What are your care options?
There is a huge spectrum of choice in the world of home-help and care, and no one-size fits all. As our needs change, so the help we need changes over time. We’ve been helping a number of people recently with choosing what’s next, so here is our summary of the options.
Getting started
Often the first stage is getting some help at home. It might be as simple as having a cleaner for the first time. It might be a bit more involved than that, perhaps a home-help individual or organisation that can help with shopping, cooking, and other jobs around the house like laundry and changing the bed linen. You might need help with washing and dressing.
It might be that what you really want is someone to go out with for an outing and a coffee, in which case you will need your helper to have a car.
If you make an arrangement directly with an individual it may well cost you less, although if you are their only source of work you may need to employ them officially, including responsibility for tax, national insurance, pension contributions and you will need to deal with any difficulties about how well they are working for you. If you use a home-help or home care organisation it is likely to cost you more, although you will have the benefit that they deal with the employment side of things, will be able to arrange cover in case of sickness or holidays, and handle the bills with you so that you don’t have to have a direct financial relationship with your helper. If you are speaking with home-help or home care companies make sure you ask if they can ensure you have the same person each time and can guarantee they arrive at the times you have asked for.
Very little is paid for by the local authority these days. If you have assets or savings of more than £23,250 then you will need to pay personally for any help at home. If you’re over 65 years and need help and support at home you may be able to get the Attendance Allowance which is not means tested so it’s definitely worth applying for. You can print off the form from www.gov.uk/government/publications/attendance-allowance-claim-form or phone the helpline on 0345 605 6055.
Case study
We were originally contacted by Mrs P’s daughter saying that she was in the process of finding a care home for her mother but could we provide some home help urgently in the meantime. Mrs P had spent six weeks in rehab following a fall and breaking her back, and had no family living nearby. Her mobility was tricky in the early days, but she was absolutely determined to get better and to get out and about. We helped her for three hours, three times a week, taking her shopping, to health appointments, keeping on top of the cleaning and laundry, and preparing meals. But perhaps most importantly we provided companionship and Mrs P made a new friend. As Mrs P said in her own words when we first met her “My dear, when you reach 90 most of your friends have died”. After the first few weeks her daughter phoned back to say the search for a care home was off, and Mrs P was feeling very confident about living independently again now that she had support.
Staying put
If you are staying at home it might be worth thinking about making some adjustments to your property. Some quite small aids and adaptations could make your home much easier to live in. Simple things like long-handled shoehorns and grabbers can make dressing much quicker. Raisers can make beds and chairs much easier to get in and out of. Kettle tippers can be the difference between making a cup of tea and not bothering. Grab rails are great for getting in and out of the front door. Other adaptations might be more grand-scale, like having a ramp installed or re-siting a shower and toilet downstairs. Age UK has a great website with information on adapting your home and Brighton and Hove has some excellent mobility centres which stock a range of equipment. We don’t like to dwell on our safety too much but door intercom systems, secure locks, security lights, burglar alarms, carelink alarms, fire and smoke detectors all help give peace of mind if you are living independently.
If you feel you need a significant amount of care and want to remain in your own home then having a live-in carer is another option. Again, you can employ your own live-in carer directly or use an agency to help you find and employ someone. Many of the agencies work on a rota system whereby you may have a live-in carer for two weeks who is then replaced with another carer for two weeks, and so on. You will need to have a property with a spare bedroom for the carer. Live-in care doesn’t have to be permanent. It can also be a great way to provide intensive care in the short term following illness or discharge from hospital. Funding live-in care can be a concern for people. There are financial advisors who are specially accredited to work with older people through the Society of Later Life Advisers (SOLLA) and can help with equity release and other appropriate schemes. Look up your local SOLLA advisor at www.societyoflaterlifeadvisers.co.uk or call 0333 2020 454.
Case study
Mr & Mrs D were suddenly plunged into crisis. Mrs D, carer for her husband in his 90’s, broke her hip and was whisked into hospital. The paramedics were aware that Mr D couldn’t be left and so he went along for the ride, but by the following day the hospital were trying to find somewhere for him to stay whilst Mrs D recovered. Their son asked Home & Company to find a live-in carer at short notice to prevent Mr D being placed in a care home, knowing that Mrs D would be back home within a number of weeks. By the following day a very experienced live-in carer was put in place for an initial four weeks. Three months on, Mrs D is back at home, and the family have made the live-in position permanent as a way of Mr & Mrs D remaining in their own home. It’s worth noting that the house is a good size so everyone can have their own space!
On the move
Staying at home is not the answer for everyone though. The responsibilities of running a home can become a burden, and the idea of having a live-in carer in your home can also seem uncomfortable and rather intense for some.
For many people, moving out of the family home to sheltered housing is the obvious choice. It means you’ve still got your own key to your own front door if that is what feels important to you. Most sheltered housing accommodation is for people over the age of 55 and includes carelink equipment in the rooms in case of needing help, a communal area where activities take place, and a manager or warden who oversees the property. Over the past few years though many sheltered housing schemes have put less emphasis on the warden role so you need to ask in each property if the warden is situated permanently on site and what you can expect of them. Extra sheltered housing schemes mean you can still purchase your own accommodation, but with the option to buy in care services on site as you need them, and have meals in the communal restaurant. Retirement villages offer a similar level of support, and often have attractive health and leisure facilities too, but they can be set in out of town locations so think carefully about whether that would suit you and how you would get out and about.
You may feel that you no longer want to be responsible for a property and that you would enjoy the company of other people, in which case a care home is a great option. It means that all the domestic chores such as cooking, cleaning and laundry are done for you, and you are safe in the knowledge that staff are available day and night. You might feel nowhere near this stage, but it doesn’t hurt to have a look at a range of care homes so that you know your preference if that time comes. It’s not a bad idea to turn up unannounced and ask for a brief show round. The staff may not be able to devote much time to you but it will give you a feel for how things really are, warts and all. If you like it you can make an appointment for a longer visit another time, and have a meal there, the food is so important! Many homes don’t have very high staff ratios which means it’s tricky helping people get out and about. Do ask if they are able to take you for walks, shopping etc. Some homes are able to offer short term stays so you can go for a week or two as a trial run. It’s a good idea to read the home’s latest inspection reports available from the Care Quality Commission at www.cqc.org.uk.
Case study
Mrs O is in her mid nineties and says of herself that her mind is perfect but her body is giving up on her! She has lived independently in her 3 bedroom house for over twenty years since she was widowed. Although she has mobility problems she is still able to drive short distances, and was managing to get out and take part in her usual activities, but was beginning to feel more and more lonely and anxious when she got back to the house. She was having home-help from Home & Company three times a week but often calling to ask for an extra evening visit as the prospect of the nights alone began to really worry her. She had spent six weeks in a great local care home following an illness previously, and with the support of her family, booked in for another two week stay to test out whether it was really time for her to make the move. She enjoyed her two week stay but was determined to return home, which she did. But only a few days later, her anxiety about being alone at night was beginning to take hold, and with a certain amount of reluctance, she agreed that it was now time to move to the care home. A few weeks on she has now moved some of her favourite furniture and ornaments into her room at the care home and is beginning the process of making it her new home. Her anxiety has diminished dramatically and although she doesn’t yet feel completed settled she feels knows it was the right move, albeit that it took a few goes.
Whatever decisions you make it’s really important to feel you are in the driving seat. They key is not to wait until you hit a crisis before you put some help in place, as at that point decisions might be made for you. There are many sources of advice and support but it can feel like a minefield. It’s worth asking your local Age Uk office as a starting point.
Home & Company is also very happy to help with advice and signposting so do feel free to give us a call.