The costs and benefits of moving to a care home

Dementia symptoms get worse over time, so every person with the condition will begin to need more support. Solutions that have been working well at one stage may no longer be enough to keep the person safe. 

Care homes are sometimes seen as a last resort, but they are often the best way for the person to stay safe and well. Many carers reach a point where they feel unable to continue at home, even with additional support. Some wish they had discussed care homes sooner.

Sometimes, accepting that the person needs more help than you can provide is the best way to support them – even if it means moving to a care home.

You may find that over time, the risks of the person staying at home, or even in supported or assisted living, outweigh the benefits. This might be the right time to consider a move to a care home.

Types of care home

There are different types of care home. These include: 

• Residential care homes. These can be helpful for people who need support or supervision to complete daily tasks, such as eating, washing, dressing and going to the toilet.
• Nursing care homes. Like residential care homes, nursing homes support residents with their daily care needs. They also provide help with nursing care. For example, if the person has medical needs or issues with continence.

To find out whether someone needs nursing care, an NHS continuing healthcare (CHC) checklist should be used. Ask your local authority, trust, or a medical professional to arrange this. 

This should show whether the person is eligible for CHC or funded nursing care. If they are, they should live in a nursing care home, rather than a residential care home.

Funded Nursing Care and CHC are different types of funding, but the same checklist is used to see if someone is eligible.

The benefits of a care home for a person with dementia 

There are many benefits to care homes for people living with dementia. Some of these are listed here.

• Care at all times of the day
  A care home will have trained carers who can provide continuous support day and night. This is important as the person’s dementia progresses and their needs become more complex.
   
• Support with a variety of tasks
  A care home will also have a team of people who provide support in other ways. This could include cooks, cleaners and activity coordinators. It can be very difficult for family and friends to perform all of these roles themselves if they are caring for the person at home.
   
• Social benefits
  Residents can meet one another and join in group activities. This can help a person with dementia to maintain social skills and self-confidence.
   
• Meals
  Care homes will provide regular, nutritious meals according to the residents’ dietary needs. Carers can be assured that the person is getting the nutrients they need and that they won’t forget mealtimes.
   
• Staying hydrated
  The staff will ensure the person stays hydrated. This can prevent urinary tract infections (UTIs), which can make confusion worse.
   
• Medicines management
  Care home staff will ensure the person takes their medication at the right time and at the correct dose.
   
• Care tailored to their needs
  Although there will be a number of residents, everyone who lives in a care home should receive person-centred care and have their own care plan. This means that each person should be given support that is tailored to their needs, interests and personality. For example, if they prefer to go to bed at a later time, they should be supported to do this where possible.
   
• Activities
  The person can continue to do things that are enjoyable and meaningful to them. Care home staff can adapt activities for the person’s skill level. They can also introduce them to new types of activities. This can help with self-esteem and ensure the person with dementia stays engaged and stimulated.
   
• Affordability
  If the person needs constant support or supervision, homecare costs can be very high. In some instances, care homes are a more affordable way for people with dementia to access the level of care they need as the condition progresses.
   
• No maintenance or adaptability responsibilities
  The person can use and enjoy the living environment, communal areas and any outside areas of the home without having to maintain them. These spaces are likely to have been designed with people with dementia in mind. For instance, there may be signs, helpful lighting and grab rails that help the person move around safely.
   
• Visits
  The person with dementia can still see family and friends during visits to the care home. They may also be able to leave the home for trips or weekends away. This allows family and friends to spend quality time with the person, without focusing on their day-to-day care.

Considering costs when looking at care homes

The cost of a care home varies. It depends on: 

• The type of home and support provided 
• Who is paying the fees
• Where the care home is

It’s worth looking into care home fees as early as you can.

It may help to ask the following questions:

• What level of support does the person with dementia need? Asking the local authority or trust for an assessment will help identify what help is needed and where their needs can be met.

• Who will fund the person’s care? The person may pay for their own care – this is known as being a ‘self-funder’. Or they may get financial assistance from the local authority, trust or the NHS. If you’re not sure if the person is eligible for this support, ask the local authority or trust to arrange for the person to have a financial assessment. This will look at the person’s savings and their income. It will show whether:

  • The person has to pay for all their care fees, or
  • Whether the local authority or trust will contribute
    to the cost.

  The local authority should also arrange for an NHS continuing healthcare checklist to be completed if they feel the person may qualify for funding through the NHS.

• How much do different care homes cost? The website PayingForCare has an online calculator to help work out the average cost of a care home in your area.  If you think the person may be eligible to receive financial help to fund their care, talk to your local authority or trust. This should give you some idea of the budget that may be available. You can also ask them for information on local market rates.

Your choice of care home may be limited by the cost, especially if the person’s care is being funded by the local authority or trust. This is because there is usually a limit to how much they can fund. 

This may affect your decision about whether a care home is the right option for the person with dementia.

It is a good idea to start looking at care homes earlier than needed to get a sense of what is available, and the costs involved.