Home or away for care and nursing homes?
Joan is about to move to her third home in two months – and that’s not counting the flat she left behind following a fall and a spell in hospital.
The first, a care facility in her home town, decided she needed nursing care, which they couldn’t offer.
The second was nearby and very amenable, but Joan decided that in the long term she would actually move a few hundred miles to be close to her sister.
This question of ‘Where?’ isn’t one that always comes up in the tips about choosing a care home. It may seem obvious that your relative or friend will go into a home in the area where they’ve been living. That’s where their friends are, where their GP is, and they know the area.
But it’s not that clear cut. Here are a few of the reasons for and against staying local, or moving to be closer to family.
Friends and neighbours
When someone moves into a care or nursing home, their hope is often that friends and neighbours will visit them and keep them up-to-date with what’s happening in local circles. It’s great when that happens, but it’s not always the case. Out of sight really can be out of mind. It’s not that your relative is forgotten – it’s just that busy people get on with their lives and often think of their erstwhile friend as having moved on to a new life altogether.
There will be good friends who continue to visit regularly, but the longer you live in care, the less you have to talk about, and some people can feel this very keenly.
This is what happened to Joe. He had already decided where he would go if and when the time came, and was fortunate that the home had a lovely room available for him. He had lived in the area for around half a century, and as a sociable man had made many friends over the years. A few good friends and neighbours continued to visit, and would help out with a little shopping. He enjoyed his first few years there, but the last year did become a little lonely, as he started to discourage visitors when he felt unwell.
That all sounds desperately depressing, but it’s just something to think about when your relative is deciding whether to stay local or move away. They aren’t really the sort of reasons you’d want to present to them as evidence that they don’t need to stay around in their home area. It’s just worth bearing in mind that the friends link may not be as strong as we’d all like it to be.
Continuity with medical services
It doesn’t matter how long your relative has been with their doctor, the chances are that they will have to change when they move into a home. Care and nursing homes generally have agreements with local surgeries that mean there are GPs available to visit the home regularly.
That’s often actually a good thing, as it’s often difficult to transport a resident to appointments, but it does mean that continuity of GP care isn’t possible. And that’s especially true if your loved one moves a few times before they settle in what might be their home for the rest of their life.
Another important consideration though is that if your parent has regular hospital appointments and you are satisfied with the care they receive there, that in itself is worth a great deal, and definitely worth adding in to the equation.
Knowing the area
How easy will your relative find it to get out anywhere they know – to local events and or even their favourite shops? They and you will have to think about transport, and the home will be concerned about safety.
That might mean that they need to have a companion with them whenever they leave, which could be family or friends, or a carer whose time will have to be paid for.
Closer to family
An alternative is to move your parent or other relative closer to family. There are benefits and downsides to this approach too.
Ease of choice
Sometimes finding a nursing or care home is a matter of urgency. Perhaps your loved one needs more help than carers at home can provide. Or they’re being discharged from hospital and recognise that living independently isn’t really going to be an option at least in the short term. Or they’ve reached a point in living with dementia where they need a safer place to be.
Whatever the reason, if finding a home is urgent and it’s down to the family to search for one, then looking near to where you or other family live is going to be much easier. That’s simply a matter of logistics and practicality.
Building relationships – keeping an eye on things
If your relative comes to live in a home near you or another family member, it means you can enjoy more and regular visits. With that comes an opportunity to establish closer relationships with the staff at the home. If carers and managers have regular contact with you, they’ll be able to build up a bigger picture of who your loved one is, their story, and the strength of the family around them.
You could also see it as a way of keeping a gentle eye on how care is being managed, if you feel that’s necessary. We do hear stories occasionally of abuse in homes, and sometimes people living with dementia, for example, are confused about the quality of care they are receiving. You’ll be able to allay or address any worries if you’re there on a frequent basis.
You do need to consider whether you are able to make that commitment to more regular visiting if your relative is nearby. If you’ve been used to seeing your relative on special occasions, and suddenly they’re hoping to see you every week or more, that can be a struggle. Remember that your own life is important too, and don’t commit to more than you feel you can comfortably do.
Getting out and about
Older people tend to have a lot of medical appointments. They may be able to take advantage of visiting services to the care or nursing home, such as GPs, podiatrists or even hearing aid dispensers, but they will still need to get to hospitals, dentists, opticians, and all the other specialists to help ageing bodies. That will be much easier to organise if you or another relative live close by and can just take them, rather than arranging taxis with carers or an ambulance.
It’s not just about the necessities of life. Being nearby also means that you have the opportunity to take your loved one to more pleasant places – lunch out, a wander round a local garden, even the cinema if they’re up to it. If you only get to visit your relative for a short time on an occasional basis because they’re too far away, these sort of sharing experiences can go by the wayside, sadly.
In the balance
If your relative is self-funding, they have a wide choice of care and nursing homes – depending on their budget.
But there are huge geographical differences in how much care and nursing home places cost across the country. If you’re moving from Devon to London, say, the difference could be several hundred pounds a week. So assets will be eaten up faster in the more expensive areas, and there’s the possibility that they could run out.
While we wouldn’t want to think we’re deciding someone’s future purely on economics, in today’s climate savings need to stretch as far as possible to ensure a comfortable life.
To help your relative make their decision about where to find a care or nursing home, you can look at:
- The availability of local friends and family to visit and take them out
- The comparative cost of care and your relative’s budget
- The comparative quality of medical care available
- And, of course, your relative’s own preferences
If you would like to anything to this discussion of how to choose home or away for a care or nursing home, or disagree with anything we’ve said, please do join the conversation by adding your comment below, or emailing [email protected].
Other articles you might find useful:
- An insider’s guide to asking the right questions when choosing a care home
- 10 questions to ask when choosing a care home
- Visiting grandparents in their new care home