Finding a care home
This guide explains the different types of care home for people living with dementia. It also advises how to find and choose the right one.
Many people with dementia move into a care home once their dementia progresses to a certain stage. Some people with dementia have other illnesses or disabilities that make it difficult for them to remain at home. Some people may need to move from one care home into another. Good quality care that preserves dignity, treats people with respect and promotes independence can improve the lives of care home residents with dementia.
Choosing the right care home is, therefore, very important but it can be difficult. This guide looks at how to find a care home and explains what high-quality care for people with dementia should look like. It also includes a checklist of some key things to think about when visiting different homes.
Different types of care home
Care homes provide either residential or nursing care. The type of home that the person requires will depend on their general health and care needs. Everyone with dementia is different. For some people with dementia the main problems that they experience will be dementia-related, whereas for other people with dementia their main problems may be caused by a different condition, such as a stroke.
Residential care homes provide help with personal care such as washing, dressing and eating. In some residential care homes staff have had specialist training in dementia care. Nursing homes provide personal care but also have a qualified nurse on duty 24 hours a day. Some homes that are registered for nursing care will accept people with personal care needs who may need nursing care in the future.
Finding care homes in your area
Lists of local care homes and inspection reports are available from the Care Quality Commission (CQC) in England, the Care and Social Services Inspectorate Wales (CSSIW) or the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland. See 'Other resources' for contact details.
However, not all care homes are suitable for people with dementia. A professional such as a doctor or social worker, or a voluntary organisation such as your local Alzheimer's Society or Age UK office, may be able to give advice on the type of home that may be suitable for someone with dementia.
Phone or write to a number of homes and ask about the level of care provided for people with dementia, the fees and the waiting list. Review any information they send you. It is important to visit the homes that seem promising.
Choosing a care home
Care homes may be arranged through the local authority but many people will arrange them independently. It is a good idea to visit several homes before making a choice. Make sure you spend enough time in each home to get a good idea of what it is like. Ask yourself the questions in the 'Things to think about when visiting care homes' page.
If you are looking for a home on behalf of the person with dementia, you may want to make the first visit on your own and then, if you think a home may be suitable, visit again with the person. You can then see what their reactions are, and how they might settle in. You may be able to arrange a trial period - many homes require these anyway and they can be very useful.
Before making a final decision, you may want to look at a recent inspection report for the home. These often give a lot of detail on how the home operates. You could ask the home itself to give you a copy or they are available from the CQC (in England), the CSSIW (in Wales) or the RQIA (in Northern Ireland).
If the local authority is arranging the care home, and there is more than one suitable home to choose from, the person has the right to choose which home they would like to live in. A care home is suitable if it can meet the person's needs, meets the local authority's conditions of cost, and has a place available for the person. The care home must also be willing to sign a contract with the local authority. If the person with dementia cannot make decisions for themselves (that is, they have been assessed to lack the mental capacity to do it themselves), the local authority must speak to the person's guardian, someone who has lasting power of attorney (LPA) for personal welfare or someone who is closely involved with the person. If there is no guardian, LPA or carer involved, the person has a right to an independent mental capacity advocate to make sure that the choice of care home is in their best interest.
Moving between care homes
It is sometimes necessary for a person with dementia who is already living in a care home to move to a different home. Such a move can be stressful and people may react in different ways. It is therefore important that the move is carried out with proper planning and preparation. If the local authority would like to move a person to a different care home they should first carry out an assessment that considers the possible impact of the move on the person.
The person should move during the day, accompanied by someone they know. An optimistic attitude about the move will encourage the person with dementia to see it as a positive change. It is also best to give the person with dementia as much choice and control as possible. For example, visit two homes and give the person a choice of which one to move to. If there is more than one bedroom available at the new home, try to choose one that is similar to the person's previous room. For example, choose a room with a similar layout or a room where the way to the bathroom is similar to before.
If the person is moving to a care home in a different local authority, disputes about which local authority is responsible for the person's funding can arise. This should not lead to any delay in the provision of care or accommodation, and until the dispute has been resolved one of the local authorities must accept responsibility.