As you or your loved one begins to need more assistance in life, you may be wondering how you can ensure safety, happiness and comfort without the upheaval of hospital trips or nursing homes.
Let’s start with the basics.
The term ‘domiciliary’ means anything concerning someone’s home, so domiciliary care refers to the care someone can receive in their own home, as opposed to in a hospital, assisted living facility, or nursing home. Domiciliary care is an important service that supports individuals who need a helping hand with their daily living activities, but are not yet ready to move to an assisted living facility or nursing home.
Domiciliary care allows those individuals to remain in the comfort and familiarity of their own house or the house of a loved one, and continue their independence while receiving the required care from professionals. A trained professional can visit them to help with things like personal hygiene, meal assistance, companionship, medication management and more.
Lots of different types of people can benefit from at-home care, but it can be particularly helpful for the likes of seniors, individuals with disabilities, or anyone recovering from an illness or surgery. This might include anyone with mobility, health or cognitive issues that require them to avoid things like excessive movement, strenuous activities, or remembering to carry out certain tasks – like taking medication at specific times, or turning off appliances.
In other cases, home care can simply be light-touch support or providing weekly company so an elderly individual can remain at home, stay connected to their community, and never feel lonely. Domiciliary Care can be invaluable in order to maintain a sense of independence and positive quality of life. Not only does it allow the individual to feel in control of their own life, it enables their family to effectively manage their own responsibilities while safe in the knowledge that the wellbeing of their loved one is in good hands.
There are a number of at-home care services, which might include things like:
As often as possible, people who require additional help should be offered the best care option for their circumstances that doesn’t diminish their current independence, but also doesn’t leave them with unmet needs. Home care is a great way to achieve this goal.
Most home visits aim to help older individuals retain independence and stay in familiar surroundings. Here is a brief overview of some of the services typically on offer.
Keep an eye out for the right carers who are highly trained to deliver the services you need. Plus, during the selection process, look for people who enjoy similar interests so that you can find the right person to support you. No matter what type of home care you are looking for, remember the best solution will be a tailored service that suits you or your loved one.
There are many benefits to choosing home care instead of a care home, but this is a big life choice, and we understand you will want to make the best decision for yourself or your loved one. Let’s take a look at the most common questions about the pros and cons of both options.
Home care has many advantages that make it a perfect choice for individuals with disabilities or anyone recovering from an illness or surgery, however it is also a great option for seniors who require additional care as they age. Not every elderly person will benefit from home care, but here are some of the advantages:
The World Health Organization recommends elderly individuals be cared for in their own homes for as long as possible to maintain a strong sense of wellbeing, ideally by a home help organisation in order to reduce pressure on families.
Individuals living with dementia may find home care especially helpful, as staying in familiar surroundings means they are less likely to feel confused, anxious or lost. A 2013 study found those living with dementia at home experienced higher activity levels, quality of life, and felt more socially connected than those living in a care home. Another study found that after one month of home care, participants were less likely to develop acute confusion than those living in a care home.
Staying at home also means the individual can manage things like temperature and noise levels in the home, when they feel like socialising, when they want to eat and sleep, and more. All of these options contribute to a sense of independence.
Everyone requires bespoke care, and home care won’t suit everyone. Some disadvantages of this type of care include:
Here are some of the benefits of care homes.
Care homes also have equipment and infrastructure to help those with mobility issues. These can also be installed at home, and studies have shown home assessment and tailored interventions can reduce recurrent falls of elderly individuals by as much as 38%.
As above, care homes also have their disadvantages, for example:
While care homes can be useful, for all of the above reasons many people choose to avoid moving into a care home for as long as possible. Instead, home care can be a great option that can maintain health, independence, wellbeing and a sense of control over your life and care.
It can be overwhelming to start looking into home care options, but we have broken the process down step-by-step to make it as simple as possible for you.
The people who know you best may have some thoughts on what your home care needs will involve, and it helps to include someone you trust in the process so you feel supported throughout.
Start by having an honest conversation about what you need from home care. You may feel wary about admitting to needing help in some areas, but the goal is to keep you happy and healthy at home, so try to open up about the things you are currently struggling with, and where you think you could struggle in the near future. Chat to a trusted friend or family member about how often you might need help, and anything they believe would help too.
Don’t forget to discuss your budget with them if you feel comfortable doing so. This means they can help you stick to your budget when reaching out to home care providers.
If you are unsure where to begin with home care, speaking to your GP can be a great start. They can usually break down the process for you, recommend any care options they think could work for your medical needs, and put you in touch with your local community healthcare team (regulated by Integrated Care Systems).
They can also help to arrange a Care Needs Assessment, which means your local social services team will visit you to discuss your needs and do a financial assessment to find out if you are eligible for funded home care. If you choose to organise this on your own, you should reach out to the adult social services department within your local council. A Care Needs Assessment is free for everyone.
Once your doctor has arranged your Care Needs Assessment to evaluate the level of support you need, an assessor will contact you to let you know when they will visit. You could be offered an assessment over the phone, but you are entitled to ask for a face-to-face assessment if you think this would be more beneficial.
It can help to make sure your trusted friend or family member is with you for this assessment, as they may be able to provide more insight into your care needs and help answer any questions the assessor has. The assessor can help to clarify what support is available, and this will give you a chance to express your desire to receive home care instead of being placed in a care home. Don’t worry – you won’t need to convince your assessor to keep you at home. Typically the end goal of your local social services is to keep seniors in their own homes as long as possible, provided they are safe and well there, so they will usually do all they can to support this.
The assessor’s recommendations might include anything from a carer, to personal alarms, to home adaptations, to activity groups, and more. Remember, if you plan to fund your own home care you do not need to carry out a Care Needs Assessment.
Everyone wants the very best care for themselves and their loved ones, but the financial considerations of this are undoubtedly important and a big part of your decision.
According to the National Audit Office, the projected increase in adults aged 65+ requiring care by 2038 is 57% (compared with 2018), and the projected increase in cost of care for the same demographic is 106%. This shows that not only will demand for care homes increase, but the price of care will increase also. Home care can provide an excellent, cost-effective alternative to care homes that means you pay only for the care you need.
Depending on the type of home care service you are interested in and the area you live in, costs will differ. As of January 2023, there are 11,544 domiciliary care services registered with the Care Quality Commission, and all will have their own price points. As a rough estimate, according to research in 2022 from the Nuffield Trust, in the UK:
The above figures are estimates, however there is thought to be a disparity in the cost of care for those self-funding it versus those being funded by their local authority. The government has discussed plans to require councils to pay providers higher fees for care according to the Fair Cost of Care Policy. This is in the process of being implemented, and should make the cost of care more equal for all.
Once you have been assessed, or have discussed your needs with a trusted advocate, you can start to consider the type of home care you would like to receive.
As a reminder, these can include (but are not limited to):
The above options may be helpful for you depending on your specific needs and medical requirements. There are a number of different people and organisations who can provide this care for you, including:
Many people prefer to be looked after by a loved one as they feel more comfortable with them. On the other hand, some prefer to keep their care needs and family separate, so their family does not become overwhelmed with the responsibility, or have to give up their jobs or interests. Family members may also lack the qualifications or experience to provide specialised care needs such as medication.
However, keep in mind that hiring a private carer means you effectively become an employer, which comes with financial and legal responsibilities. This also means, should your private carer take time off, you must source a replacement yourself rather than having an agency do this for you. You must also check the private carer’s qualifications and experience – private carers are not usually monitored by care regulators in the UK, so you may need to look into their background yourself.
Agency care can offer the likes of companionship, home help, personal care, night care, respite care, Alzheimer’s and dementia care, cancer support, palliative care, postoperative and recovery care, arthritis and mobility care, vital signs monitoring, diabetes monitoring, and much more. Whatever your needs, they can usually provide a flexible, person-centred care package to suit you.
Inviting a stranger into your home can feel overwhelming to many people, so knowing that they can be trusted to look after your needs and have been recommended by others can really put your mind at ease. One of the best ways to get to know the organisation and carers that may be involved in your care is to look at their ratings and reviews online. These will be based on work they have done for other individuals in the past.
Try not to rely on reviews on the organisation’s own website, as these can be weighted towards their own service and may only display positive reviews. To find impartial ratings and reviews, you can look at the Care Quality Commission search page, which provides a traffic light system to show which services are described as ‘good’ or ‘requiring improvement’. You can also look at listings on Homecare.co.uk, which includes client reviews.
Once you have a shortlist of providers, reach out to them to express your needs, and arrange a visit with them in your home. Again, it helps to have your trusted friend or family member with you, especially if they will be communicating with the agency on your behalf.
The agency will typically arrange to send a member of their team to your home to discuss your needs in detail and come to an agreement on what they can provide. Based on your needs and personality, they should aim to pair you with the Care Professional they believe can assist with everything you need and also suit your lifestyle. You will spend a lot of time with your Care Professional, so it is important to ensure you are a good fit for each other.
The home care service may ask questions such as:
You may want to ask questions too, and you should be encouraged to do so. If you are unsure what to ask, here are some that could be useful:
You may wish to arrange visits with several home care organisations in order to find the best fit for you. Remember, you should feel comfortable asking as many questions as you like, and never be pressured into continuing with a service that you are not happy with. Research ahead of time with a trusted friend or family member who can advocate for you, and don’t be afraid to make your needs and preferences clear.
For many home care providers – including the service we provide at Home Instead – bespoke and personalised care is the priority, so your needs and desires should always be taken into consideration. By voicing what is on your mind, your home care service can ensure you get exactly the care that works best for you.
Deciding when it’s time to look for the support of a carer, whether for yourself or for a loved one, can feel overwhelming. Not only is it difficult to see the signs of needing additional help, but it can feel daunting to begin searching for the care you need.
If you are wondering how to identify when the “right” time might be, know that the answer to this question will be different for everyone and may depend on a number of factors – the health and mobility of an elderly person, the level of support from family already available, the home setup, and more.
Here, you will find the most common signs that it may be time to start having conversations about enlisting support. This can provide many long-term benefits, and could be the beginning of a much easier, more enjoyable daily life for yourself or your loved one.
Many people of all ages and backgrounds can benefit from receiving care, whether at home or in another setting such as a care home or clinic. Care can be helpful – or in some cases a necessity – for seniors, individuals with disabilities, those with significant health challenges, or anyone recovering from an illness or surgery.
Someone with mobility or health issues could require help to avoid excessive movement or strenuous activities, while those with cognitive issues may need help with things like remembering to take medication.
Care should be bespoke to the individual requiring it, and this can take place in a number of settings. For example, someone with intensive health needs may be required to attend a hospital for care, while someone who needs round-the-clock care may prefer to be moved to a care home where they can feel safe and supported day and night.
For others, home care is a great alternative, allowing them to receive the flexible care they need from the comfort of the home they have spent many happy years in.
Whether you are considering pursuing care services for yourself or a loved one, the decision can feel like a big one. If for yourself, you may be struggling with the idea of losing any part of your independence. Or, if you are researching care for an elderly relative, you may be struggling with feelings of guilt about making decisions too early or too late.
Here are some common signs that indicate the right time to start looking into care:
Noticing changes in your own physical appearance isn’t always possible when you see yourself every day, but weight loss is a common sign that something has changed. This could be due to a number of reasons, such as forgetting to eat regularly, losing confidence with cooking, or a medical issue such as cancer – if you notice dramatic weight loss without diet changes, speak to a doctor to rule this out.
A carer can help if you or your loved one require assistance with tasks like ensuring the kitchen is always stocked with food, cooking nutrient-rich meals, and sticking to a regular eating schedule.
Ask yourself:
❐ Have you / has your loved one lost a lot of weight in a short amount of time?
❐ Are you / is your loved one skipping meals often?
❐ Do you / does your loved one still feel confident cooking your/their favourite meals?
Personal care can include things like washing regularly, applying products and getting dressed. If you feel you are no longer able to carry out your usual routine, then getting a helping hand with this part of your day could help you feel fresh, clean and confident.
If you notice your loved one is not taking as much time over their personal care activities, or notice any of the below signs, they may need some assistance in their routine:
There are a number of reasons an elderly person may neglect their personal care routine without realising it. For example, they might struggle to get in and out of the shower or bath due to mobility restrictions or a fear of falling.
Bringing up someone’s hygiene can be a sensitive topic, so try to do this in an empathetic manner so they don’t feel embarrassed. Remind them that anything you say or suggest is to keep them feeling comfortable.
Ask yourself:
❐ Do you see stains on your loved one’s clothes or around the home?
❐ How often do you bathe? This doesn’t need to be daily, but you should have regular access to a safe way to get clean.
❐ Do you/they have any mobility restrictions making certain tasks more difficult and potentially dangerous, such as trimming toenails?
Depression can develop gradually, which makes it difficult to recognise in oneself or in a loved one. However, it is vital the signs of depression are acted upon as soon as possible. According to the World Health Organization, the most common mental health conditions for older adults are depression and anxiety, and a 2019 report found around 27.2% of global deaths from suicide happen to those aged 60+.
Watch out for changes in loved ones, such as becoming withdrawn and quiet, losing interest in activities which were once enjoyable, feeling reluctant to see family and friends, sleeping more often, or experiencing mood swings.
Ask yourself:
❐ Are you / is your loved one quieter than usual?
❐ Do you / does your loved one feel less interested in taking part in activities?
❐ Are you / is your loved one becoming more withdrawn from family or the community?
Elderly adults have an increased risk of loneliness and isolation, as they are more likely to live alone and experience the loss of friends. According to the WHO, loneliness and social isolation are key risk factors for mental health conditions in the elderly, and a report from the National Academies of Sciences, Engineering, and Medicine found almost a quarter of adults aged 65+ are considered ‘socially isolated’. This presents health risks, with the Centers for Disease Control and Prevention stating social isolation is associated with around a 50% increased risk of dementia.
Social activities can lead to significant improvements in mental health, reduced depression symptoms and increased quality of life. Not only can carers provide much-needed companionship, they can also help to organise other social opportunities, community initiatives, creative arts groups, leisure activities and more.
Ask yourself:
❐ Do you / does your loved one feel less connected to family and friends recently?
❐ Do you / does your loved one get regular visitors to the home throughout the week?
❐ Are you / is your loved one experiencing any the symptoms of depression?
One of the key signs of requiring additional care is forgetfulness or confusion. If you have experienced this recently, don’t worry; forgetting things does not always equal dementia, and if you are concerned about forgetfulness at all you should not hesitate to discuss these signs with a loved one or medical professional. It may simply mean you need a little extra help with everyday tasks. If you have found yourself doing things like forgetting to take medication, or leaving the cooker on, it is much safer to let someone know you have these concerns. Don’t keep it to yourself, as this could become dangerous for your wellbeing.
Dementia can sometimes be a concern in these cases. If your relative is showing signs of forgetfulness or confusion, needing help when making decisions, forgetting where they are, struggling to follow directions, or putting things in the wrong place, you should consider helping them book a doctor’s appointment to discuss this.
Ask yourself:
❐ Do you / does your loved one often forget important details you believe should be easy to remember?
❐ Do you / does your loved one often feel disoriented, confused or scared?
❐ Have you / has your loved one forgotten to do something that might be considered a safety concern, such as leaving the gas stove on for several hours after cooking?
A lack of cleaning and tidying around the home can sometimes be a clear indicator that someone may need help in this area or other areas of life. For example, if your loved one’s home starts to look unclean, messy, cluttered, or perhaps you notice spills haven’t been properly cleaned, it could be becoming unmanageable for them and they may require assistance with housework and other chores. You may also notice a change in the smell of their home if they have been unable to clean their space, or signs of excessive hoarding which can build up quickly. A carer can provide home help and housekeeping to make home maintenance easier.
Administrative chores can also feel overwhelming. For example, keeping up with finances can be daunting with the likes of online banking. Seniors are more at risk of being victimised by scam artists and fraudulent activity, so if you are worried you or a loved one might be tricked in this way, a carer could help provide peace of mind when answering phone calls, dealing with mail, or ensuring no personal details are given out.
Ask yourself:
❐ Does your / your loved one’s home look or smell unclean?
❐ Does your / your loved one’s home look untidy, or full of clutter?
❐ Are you concerned about keeping up with your / your loved one’s administrative responsibilities, such as paying bills?
Accidents can happen to anyone, but seniors may experience falls if they are unsteady on their feet due to mobility issues or health conditions. When this happens, there can be much higher risk of broken bones or life-threatening injuries.
A survey by Age UK found around 4.3 million older people are worried about falling, with 36% saying it is their primary concern. If you have had a fall that has worried you, caused bad injuries, or has led to a fear of moving around freely in your home, a carer could offer peace of mind. Similarly, if your loved one has had a concerning fall, you may wish to look into care options so you feel confident they are not undertaking activities at home that could lead to falls, such as reaching for high shelves or showering in the morning.
Remember, simple tasks others take for granted can be difficult for those with mobility issues, such as tying shoelaces or climbing steep stairs. If you believe you or your loved one is more at risk of having an accident, consider what kind of care or home improvements might be necessary to keep them safe and enjoying their home without the threat of injury.
Ask yourself:
❐ Are there any areas of concern in your / your loved one’s home that could cause trips?
❐ Do you feel scared to walk around your home freely after a fall?
❐ Does your loved one have any injuries they may not have disclosed? Bruises, scrapes and swelling are all indications of recent falls that should be addressed.
If you answered yes to some of the above questions, then it could be time to start having discussions with a loved one about care needs. This does not mean you must receive full-time care, as there are many different types of flexible care available. Understanding the above signs is a great first step, so you can start to recognise where help might be needed.
If you have any concerns about your own wellbeing, start by bringing this up with family and have an open and honest discussion about what you are struggling with, and where you believe you require additional help. If this is something medical, you may prefer to speak to your doctor about this.
Similarly, if you are concerned about a loved one, starting conversations about future care needs as early as possible will mean broaching the subject isn’t as difficult when the time comes. Always remind your loved one their safety and comfort is your number one priority, which is why you are considering their care needs early.
If you have noticed a physical, emotional or mental decline in your loved one, then it’s time to start looking into the process of acquiring care for them.
If you are considering care for yourself or a loved one, you will undoubtedly be curious to know more about the Care Needs Assessment, including how to get one, how the assessment works, what questions you might be asked, and more. Let’s get into the specifics of the Care Needs Assessment and why this is such an important part of the process.
A Care Needs Assessment is an evaluation done to determine what an individual needs for their health-related care and social support. By undergoing a Care Needs Assessment, an independent assessor can see what your physical, mental and emotional needs might be. For example, you might need a hand getting dressed in the morning, or with home administration such as paying bills, or perhaps you are feeling lonely and in need of companionship.
The Care Needs Assessment will take into account things like:
A Care Needs Assessment is often carried out by a social worker, healthcare worker or someone else qualified to examine your day-to-day needs. The outcome is a personalised care plan to address your individual requirements, with the top priorities being to enhance your wellbeing and quality of life.
If you believe you may need help in certain areas of your life, your eligibility for this will depend on a number of factors, including where in the country you live.
The local authority organising your Care Needs Assessment will take into account whether or not you are able to manage or maintain:
They will also consider whether you struggle to achieve a specific outcome without needing assistance, without causing significant pain, without stress or anxiety, without endangering yourself or others, or without taking much longer than would normally be expected.
If you are unable to achieve two or more of the above, you may be eligible for care and support, and this is what the Care Needs Assessment helps to evaluate.
No. Anyone can apply for a Care Needs Assessment, and it is completely free to organise, no matter your level of income.
If you believe you could benefit from a Care Needs Assessment for you or a loved one, it’s time to organise this. To book an assessment, you will need to contact the local authority or healthcare provider in your area.
If you are unsure about the process of contacting your local council, and do not have anyone who can do this for you, you can visit your GP to have a conversation about where to start. They can recommend options they believe could work for your medical needs, put you in touch with your local community healthcare team (regulated by Integrated Care Systems), and help to arrange a Care Needs Assessment if you cannot do this yourself.
You can also contact the local authority on behalf of a loved one to arrange a Care Needs Assessment if you think they may be struggling to cope in certain areas of life.
If you need an urgent Care Needs Assessment for yourself or a loved one, you should make this clear when booking. Sometimes, a service can begin providing support before a Care Needs Assessment has been completed, so don’t be shy about letting them know if your care needs are high-priority. This will be followed by a full assessment as soon as possible to get the proper, personalised care in place.
A Care Needs Assessment is not something to worry about at all. The social or healthcare worker who comes to your home will simply want to get to know you and your daily routine, and figure out what interventions they can recommend to help improve your quality of life and make things easier for you.
Although you do need to prepare a few things beforehand (more on this below), you shouldn’t think of it as an examination, as you don’t need to learn anything beforehand. Just focus on being open and honest; don’t try to conceal anything you struggle with as the point in the assessment is to see where you need genuine help.
A Care Needs Assessment typically goes something like this:
The Care Needs Assessment is simply about observing how you currently live, and talking to you about the things you struggle with, so there isn’t much to do in the way of preparation for your assessment.
However, you cannot assume the assessor will fully understand your challenges from one meeting, so it can help to gather any relevant information together ahead of time so you don’t forget any details. You may want to list out things like:
If you aren’t sure exactly what care needs you have, it may help to keep a brief diary in the week leading up to your visit so you have some fresh examples of times when you may have needed a little more help. This can be handy for identifying what help you need, as well as when you need it most. It can also help to show the assessor – if you tend to have some good days and some bad days – that even if your needs aren’t obvious on the day they arrive, you can discuss what your needs are on the not-so-good days.
During your assessment, you may be asked about your emotional and social needs too. While this can be a difficult discussion to have, this is not the time to bottle up any complicated emotions, such as loneliness or fear. Let your assessor know if your emotional needs are not being met so they can suggest helpful interventions like companionship or social activities.
It can help to involve a family member or caregiver in the assessment process. Having someone you trust with you can help you feel supported throughout, offer more insight on what your care needs may be, and can be useful when answering difficult questions. The people who know you best may have thoughts on what your home care needs will be, so try to involve them in the discussion if you feel comfortable doing so. If you want to talk about anything private, you can ask them to leave the room. If you don’t have anyone who can support you during the process, you have the right to request an independent advocate who can ensure your preferences are being taken into consideration.
Openness and honesty are key during the assessment, as the goal is to keep you happy and healthy living at home. With person-centred care a priority, your local authority should involve you in your assessment as much as possible. Whether you need an interpreter to fully communicate, an advocate to help if you have difficulty retaining information, or something else, your assessor must take this into account.
Your assessor will aim to understand as much about your care needs as possible during their visit, so they will likely ask you some questions about your situation. The questions might include things like:
If you are eligible for care, your assessment will be followed by a written copy of your new care plan, which will detail all information about the care and support you need. For example, adaptations to your home (grab rails, stairlifts, etc.), home help (cleaning, cooking, etc.), or respite care in a day centre may be recommended.
Your local council will then usually carry out a financial assessment to decide whether your care can be covered by the council, or if you will have to pay some or all of the cost yourself.
All of the above information on the Care Needs Assessment is relevant if you are arranging this on behalf of someone you are caring for. However, if you are currently caring for someone, you’re also entitled to ask for a free carer’s assessment, which looks at what help could make your life easier as a carer.
This assessment may lead to recommendations like respite care so you can take breaks, training, help with transport needs, support groups for carers, benefits advice and more.
Let’s take a look at the details of the Care Plan you might be assigned after the Care Needs Assessment, including what is included in a Care Plan, what to do if you’re not happy with the care you are receiving, the importance of person-centred care, and more.
A Care Plan is a written document created after a Care Needs Assessment is carried out and an individual has been identified as being eligible for care. It details the type of support needed to meet the care needs of the person in question. As well as ensuring the plan is written up formally, the local authority that carried out the Care Needs Assessment will arrange for the recommended support and services to be implemented.
As an example, a Care Plan might recommend something like moving an individual into a nursing home in order to meet their daily medical needs, or it may recommend home adaptations such as adding grab rails or a ramp, to make life at home safer.
A Care Plan is an important document to break down exactly what recommendations have been made, and why. It allows everyone in the chain – from local authority administrative staff, to carers, to your family and loved ones – to understand your needs and ensure they are being adequately met in the right areas, at the right times.
A Care Plan should always take into account your individual wishes and preferences, and take reasonable steps to accommodate these. Each Care Plan will be unique to the individual, but they are all created for the same purpose; to ensure you get the care you need to live as independently as possible, to ensure you receive the same care no matter which care worker is on duty, and to record everything that happens.
According to the NHS, a care and support plan should include:
Before you are assigned a Care Plan, you must undergo a Care Needs Assessment to establish exactly what type of needs you have.
As a brief overview, however, a Care Needs Assessment usually goes something like this:
Each Care Plan is entirely personalised to the individual, as everyone’s needs are completely different. Some of the recommendations that may be in your Care Plan include:
All Care Plans are different, but according to the National Institute for Health and Care Excellence, all support plans should include information on:
The Care Plan should include a record of what takes place during care, to make it easy for a care worker to pick up from where the previous carer left off. This also allows for care to be easily transferable between hospital, home and care home settings, if needed.
Plans should be flexible as your needs change, and should also be reviewed regularly – more on this below.
Receiving your personalised Care Plan is not the end of the process. In the UK, the NHS and local councils prioritise person-centred care, meaning you will be highly involved in the creation of your own Care Plan and the subsequent care you receive.
On the written document containing your Care Plan, there will be contact details for the best person to get in touch with if you have questions or concerns about what is included in your Care Plan, or the care being given. Should you experience any further worries about your Care Plan or carers, the Local Government and Social Care Ombudsman (LGSCO) acts as an impartial service to look into complaints about councils and other organisations, including adult social care providers – this service is free.
If you require care whilst ironing out any issues with the care being provided by your local authority, you may wish to look into private home care if your budget allows. At Home Instead, our Care Professionals are expertly trained to deliver the services you need from home, no matter how complex your needs are.
Initially, you will likely have the first review after six to eight weeks of starting the Care Plan to see that everything is working as it should be.
Your care needs will likely change over time, so your local authority will review your care and support plan at least every 12 months. You can ask for an earlier review if you believe your situation has changed, or a full re-assessment if you think more drastic changes need to be made to your plan.
Data from a 2014 English National GP Patient Survey suggested that 84% of patients with a long-term condition reported some care planning discussion in the last 12 months, but only 12% reported being told they had a Care Plan in place. By not involving patients in their own Care Plan, important needs can be missed. For this reason, it is crucial to continue improving these numbers and involve people in the organisation of their own care.
As of a review in 2011, getting patients involved in decision-making around their own health is a central theme of national and local policy within the NHS, as this is thought to improve health outcomes and patient satisfaction. Research suggests that patients feel more involved in their own care when they are treated as equal partners in the decision making, when their thoughts are listened to, and when they are provided with all of the information they need.
Furthermore, research on mental health and wellbeing shows that involving patients in their own care planning can lead to improved service outcomes and mental wellbeing. As a result, steps are now taken to ensure all Care Plans take this into account.
Discussing care needs with an elderly relative can be difficult, depending on the specific requirements of your loved one and their attitude to receiving help. For some, companionship and help around the home is welcomed with open arms, whereas others see this as losing their independence.
Assuring your loved one of the positive aspects of receiving care can be tricky if their mind seems made up, so let’s take a look at the difficult subject of organising home care for an elderly relative if they are refusing help.
It can feel very strange to discuss care needs with an elderly relative if they used to care for you as a child. We often see our parents as invincible for most of our lives, but eventually the time comes when they need help to live safely and comfortably in their own home.
This transition is easier when your loved one accepts their need for help, but it can be challenging if they are in denial about their needs and refusing the care that will help them. Research from Age UK in 2019 showed 15% of the 65+ population struggle without the help they need to carry out essential daily tasks like getting out of bed, and getting washed. For this reason, it’s important to keep a watchful eye over loved ones in case they are silently struggling with these everyday activities.
If you are unsure how to start this discussion, here are a few things to keep in mind:
Research shows 2 in 3 people aged 70+ say they have not shared their plans for care with their adult children, so you may feel in the dark about your loved one’s thoughts on home care. Alternatively, your relative might be adamant they do not want home care from a stranger, or feel they don’t need it.
Rather than pressuring them to receive care regardless, it is important to listen to their objections and personal reasons. Try to understand any doubts or fears they may have so you can respond appropriately to put their mind at ease. It can sometimes feel like an elderly relative is simply being ‘difficult’, but more often than not there is an underlying reason for their objections, and understanding this can make subsequent discussions easier for both of you. Some of these reasons may include:
One of the best ways to approach care discussions if an elderly relative is hesitant to receive care is to bring up the subject early – long before the person actually needs help. Without any urgency to organise care, it can be easier to ask questions like: “What are your thoughts on installing a stair lift now so it’s there if you ever need it?”
By introducing the idea gradually rather than all at once, your loved one can start to consider it themselves and become more comfortable with the idea when it’s needed down the line. It can be useful to suggest having, for example, a carer pop in once a week to do any difficult housework chores so they start to get used to having someone in the house regularly.
It’s true that sometimes we don’t have the time to gradually work up to the subject of arranging home care, but if it’s possible, a staggered approach can be a really useful way to bring it up when care is still a nice-to-have rather than a must-have.
If you are trying to have a serious discussion with your elderly relative about arranging care more imminently, it can help to approach the subject having done some initial research into the types of care available, what you think would help your loved one most, and the cost of implementing each type of care. A pros and cons list could be useful, or collecting some recommendations from others who have already started using home care services.
Remember, your loved one may have already thought about their care needs and how they feel about certain elements of this. Don’t dive in with your own research on the subject until you have asked them their opinion on home care and what they think might suit them best. Find out what they think, and follow up with the research you have done.
Home care can be a solution that many elderly people are open to, as it provides an excellent alternative to moving to a care home. By considering creative ways to solve your loved one’s problems using flexible home care services, you can discuss a middle ground that keeps them safe while also respecting their wishes and routine within their own home.
Here are a few tips for having the discussion about arranging home care:
When discussing home care with a loved one, it can help to mention benefits such as:
It can be tough if an elderly relative is refusing to discuss their care needs, so if all of the above is not working and they are still saying no to care, you may want to try:
In a survey asking participants their reasons for leaving work to care for elderly parents, one of the top responses was “there is no one else who can help”. With studies revealing almost 5% of the population are providing 20 hours of unpaid care or more every week, it is normal to start feeling overwhelmed by caring duties. If you aren’t sure what to do about a loved one refusing care, do not give up on having the care discussion.
Continue to bring this up as often as feels appropriate, and engage the help of others who can assist such as your relative’s GP or healthcare team. You can also reach out to us at Home Instead to discuss the types of home care that could be useful, and arrange a home visit so your loved one can meet their potential carer and discuss the idea of home care with a professional. This will hopefully answer their questions and put their mind at ease.