3. Care at home
Arranging temporary care in the home of the person with dementia has some advantages – for example, the person may find it reassuring to remain in familiar surroundings. However, any regular carers might have to spend considerable time and effort making arrangements to ensure that the person is well cared for and that the home runs smoothly while they are away.
The easiest solution might be to arrange for a friend or relative to stay. If this isn’t possible there are a number of other options. It is important to think carefully about the type of care required. Full-time nursing care is usually very expensive, and may not be necessary. The options for finding someone to provide care at home include:
- Personal recommendations – perhaps another carer or the GP surgery may know of someone suitable.
- Advertising – advertising locally is often best because the person with dementia and those who care for them can get to know the person beforehand.
- Homecare agencies – these can find people to provide respite care, but will probably be more expensive. The local health and social care (HSC) trust may have a list of local homecare agencies.
- Care packages – if the person does not need support 24 hours a day, a care package involving family, friends or neighbours, social services, voluntary agencies and even some private care might be the answer.
- The local HSC trust – some local HSC trusts arrange homecare, although they vary in this respect (see ‘Community care assessments’ below).
Checklist: setting up respite homecare
- Always interview the applicant personally, and take up references.
- Ask whether the applicant has any experience or training in dementia care.
- Introduce the applicant to the person with dementia to ensure that everyone is comfortable with the situation.
- Check with your home insurance company that the person with dementia is covered for someone working in their home (in case of accident or theft).
- Ask the applicant about their employment status. If they are not self-employed, the carer might be responsible for their tax and national insurance. The local Citizens Advice Bureau may be able to advise (see ‘Other useful organisations’).
- Make sure that you agree with the applicant exactly what the their role will be. For example, you need to make it clear if you expect them to do certain household tasks, or to take the person out each day.
- Make sure that everyone is clear about the hours and fees, and put this in writing.
It is essential to leave very clear explanations and instructions for whoever is caring for the person with dementia, preferably in writing. This means that there is less possibility of them forgetting, or of there being a misunderstanding. Instructions should include:
- details of the usual routine and activities of the person with dementia, their likes and dislikes and any dietary, religious or cultural practices that should be respected
- clear instructions about the running of the home – for example, which keys lock which doors, and how the washing machine operates
- important phone numbers – for the GP surgery, for example
- the contact details of carers or family members, or of someone else to contact in an emergency.
Tip: using life history books
Life history books or personal profiles can be an invaluable toolkit for any third party spending time with the person you care for. These should include key facts about the person’s life experiences, where they have worked, important people in their life, their interests and any particularly sensitive subjects. Try to include photographs that interest the person with dementia, with clear information about the photograph to stimulate conversation.
Alzheimer’s Society produces a tool called This is me to record key background information about a person. See alzheimers.org.uk/thisisme