- Choosing a care option for your loved one can be a difficult process and usually follows a big life change for many families.
- It is common for families to be pointed towards standard care options such as care homes, however there are other, potentially more suitable options available.
- Live-in care is an alternative to typical care types, offering full-time care and support in the comfort of your own home.
For many families, choosing a care option can be a difficult process – especially as it often comes as a result of a big change to the life of someone close to you – following a stroke, a fall or a diagnosis of a medical condition, like dementia.
It’s a hard moment. Deciding which care option is best for your loved one can feel like an overwhelming decision. You’ll likely already have a social worker or health professional who can advise on the choices available to you. This can be a great source of support.
However, often they may limit the options they signpost you towards – frequently recommending either a care home or hourly home care. Many families simply accept one of these with a sense of resignation, and a feeling that it’s inevitable. But, it isn’t.
There’s actually a much broader variety of choices available. One is caring for your loved one yourself, or sharing the responsibility with the rest of the family. But, often, this simply isn’t practical.
Life gets in the way – whether it’s going to work or looking after the kids – meaning it can be difficult or impossible for you to provide all the care your loved one needs, even if they live close by.
As well as the issue of having to make significant changes to your life, comes the matter of expertise. Medical conditions may mean that they need a high level of care that can only be provided by a professional.
What are the different types of care available?
Although care homes have always been the go-to for many, nowadays, there are various care options for families to consider for their loved ones. Different options tend to be better for different situations, and there’s never a right or wrong decision.
Either way, it pays to do your research. As we’ve mentioned, you can’t necessarily rely on your social worker to know all the options available. You may need to be proactive to put in place what you think is best. So let’s start by running through the most common care types available. The main types of care are:
- Nurses on hand to support with more acute care needs
- Accommodation, meal and activities all arranged, so little planning required
- Often a real sense of community fostered by staff and residents
- Funding more readily available if nursing care is required
- Life can be quite regimented, which may impact mental health
- Less control over the possessions they can bring with them, daily meals and activities
- Away from family and community, independence limited
- One of the most expensive options if funding is not available
Nursing homes, often called care homes with nursing, are staffed by registered nurses supported by care assistants. The care is planned and supervised by a nurse, but much of the hands-on support is provided by care assistants who’ve completed the appropriate training.
Many carers in nursing homes have National Vocational Qualifications (NVQs) in Health and Social Care, and sometimes further training in supporting people with various health issues.
What is a nursing home?
Nursing homes provide care and accommodation for those with more advanced needs. Often, it’ll be the only option available to you if these needs are particularly complex, intense or unpredictable.
Your loved one would have their own room, in which they’d be able to keep some of their most prized possessions. Often these can be made to feel quite homely but, it goes without saying, they won’t be able to take everything with them. This can take some getting used to.
A lot of effort is made to help make the residents feel welcome. Most nursing homes give their clients the option of dining with the other residents or in their own room, and there are often organised activities on offer. This can really help foster a sense of community, which can be invaluable in the later stages of someone’s life – when loneliness can become a common concern.
However, if your loved one moves into a nursing home, they’ll have to adjust to the routines that keep the home functioning efficiently – for example, bedtimes are often kept relatively close together.
It should be said, many nursing homes are moving towards person-centred care, meaning they try to offer their residents as much choice as possible in their daily living. But, clearly, there’s only so much they can do.
In such a facility, safety is a key priority. There will usually be a call-bell system, meaning your loved one can call for help at any time of the day or night, with a nurse on hand. This can be very reassuring, especially if your loved one has very changeable needs.
Ultimately, nursing homes offer a level of care in between a care home and a hospital ward. This extra level of provision comes at a price. Nursing homes are expensive – the average cost is over £800 per week. This can be significantly higher in London and the South East.
Cost of live-in careElder live-in care starts at £1295 per week, for one-on-one personalised care. Depending on specific care needs, there are additional plans available.
Luckily, funding for those who require nursing care is often much more readily available compared to those requiring less intensive social care. If you’ve been told by a health or social care professional that this is the best option, you should ask about NHS Continuing Healthcare or NHS-Funded Nursing Care. These can help you meet all, or part, of the costs.
- Care homes provide a great sense of safety and security
- Group activities, accommodation and meals are all planned
- Depending on the home, there can be a real sense of community
- Help with administering medication is often available
- Less choice when choosing a care home if you’re receiving financial help
- Unfamiliar setting, without home comforts or own community
- Lack of independence which may impact mental health
- Less control over the possessions they bring with them, daily meals and activities
A care home tends to be the primary option for elderly care and is usually considered when a loved one is struggling to live alone.
Following a care needs assessment by a local council, a care home is usually recommended by social care professionals, such as a social worker or occupational therapist. There are systemic reasons they’ll refer you to residential care first. Namely, that it’s cheaper and it’s what they’re used to.
Care homes offer a secure place for a relative to stay, with someone on hand night and day to respond to emergencies. Many provide additional medical attention, though they may not always be equipped to cater for particular needs. Likewise, facilities and amenities – single rooms, gardens, visiting schedules, special events and so on – vary from home to home.
Those living in care homes have their own bedrooms and bathrooms, but share all communal areas – for example, lounges, dining rooms, and gardens – with the other residents. Staff provide meals, housekeeping services and assistance with everyday needs – dressing, mobility, personal hygiene and so on.
But since the number of staff varies from residence to residence, so does the amount of one-on-one care your loved one receives.
There are clear advantages to understand. Care homes alleviate the stress associated with having to care for a loved one yourself. They provide the reassurance that your loved one is being cared for throughout the day and night.
They can also be very sociable environments that can help your loved one fend off loneliness. Group activities, days out and a close relationship between residents and staff are common.
What is a care home?
A residential care home is a facility that provides accommodation and personal care. It differs from a nursing home in that there are no nurses on-site. The support provided is centred around social care needs, this includes but is not limited to:
As well as this practical support for the elderly, care homes can also help in other ways. Many will lay on social activities and have in-house hairdressers, themed evenings, collective celebrations, and visiting therapists.
When deciding on a care home for your loved one, these are the kind of additional benefits you should look out for. Be careful to do your due diligence. Make sure you visit any facility you’re considering before you go with it.
Care home lifestyle
Care home staff make an effort to create as independent and inclusive a lifestyle as possible. They host events, encourage exercise and offer increased independence to low-risk residents. And for many residents, care homes can become a close-knit community where security and friendship go hand in hand.
But when they move into a care home, your loved one leaves behind the familiarity and comfort of their own four walls. They may have to move some way from their nearest and dearest, and may not be able to take all of their belongings with them (or a pet, if they have one). In short, this jump from independent to residential living can feel like a pretty significant overhaul of the way they live their lives.
Moving to a care home can be a disruptive process, especially for those with dementia. It can be difficult adjusting to a regimented way of living for some although for others the sense of routine can be beneficial. The best type of care for one person may not always be for another – which is why it is important to understand the different options available.
Sometimes, living in more of a communal setting is not what people want. And, there’s also the underlying feeling that, although they can be pleasant environments to live, it’s ultimately not your home.
On top of this, it’s crucial to understand there’s no set standard of care homes. There are good ones and bad ones. Some are specialists, some are generalists. There are expensive facilities and more cost-effective alternatives. If you’re erring towards the residential care option, it’s essential you really do your homework to get the type of home that’s best for you.
Also, ask lots of questions – particularly about hidden costs, this is something that has been highlighted by Citizens Advice as a persistent issue. You can find out more about choosing a care home here.
- Offers a sense of community, with some of the benefits of your own home
- Sometimes offer organised social activities to foster a sense of community
- Support available around the clock
- Still allows some sense of independence with self-contained housing
- May not be suitable for those with complex conditions
- Not always available from the local council in all areas
- Moving to a new home could be difficult
- Often very expensive, as a dedicated supporting carer is required
Assisted living is a type of care that allows the care recipient to retain a certain level of independence, while still receiving help with things such as washing, dressing and toileting, as well as taking medication where necessary.
What is assisted living?
Assisted living is a type of ‘housing with care’. It differs from a care home in that it can allow a much greater level of independent living. Those who live in assisted living developments will have their own self-contained flat, which has its own door. But, like a care home, there are staff on call 24-hours a day who can assist with personal care and support.
Assisted living facilities are generally a community and there are organised social activities so they can be a very social place to live. In addition, there are also often communal lounges for residents to socialise as they please.
Some assisted living houses are available to privately rent or even buy, and some are available from the local council – how you go about this will depend on your financial circumstances and care needs. In some ways, assisted living is a good medium point between staying at home and moving into residential care. Your loved one gets their own private space, adapted to their needs, with support on hand.
However, it still entails a degree of disruption. This can still be very distressing for those living with dementia. There are other problems too – it can be hard to find a space in such a development, which may mean a private room can’t be guaranteed. As with other areas of the social care system, staffing is often overstretched. And, because of this, visiting hours are usually limited.
On top of this is the financial consideration, weekly costs can be extremely high – often over £1,000. When working out whether you can afford assisted living, you should consider that many people will also need extra help from a visiting or live-in carer too. If this is the case, you might be better off looking at home adaptations, for which there’s funding available regardless of your financial situation.
- The care receiver gets to remain in their own home
- Help with medication can be available
- Assistance with personal care
- Frees up the time of family members
- It may not always be the same carer
- The carer’s time is stretched as they have to visit others
- Care is not available around the clock
- Support may not be there when it’s most needed
This type of care, also known as domiciliary care, is usually carried out by a caregiver who visits the person’s home at set times to help with whatever is needed. The amount of time carers spend with their clients can vary from just one short visit every day, to three or four half-hour sessions, depending on a person’s needs.
What is home care?
If your loved one is receiving this kind of care at home, they need to accept that the carer’s time is limited and their schedule must be kept. This can limit choices about various aspects of their lifestyle, such as what time to get up and go to bed, and when to eat their meals.
Domiciliary care assistants often provide in-home care to many different people throughout the day. Their schedule is stretched and sometimes they might be late reaching your loved one if they’ve been held up for any reason with a previous client.
It’s also common to have a mixture of carers, and frequently have unknown carers step in. This can be distressing, confusing or just a bit frustrating depending on your loved one’s emotional state.
In addition to personal care, people receiving care in their own home can often get other forms of help such as meals on wheels or assistance with transport to appointments.
You can request the social services department of your loved one’s local authority to carry out a care needs assessment to determine what help they require. Some people are eligible for financial help with their care costs, and the authority can check your loved one’s position by carrying out a means test to check their income, savings and assets. This will determine whether they will need to contribute towards the cost of their care.
- Allows people to remain in their own home and retain independence for longer.
- Personalisation of activities, socialisation, meals and routines
- Around the clock support – including for complex care needs
- Various funding options available
- It is often thought that live-in care is an expensive option
- Carer needs should be considered – not suitable for nursing care
- Involves a stranger living in the home
- Home adaptations may be needed depending on mobility
Live-in care is when a carer moves into your loved one’s house to take on all their care needs and keep them safe and comfortable. This can include help with personal care such as washing, dressing, eating, and mobility, but is not restricted to this. It’s general support to help someone to live independently, and to lead the best possible life they can in older age.
What is live-in care?
Live-in care offers an alternative solution to standard care options, such as residential care. The care will usually work on a rota basis with another person, working four weeks on and one week off, for example:
This is the preferred option for many people in need of elderly care. However, families are often put off because they think the costs are simply too high. This is a common misconception. A large part of the costs in care homes is the so-called ‘hotel costs’. Something you don’t have to pay when you’re receiving care in your own home.
Often, live-in care works out at a similar price to residential care. Plus, there are still plenty of funding options available. In fact, you’re actually more likely to get funding because, during means-testing, your home is excluded when being assessed for care in the home.
Types of live-in care
A key advantage of live-in care is that it’s one-on-one. The experience of the carer can be matched specifically to the requirements of your loved one. As a care type, this means it’s quite flexible in the level of support it provides.
What are the differences between live-in care and other types of care?
With live-in care, your loved one is able to remain close to family and friends, and doesn’t have to pick and choose which belongings to hold onto. In fact, there’s no need to change anything about the way they live their lives, other than to make space for a new tenant.
As live-in care providers, we know how important it is to get that right, too. That’s why we make the time to match care recipients with caregivers we think they’ll love.
Live-in carers are carefully matched with their client – so they have similar interests, hobbies and personalities. This means we’ll try to pair keen chefs with keen chefs, football enthusiasts with football enthusiasts and outdoorsy types with outdoorsy types.
Because the carer moves into the home, it’s really in everyone’s interests to try to ensure your loved one is matched with someone they’ll really get along well with.
Full-time support in the home can also provide help with the more practical aspects of life such as:
Help getting dressed
Support with mobility
Some carers who provide this type of care at home are able to drive your loved one to meetings, appointments or any social activities they would like to attend, allowing them to maintain independent living even when their health or mobility is compromised.
In addition to general personal care needs and domestic tasks, specialist live-in carers are experienced in caring for those with specific conditions such as dementia and Parkinson’s. For those with more intensive care needs, intermittent nursing care can also be utilised from a district nurse.
24-hour care is when your loved one has carers looking after them for every hour of the day. It’s a very intensive form of social care, often for those with life-limited or life-changing conditions or prognosis. End of life palliative care is often given 24-hours a day.
Care homes often provide 24-hour support, as do nursing homes. But live-in care can also be 24-hours. Where standard live-in care involves one carer who works up to a 12-hour shift and then stays overnight, with flexibility for three awakenings, 24-hour care involves two or more carers working in rotation to ensure there’s always support available. Because in-home care on a 24-hour-a-day basis involves one-to-one support for your loved one, it ensures they are consistently receiving the care they require.
And, if your loved one is in the last days, weeks, or months of their life, it’s really crucial their spirits are lifted as much as possible during this precious time. Having someone to chat to and share their life with can make all the difference.
Due to the nature of the conditions defined as dementia – such as Alzeimher’s, Lewy Body dementia, Vascular dementia and Frontotemporal dementia – it is important to have a proper support system in place.
Dementia live-in care can help those living with dementia retain a level of independence, and continue to live a fulfilling life for as long as possible. Dementia care is a specialist type of care which is carried out by those who are trained to do so.
Benefits of dementia live-in care
In-home care is particularly valuable for those who are living with conditions such as dementia. If your loved one is living with Alzheimer’s disease or another type of dementia, you’ll be aware of how they can become upset by changes to their routines or environment.
Having a consistent carer who’s in residence for the majority of the time means a familiar person will be helping them with intimate tasks. This could mean they’re more likely to accept the kind of help that could feel quite intrusive in a nursing home, where there may be many different staff members and less familiarity.
Dementia care homes
Some care homes are registered to care for people with dementia. Some of their staff will have Alzheimer’s care training. They may need higher staff to patient ratios than general nursing homes, and different registration conditions regarding the physical environment may be in place..
People with dementia can often experience problems interpreting their surroundings, and regulators may want nursing homes for people with dementia to install special signs to help them find their way around. If your loved one can stay in their own familiar home surroundings, they are less likely to become confused and disorientated.
Frequently asked questions
What are the different types of care?
There are many different types of care available, but the most common options for elderly care are:
– Residential care home
– Nursing home
– Domiciliary or visiting care
– Live-in care
– Retirement village/assisted living
What is the difference between domiciliary care and residential care?
Domiciliary care is a form of home care in which a trained carer will pay regular visits to your loved one’s home to ensure they’re receiving the support they need in terms of personal care and general housekeeping. They generally visit multiple clients in one day and will be on a fixed schedule.
Residential care usually involves a care home facility your loved one will move into.The carers there will help with their personal needs and ensure they receive their medication and meals as necessary.
What do residential care homes provide?
Residential care homes provide residents with accommodation and personal care support for those who can no longer live alone. Personal care support can include help with getting dressed, help washing and grooming, help with toileting and with medication.
What type of care is a care home?
A care home is a type of residential care in which the care recipient will move into the facility and receive care on the premises. Depending on the needs of the individual the care home may be a nursing home, in which more complex care needs are met.
Read more about Elder
Elder Standards – what you can expect Arranging live-in care for a loved one is a big decision. It’s important
Paying for care
NHS Continuing Healthcare – your complete guide NHS Continuing Healthcare covers every penny of your care costs. It’s available for anyone with long-term health needs.
Local authority care funding – everything you need to know If you need live-in care or have to move into a care home, local authority