One of the most common questions we get asked at Elder HQ is: ‘What do live-in carers actually do on a day-to-day basis?’
Maybe the best answer would be another question: what don’t they do?
After all, live-in care – that is, 24-hour care in the comfort of your loved one’s home – is about much more than just practical assistance. It’s about improving their lifestyle without asking them to change they way they like to do things, and creating new opportunities that might otherwise have been out of reach.
In short, their role and responsibilities depend on the person they’re looking after. No two people – and no two days are the same, and live-in carers know just how important it is to be flexible to shifting needs and circumstances.
But we don’t do things by halves here at Elder, and we’d prefer to give you an in-depth look at the sort of tasks a live-in carer may carry out. In this guide we’ll walk you through what life may look like for a person receiving live-in care, from the moment they wake up to the moment they drift off to sleep.
By their late 80s, more than one in three people have difficulties undertaking five or more tasks of daily living unaided and between a quarter and a half of the 85+ age group are frail, which explains why it is people in this oldest cohort who are most likely to need health services and care support.
Who is live-in care suitable for?
Live-in care is most suitable for people with low to mid level needs – from wanting some consistent companionship, to living at home with dementia. It’s a flexible option that works around your loved one’s schedule and requirements, and all in the comfort of their own home.
This kind of care is equally suitable as a short-term solution – perhaps after a stay in hospital – as it is for those with chronic conditions. It’s also a great way of looking after those with early to mid-stage dementia, though in the later stages a nursing home, or home care this a nursing care component is likely to be a better choice.
Some of the benefits of live-in care include –
- Round-the-clock care at home
- A flexible and bespoke care solution
- Dedicated one-on-one support from a familiar carer
- Continued independence, maintaining a comfortable daily routine
- Expert support for chronic conditions
What 24 hours of live-in care could look like
Rise and shine. We all want to start the day well, but morning routines can be the first to drop off when things start to get a little tougher.
An Elder approved live-in carer can make sure an older person starts the day right. They’ll help them get up, washed and dressed – and, ultimately, start the day feeling positive in themselves.
8am: Getting up
After a long night in bed, an older person may have a little difficulty first thing in the morning. But with a carer, it won’t take them long to find their feet.
The carer can offer any support that’s required, whatever that may look like. It may be that a person needs help getting into their dressing gown, or support in getting to the bathroom, or even someone to tend to more personal needs.
If they have bowel or bladder issues, for example, a carer can provide discreet support to ensure the person they’re caring for is clean and comfortable. This is crucial not only for self-confidence, but for health, too: urinary tract infections are one of the most common causes of hospital admission for elderly people, but can be avoided with adequate hygiene and dealing with dehydration effectively.
8.15am: Having a shower
For families with elderly relatives, bathroom safety is usually at the top of the list of concerns.
It’s normal to worry that about them slipping on a wet floor, or scalding themselves with hot water. But a carer’s role is to keep an eye on the situation, suss out just how much help they need and know when to step in and offer gentle, sensitive support.
After all, bathing is a personal thing. An older person may simply need help getting in and out of the bath, or want to wash themselves with a towel wrapped around them. Whatever they prefer, a carer is there to work around their wishes and create the most comfortable environment possible.
Carers also cater for other aspects of a preferred bathing routine. So if an older person favours washing in the evening, would rather a bath instead of a shower or has some favourite toiletries, the carer will do their best to build these into their daily routine.
The bathroom: things to think about
- Handrails or a shower seat can provide additional support
- Lay non-slip mats to limit the risk of accidents
- A hand-held shower can provide more manoeuvrability
- Use liquid soap rather than a bar of soap, which may be a slip hazard
Age UK has a range of products designed to help safer bathing, and can also help with questions about and provision of adapted bathrooms.
8.45am: Brushing teeth
When it comes to oral hygiene for the elderly, consistency is key – and a carer can make sure an older person brushes every morning and evening like clockwork.
They might simply need to give them a nudge every now and then, or – if they have trouble holding the toothbrush – take a more manual role and brush their teeth for them. In any case, it’s important they do: according to the British Dental Association, poor oral health can ruin the fit of dentures, causing ulcers and eating difficulties.
Saliva, too, is fundamental in keeping teeth clean, but its production declines as we age, making the elderly more vulnerable to decay and infection. A carer can also see that the person they’re caring for keeps up with their dentist appointments every six months too.
9am: Getting ready
Everyone likes to look their best, no matter what their age. Carers are on hand to help with getting dressed – a task which only gets more difficult for those with joint trouble. Conditions that cause confusion such as dementia may make it more difficult to choose the right outfit too – as it may be more difficult to keep up with the weather and time of year.
Carers can also help with giving hair a spruce.
If haircare is a high priority for the care recipient, the carer might even consider booking a mobile hairdressing service to visit them at home – an opportunity not only to keep their hair in good shape, but to have a bit of a natter on a lazy afternoon.
9.30am: Taking medication
A carer can help an older person stick to their medication schedule. This may be as simple as the odd reminder, or it may demand a little more imagination.
Whatever the case may be, the carer is always around to build it into the care recipient’s routine – not to mention keep an eye on their behaviour and condition.
This means they’ll be first to notice if there’s anything wrong, or if the person they’re caring for is refusing certain medications, and know the appropriate health professionals to alert. They’ll also be able to keep the family fully informed, giving everyone an opportunity to respond to challenges as they arise.
In cases of dementia, this may be even more essential, as changes are inevitable, continuous and can be drastic between early stage and late stage.
Looking after a home takes a lot of hard work at any age. But for an elderly relative, this responsibility can become a burden.
That’s where a carer comes in – they’re able to assist light domestic chores such as hoovering or keeping on top of laundry. It all depends on how much an older person wants to keep doing themselves.
So, there may be general housekeeping that needs doing – floors to mop, beds to change and dishes to wash – or minor practical jobs to check in on – light bulbs to change, pets to feed or garden paths to sweep clear of fallen leaves. The exact help that’s needed will be outlined in the online care appraisal before care begins, to help the carer make the most of their time each day.
Living with Live-in Care: Dulcie’s Story
In this short video, 100-year old Dulcie, her family and her carer talk about what it’s like to receive live-in care and how it has enhanced their lives.
11am: A cup of tea and a chat
A carer is as much there to offer companionship as physical support. That’s why a cup of tea and a chat is sometimes just the tonic.
At Elder, we spend a lot of time and attention capturing as much information as we can about both care recipients and carers, and matching people who could develop a real rapport and a genuine friendship. We’ll find out what your loved one likes and what they don’t like, and the sort of person they’re after.
In short, even an older person’s downtime becomes something that keeps their mind engaged and a sense of isolation at bay. Just a cup of tea and chat can make all the difference – especially for those with dementia, for whom a catch-up can act as powerful antidote to memory loss.
12pm: Meeting friends
When an elderly person invites a carer into the fold, they’re still able to live the same life they always have done. Now, though, it’s easier than ever for them to get out and about.
With fewer complications getting to and from events outside of the home, they’ll find they’re able to stay connected to their social circle. This can prove crucial when it comes to their wellbeing – the more they can maintain those relationships that have underscored their lives to date, the more secure in their identity they’re likely to feel.
2pm: Getting some exercise
Physical activity can be one of the first things to drop off as we get older, but it’s also one of the most important parts of day-to-day life.
A carer will make exercises an intrinsic part of an older person’s routine, whether those are chair exercises or a gentle walk to the shops. They may suggest going further afield altogether for a real stretch of the legs – to explore a National Trust property, for example.
Frequent exercise is great for morale and offers significant health benefits. Research has shown regular movement has a positive effect on mental acuity, and strengthens bone and joint health to improve overall mobility.
But there’s more to exercise than being active. Muscles and joints that are stretched and tested need a chance to heal, and they do that during sleep. That means daytime naps can be as important as the exercise itself.
Of course, it’s a narrow path to tread. One study suggests that in later stages of Alzheimer’s, people spend about 40 percent of the night awake and a sizeable part of the day sleeping. A carer can make sure that naps are gently limited to half an hour at most.
2.30pm: Firing up the grey matter
Vitality is linked to more than just the body – the mind is important, too.
Recent studies have suggested that both, when worked in tandem, provide the best possible health and wellbeing benefits. So once the care recipient has had their fill of physical exercise, the carer might suggest puzzles, board games or crosswords to keep their mind ticking over.
Anything with a problem-solving element to it will do. After all, research has shown that mental training in old age can help boost intellectual power, maintain mental functions and, in some cases, slow or reverse memory decline.
3.30pm: Catching up with family
Technology is a wonderful thing, and it can play a big role in bridging the gap between an elderly relative and their family.
A carer might introduce the person they’re supporting to video messaging platforms such as Skype, or social media networks including Twitter and Facebook. These are great ways to stay in touch with one another and eliminate any geographical distance that stands in the way. Being able to share photos and memories online can help older people feel a part of the events they may otherwise not be able to experience first hand.
In fact, a study carried out on 120 seniors in the UK and Italy found that elderly people who were trained to use social media, Skype and email performed better cognitively than those who weren’t. Both their mental and physical capacity was shown to have improved over the two year experiment, in contrast to the control group who experienced a steady decline in both.
The emphasis is not so much on the accuracy of the memory; it’s what remembering your own past does to your sense of self and in the mind and heart of the person looking after you.
Pam Schweitzer, Reminiscence Expert
Reminiscence is an activity where those suffering from memory loss discuss their lives in order to better recall the past. In many cases, it involves the use of cues: old photos, films or a particularly meaningful piece of music.
Reminiscence has become an increasingly high-profile tool in dementia care over the past decade or so, and carers have both the time and personal connection to be able to host regular reminiscence activities. They might even take an older person to one of the many reminiscence groups now being run countrywide – Sporting Memories, to name one – or a museum with reminiscence activities and initiatives, such as the National Liverpool Museums House of Memories.
6pm: Dealing with “sundowning”
If an older person is struggling with dementia, the late afternoon and early evening can be a troubling period.
They may start to get anxious, agitated or confused when it starts to go dark outside. Two thirds of people with Alzheimer’s are reported to experience this pattern of restlessness, commonly known as “sundowning”.
A carer is on hand to offer their support until it passes, and to make sure they don’t do anything to injure themselves in the meantime. They may use a range of techniques to calm the situation down, from keeping their mind busy with another activity to something as simple as giving their hand a squeeze.
7pm: Preparing dinner
There’s nothing like a home-cooked meal at the end of a long day, and a carer is here to put together something that’ll go down a treat.
Their first responsibility is to make something the care recipient enjoys. That’s why the carer takes the time to get to know what they like and don’t like, and what they’re unable to eat for medical reasons. Our senses of taste and smell can change as we get older, and the carer can accommodate for this while keeping a close eye on salt and sugar intake.
Of course, it may be that an older person is particularly discerning about the food they eat, or simply enjoys doing the cooking themselves. In that case, the carer will be happy to take a backseat, and lend a hand only if they’re asked to.
The other responsibility is to make sure the person in their care maintains a balanced diet. This means shopping for foods that are good sources of calcium (dairy products, broccoli, tomatoes), vitamin D (fatty fish, eggs, cheese) and vitamin K (brussels sprouts, spinach, cabbage) – all of which are good for the bones and joints. Fibre (found in lentils, peas and beans) is also important to keep the bowels ticking over nicely.
Lack of hydration is a major problem among older people, who may experience a reduced sensation of thirst and forget to drink enough. This is likely to be more pronounced in those with Alzheimer’s disease or who have suffered a stroke.
Poor hydration can have a major impact on kidney function and cognitive ability, and can lead to long-term health problems. The carer makes sure things don’t get to this stage, as well as offers the sort of personal support – notably for incontinence – which can embarrass the elderly into limiting their fluid intake.
9pm: Getting ready for bed
After a long day, it’s important to get a good night’s rest – but those can be harder to come by in later life as sleep problems in the elderly are common.
It’s up to the carer to put in place the sort of routine that’ll make it easy. They’ll get the person they’re caring for to bed at the same time every night, and help them change into their nightwear and brush their teeth. They might prepare them a warm drink or a hot water bottle, or simply leave them to a spot of reading. Developing this consistency is simple, but it can prove fundamental in ensuring a healthy, happy lifestyle in the long term.
And importantly, the carer is a reassuring presence throughout the night , which means the person they’re caring for – and their family – can have a stress-free night’s sleep. So there’s no need to worry if they need to get out of bed for a toilet break: there’ll be a supporting hand to guide them through the house and help them back to the land of nod.
Sleep problems can be particularly prevalent in people with dementia, as changes in the brain throw off the body clock. This can lead to insomnia, and in turn night-time activity during which they’re at greater risk of having an accident. A carer, so to speak, puts this all to bed: they’re always on hand to check up on them and put their mind at ease.
When supporting a person with dementia who is behaving out of character, it’s important to see beyond the behaviour itself and think about what may be causing it. Sometimes behaviour can be a result of frustration in the way others around the person are behaving, a sense of being out of
control, or a feeling of not being listened to or understood.
How Elder can help
We’re the UK’s leading live-in care provider, bringing the highest standard of care into your loved one’s home. With us, you can relax in the knowledge that those most important to you are well looked after, both practically and emotionally, and empowered to live an independent and fulfilling lifestyle.
We believe great care starts with great relationships. That’s why we make sure we match your loved one with the right person for them. We’ll work with you to find out more about their daily routine, as well as what they’re looking for in a carer, and handpick someone we think is perfect for your family.
To find out if live-in care is right for your loved one, you can arrange a complimentary care assessment with one of our care specialists. Get in touch on 0330 134 6372, and they’ll be happy to offer impartial advice on how best to meet your unique needs, as well as how you might fund the type of care you choose.
If you decide you’d like to take advantage of live-in care, we’ll work with you to create a bespoke plan that suits your loved one’s needs and wishes. If you’re happy, your own personal account manager will get you set up with a care plan. Remember, we’re right by your side on every step of your care journey, and they’ll be your first port of call whenever you have questions.