How can you support a loved one into a care home?
It would be lovely if there was a straightforward path to choosing and getting the best out of a care home for our loved ones. But in reality it’s a complicated business, and often frustrating for all concerned. Those with experience suggest patience, kindness and firmness are important, together with a determination to ask questions and be involved.
Before you decide on a home
Do research. There are several platforms where people give feedback on care. Comments may not be balanced – it’s likely that those who are frustrated will have more to say than those who are content. But it’s a good place to get hints on what to check when you’re looking for a home.
Visit several homes. If you’re dependent on local authority funding, you may not have many choices, but if you’re paying towards care, it’s worth taking time to visit a number of homes.
Ask questions. Ask about staffing levels at different times of day, for example. Night cover is often very limited. And how are staffing levels today compared to a year ago? Does the home place restrictions on meal-time visiting and if so, why? How often do they lock down the home because of illness? It’s important to know the rules, because they are set by the home and you may not agree with them.
Take note. Watch how the care team communicate with each other as well as with the residents. Have a look at the notice boards and see what entertainment takes place, and whether trips out are planned.
Check funding. The finances of care are very complicated, and seem to vary from one local authority in the UK to another. Sometimes care homes will attempt to demand top-up fees from family when the place should be fully funded by a local authority. It’s understandable given that LAs often can’t or won’t pay the fee the care home believes it needs to cover costs. On the other hand, you can often choose to top up to upgrade the room. It’s simpler if your loved one is fully self-funding, but still worth asking how much fees have risen recently, and are expected to rise in the future. Nursing fees should be paid for by the state in the UK.
Set up Power of Attorney. Do this as soon as possible, while your loved one has the mental capacity to agree to it. If it’s too late you will need to have them declared to lack capacity. There are two forms of Lasting Power of Attorney – financial and health/welfare. Both are important, especially once you have entrusted your loved one’s care to a home.
Ask about limitations of care. Some care homes don’t offer dementia care, for example, so your loved one may need to move to somewhere more suitable if they develop dementia. There have been reported cases of some homes requiring a resident to leave because they find them too difficult to care for, or even can’t afford the fees any longer. So it’s good to ask about reasons why residents might be evicted, and what the process would be.
Trust your instincts. In some ways choosing a care home just like moving house – you’ll know if a place feels right.
Once in residence
Manage your expectations. There’s no obvious set of care guidelines and processes to which every local authority and care home adheres. You’ll need to find out who at the local authority can advise you on care. Private care homes will need to comply with some standards, such as safeguarding, but may be a law unto themselves in some ways. Care home staff won’t necessarily have received good training, may be under pressure of time, and may have varying attitudes. It may also be difficult to form relationships with staff, as there is often a rapid turnover of employees, including management, and a reliance on agency staff. It’s important to be aware of these factors and work with them, rather than expecting processes to work smoothly.
Make yourself known. Talk to staff when you visit, by email or on the phone, and gently but firmly show your intention to be involved in your loved one’s care. Explain how to get hold of you to discuss any issues that might arise. Build relationships by listening as well as talking.
Speak up. Don’t be afraid to challenge situations or decisions if you feel they’re not right or detrimental to your loved one. You should be involved in decision-making, or at least kept informed of any changes to care or costs, and that’s particularly true if you have a Lasting Power of Attorney. Otherwise you may find decisions are being made about care, medication and costs without your involvement.
Find out what’s paid for. You’ll probably expect to pay for services such as hairdressing and chiropody. But you may be surprised to discover there’s a limit on the number of funded incontinence pads per day, so you may have to top up the stores of these, along with toiletries and other essentials.
Don’t think you’re alone. There are wonderful support groups, including one called Care Rights UK and its Facebook group Rights for Residents. Not only do people share experiences and tips, but the group has a helpline staffed by people with real knowledge of the care home world.
Be kind. It’s not an easy situation so be kind to everyone if you can – your loved one, the care home staff, and yourself.
Image from UnSplash+
