Choosing the right time for a care home is hard, but it is worth considering:
- Struggling with daily activities such as taking medication, self-neglect and challenging behaviour may indicate the need for professional care and help
- There are a number of ways to ensure you choose the right care home, including: checking the care home’s quality rating; finding out how they care for people with dementia
Caring for a loved one living with dementia can be hugely challenging, and often becomes even more difficult as symptoms worsen – and when this happens, it may be time to think about the next step to ensure your loved one receives appropriate care.
So, when should someone with dementia go into a care home? This article offers information and advice to help you make the right decision for your loved one.
Recognising the Right Time for a Care Home
It can be difficult to decide when a dementia patient should go into a care home.
To help you make your decision, are your loved one’s needs being met at home? And if not, will moving into a care home be in their best interests?
The primary indicators that suggest a dementia patient should move into a care home include:
- They struggle with mobility
- They may be confused and forgetful
- They may wander
- You may experience stress
Safety and Well-being Concerns
Self neglect is described as an extreme lack of self-care. The signs of self-neglect include:
- Lack of self-care to an extent that it threatens personal health and safety
- Neglecting to care for one’s personal hygiene, health or surroundings
- Inability to avoid harm as a result of self-neglect
- Failure to seek help or access services to meet health and social care needs
- Inability or unwillingness to manage one’s personal affairs
Self-neglect and challenging behaviour may indicate the need for professional care and help, and there are a number of ways to address it, including safeguarding.
The Care Act 2014 states Safeguarding is ‘protecting an adult’s right to live in safety, free from abuse and neglect.’
For people living with dementia, they may suffer with cognitive symptoms which can make them more at risk of abuse or neglect, including:
- Memory loss
- Problems with concentrating, planning and organising – including making decisions and problem solving
- Communication difficulties
- Difficulties with orientation
To keep you and your loved one safe, it is important to learn how to assess factors that may put either at risk. Following these steps can be helpful:
- Try to identify what causes your loved one distress. For example, are they prone to sundowning?
- Consider who this might put at risk: This could be the person with dementia themselves, you, or other people around them
- Make a plan to reduce the risk: To prevent sundowning, for example, you could close the curtains before dusk to make the transition from day to night easier
- Put changes in place: Seek help from family members or the person’s GP or social worker to make the changes
- Keep reassessing the risk: Reflect any changes – for example, a new carer or a change in the person’s dementia symptoms.
Enhancing Quality of Life in Care Homes
In 2018, a large-scale trial led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust found that increasing the amount of social interaction for people with dementia living in care homes to just one hour a week improves quality of life when combined with personalised care.
Dementia can change someone’s personality, and as the disease progresses, one of the most noticeable differences is a person’s ability to socialise.
Social interaction is healthy and can slow dementia symptoms including cognitive function and memory loss.
A person living with dementia deserves purpose and pleasure just like everyone else – and that is why activities, social interaction and continuous family contact become even more important. In fact, social interaction has been shown to boost self-esteem and relieve stress.
There are many ways in which care homes can provide activities for people living with dementia, which:
- Compensate for lost abilities
- Promote self-esteem
- Maintain residual skills and not involve new learning
- Provide an opportunity for enjoyment, pleasure and social contact
Physical activity has been proven to benefit people living with dementia, including:
- Improved mood
- Better sleep
- Maintenance of motor skills
- Improved memory
- Improved behaviour, such as reduced rate of wandering, swearing and acting aggressively
- Better communication and social skills
Other activities that can help engage people living with dementia include:
- Video games: Evidence-based activities like playing on a tablet or iPad can improve executive functions for people with dementia
- Board games and puzzles
- Dementia cafes: People can socialise, participate in dementia-friendly activities, and share experiences with loved ones and other attendees
So, when should someone with dementia go into a care home? It is a difficult decision to make, and choosing the right care home for your loved one is crucial.
Check the care home’s quality rating
The Care Quality Commission (CQC) is responsible for inspecting and rating care homes. You can find a care home’s CQC report here.
Visiting a care home in person is essential
By visiting you will see first-hand how they care for people and decide whether your family member would be happy there. You can follow this checklist when making your decision:
- Do the staff make you feel welcome?
- Are the staff interested in your loved one?
- Do you like the accommodation and what it offers?
- Would your loved one enjoy the activities available?
It is also worth being aware of your senses during a visit: What does the home smell like? Is it noisy? Do service users look well cared for? Your sight, smell and hearing will be important here.
Find out how they care for people with dementia
Is the home you’re considering a general care home? Or does it specialise in dementia care? It is important to find out how the needs of people living with dementia are met.
Find out how many carers are trained in dementia care – and to what level – and speak to the staff with dementia care experience. You could also ask to speak with other families who have a loved one living with dementia in the care home – they will be able to offer insights.
The Role of Care Needs Assessments
It is important to obtain a free care needs assessment from your local council’s social services to help you with your decision.
Contact the local council or trust of your loved one and tell them you help someone who needs care and support, and ask for a care needs assessment. If someone needs urgent support, the local council or trust can provide services before an assessment has been carried out.
Dual Registered Homes: A Flexible Solution
It helps to have all your bases covered when it comes to the care of a loved one living with dementia, as symptoms can worsen and their needs may change, which is why dual-registered care homes are worth considering.
Dual-registered care homes accept residents who need both nursing care and personal care. So, if your loved one moves in and only requires help with personal care, but their needs increase over time, they won’t need to move to a different home.
It will be much less disruptive and unsettling to move rooms rather than a completely new nursing home.
Transitioning to a Care Home
When should a dementia patient go into a care home? A question loved ones don’t want to have to answer, but when moving into a care home is the right decision, it’s important to make the transition as smooth as possible.
Your loved one may be reluctant to leave their own home, or they may have forgotten the arrangement, and so it’s important to try and reduce their anxiety.
Here are some tips that may help on the day of the move:
- Avoid or minimise anything that could cause conflict or distress
- If a staff member has met your loved one before, ask it they can be available when you arrive as a familiar face can be reassuring
- Make sure your loved one’s room is comfortable and homely with photos, a favourite blanket, and any treasured items
- Discuss with staff when the right moment for you to leave will be. For example, leaving while your loved one is distracted with an activity or meal
Your loved one may settle into the care home quickly, or they may need longer to adjust, and the care home will help advise the best way to ensure a smoother transition.
You may be asked not to visit for the first week so they can settle in, whereas some residents may respond better to more frequent visits. Encourage your loved one to spend time in the communal areas or join in activities to build relationships and feel more comfortable in their new environment.
Moving forward, you will play a vital role in helping staff build a care plan that will benefit your loved one, and open communication will help ensure their needs are met.
Understanding the Need for 24-Hour Support
Dementia is a progressive condition, and as their condition advances, they will eventually need 24-hour care. An experienced dementia caregiver can identify symptoms and is trained to respond compassionately. The caregiver will tend to a patient’s needs and ensure their comfort and safety.
Many loved ones ask, ‘Do all people with dementia end up in a care home?’ The reality is, a person living with dementia will eventually need 24-hour support and care as their symptoms get worse. Although you may be able to act as a carer at home for a while, a care or nursing home may be best, to not only ensure their needs are met, but that you don’t need to do it alone.
When deciding if a care home is the right choice for a dementia patient, consider the following:
- Continuous social interaction is healthy and can slow dementia symptoms including cognitive function and memory loss
- Obtain a free care needs assessment from your local council’s social services to help you decide on a care home
- 24-hr care is the best thing for your loved one as their dementia progresses
Before making a decision on when to move your loved one into a care home, it’s important to seek support and guidance before making a decision.
Frequently Asked Questions