have forgotten that they are moving, or be reluctant and upset on the day. The most important thing is to stay calm and in control.
Try to reduce your loved one’s anxiety by packing plenty of familiar items and treasured possessions that can help to stir up fond memories.
Photos of family and friends, favourite blankets or special ornaments are all good examples of things to consider.
You may even wish to arrange a respite stay in advance so that your loved one can ‘test out’ the care home.
Once your loved one is all moved in, it’s best to slip away while they are distracted by a meal or an activity. Long, drawn-out goodbyes can be upsetting for everyone involved.
Supporting your loved one
After the move, most people experience a real mix of feelings, from sadness and regret to guilt. Talk about your feelings with family and friends – after all, it’s a big change and can be difficult to get used to.
Some care homes advise not to visit for a week or so to give your loved one a chance to settle in properly and make friends, but after this initial cooling-off period, you’ll likely want to visit regularly.
Get to know the staff and don’t be afraid to ask them questions about how your loved one is getting on. If you have any worries about the standard of care your loved one is receiving, speak to the care home manager to express your concerns.
Dementia care plan
All care homes should provide residents with a detailed care plan. Dementia care plans should list the care needs of the patient, such as their ability to carry out daily tasks such as washing, grooming, dressing, toileting, feeding themselves and domestic tasks like cooking, cleaning and laundry.
The plan should also include specialist medication, nursing care needs or treatments that the person requires, such as dressings, behavioural issues, feeding requirements.
Dementia care plans are a really useful resource that help staff to get an understanding and a history of each person, learn what they like and don’t like and pick up specific care tips to help them treat the person properly. Care plans are also handy for care homes where staff switch shifts a lot.
Dealing with dementia is difficult and upsetting, but moving someone with dementia into a care home is often the right decision.
Taking plenty of time to plan in advance, involving the person along each step of the way and preparing them for the move should make the transition easier.
It may feel as if you are letting your loved one down or betraying them, but by helping them to get all the help, care and support they need, you are doing the best thing you can possibly do for them.
For more advice
Alzheimer’s Society website: https://www.alzheimers.org.uk/