4. Types of replacement care
Care at home
Replacement care can be provided in the home of the person with dementia. Many people may prefer this because they can stay in a familiar environment and maintain daily routines. Replacement care at home can involve a personal assistant, support worker or paid carer visiting the home. They may do any of the following:
- come in during the day to give the carer a break, with the carer using the time to do something they want to do (eg go to the shops, visit friends or pursue education or a hobby)
- spend time with the person and engage them in social activities both inside and outside of the home
- come in to the home to care for the person during the night to give the carer a chance to sleep
- stay with the person or make regular visits over a certain period of time so that the carer can go on holiday or have an extended break away from the home.
Replacement care at home can be arranged through the local authority, or privately, directly with a homecare agency. A carer from a homecare agency may be able to provide replacement care for a few hours a day, regular visits (eg three times a day) or 24-hour support for the person at home, depending on their needs.
Some care agencies specialise in providing 24-hour live-in care. This is usually more expensive than a place in a care home. If the local authority is funding replacement care there may be a limit on what they will fund. If they can meet the person's needs in a cheaper way, for example in a care home, then they will do so. However, these decisions cannot be based on cost alone and the local authority must discuss the arrangements with the person and their carer.
Another option is to employ a personal assistant to provide care. If the carer or person with dementia is receiving a direct payment, they may want to use this to employ a personal assistant directly. For more information see page: Personal budgets.
Some local carers' organisations may offer a replacement care service. This usually involves a regular carer coming to spend time (usually a few hours) with the person with dementia. The local carers' centre can provide information on what is available locally. Carers' centres are independent charities that deliver support services for carers in local communities. Carers UK (see 'Other useful organisations') can provide details of the nearest one.
Friends and family
If the person with dementia wants to stay at home, family and friends may be able to spend some time with the person to give the main carer a break. Alternatively, family and friends could have the person with dementia stay with them, if the carer wants to have a break at home.
The person with dementia and their carer may be more comfortable with this arrangement because the person will be spending time with someone familiar. Relatives may also be more familiar with the person's routine and preferences.
However, family members and friends may not be able or willing to take on this responsibility. It can help to talk to them and try to find solutions that work for everyone.
Care away from home
Day centres can provide a range of support for a person with dementia, including activities and social interaction. Some day centres specialise in supporting people with dementia, and some are run specifically for younger people with dementia. The local authority or local Alzheimer's Society office can provide details of day centres in a particular area.
It may take the person a while to adjust to attending a day centre, and initially they may need support and encouragement to go. Some carers find accompanying the person for the first few visits helps. It's important for staff at the day centre to get to know the person and treat them as an individual. This will mean they can help the person settle in and make sure that activities meet their needs.
Holidays and short breaks
Replacement care can also take the form of a short break or a holiday. Some organisations provide specialist package holidays for people with dementia and their carers. They include support with caring tasks, and facilities that are accessible and dementia friendly. This means the carer can have a break from their caring role and focus on spending quality time with the person they care for. The local Alzheimer's Society office or carers' centre can provide more information.
Taking a holiday together may require a lot of planning. It's important that arrangements are made with the provider in advance, if possible, so that the person with dementia and their carer both know what to expect. The person with dementia may need extra support when coping with the new environment or changes to their routine. For more information and advice on travelling see our page: Travelling and going on holiday.
The person with dementia can stay in a care home for replacement care. There are different types of care home, providing different levels of care in addition to accommodation.
- Some care homes provide assistance with personal care (eg washing and bathing). These are often referred to as residential care homes.
- Some care homes provide nursing care as well as personal care. They provide care with a registered nurse on site 24 hours a day. These are often known as nursing homes.
- Some care homes are registered as dementia care homes. These specialise in caring for and supporting people with dementia.
Some care homes have beds set aside for people requiring replacement care. However, it can be difficult to get replacement care in a care home when it is wanted or needed because it depends on a room being available. If possible it can help to plan ahead for when replacement care will be needed.
Shared Lives is an alternative to homecare and care home arrangements. It is a national scheme where the person with dementia can spend time in the home of another carer and give their own carer a break. Availability may depend on the local area. The local authority or local Shared Lives organisation can provide more information.
Carers' emergency replacement care scheme
Some local authorities or carers' organisations will provide replacement care to the person with dementia in an emergency (usually between 48 and 72 hours depending on the situation). The local authority or local carers' centre can provide more information and say what is available in a certain area.