In this blog we look at when should someone with dementia go into a care home.
Caring for someone with dementia can be an incredibly challenging task.
One that often falls to family members, who learn how to handle the day to day demands of the condition as they go along.
As dementia progresses and the symptoms intensify, it may not be possible to continue looking after your loved one in your own.
At this point, carers may wonder when should someone with dementia go into a care home?
Here’s a summary of what we’ll cover in this blog:
- Care homes provide a professional service that relieves the burden of complex care on families.
- The prospect of letting your loved one go into care can be daunting and is often accompanied by feelings of guilt.
- Talking about care options before it’s too late can make the process easier.
- The importance of setting up a Lasting Power of Attorney and discussing care plans.
What are the benefits for someone with dementia moving into a care home?
Care home settings offer a greater degree of safety and security for people living with dementia.
There are a range of care home options available, depending on the level of individual need.
For example, those with lower needs, but who prefer a secure living environment, might live in supported living or residential accommodation.
However, as the condition progresses, moving to a nursing home that provides specialist support is necessary to receive the right level of care.
In a care home setting your loved one has access to:
- Professional carers on hand 24/7 for emergencies and general supervision
- Specially adapted equipment and furniture
- Opportunities for social interaction with other residents
- Prepared meals
- Supervision for daily activities such as meal times and taking medication
What are the benefits of moving to a care home for the family?
The primary reason for someone with dementia moving to a care home should be to prioritise their wellbeing.
However, during the process of caring for a family member with dementia, carers can become overwhelmed with the complexities of the condition.
Not only are they dealing with a high-level of need, they have the responsibility for another person’s health.
Not to mention the possibility of having their own families, jobs and needs to attend to as well as their caring duties.
For this reason, it is understood that placing your loved one with dementia into a care home can relieve some of the pressures that being a carer can put on families, finances and health.
As long as moving to a care home has been discussed and agreed upon by the parties involved, having a loved one move into a care home can be mutually beneficial.
These benefits to family members of someone with dementia moving to a care home include:
- Removing the pressure of complex home caring which can put a strain on relationships
- Reserving visiting time for positive family relationships
- Having the reassurance that your loved one is well looked after
This being said, it stands that the person in need of care must be kept at the centre of all decision making, even if they lack the mental capacity to make decisions themselves.
Understanding and handling your emotions
The decision to move your loved one into a care home can be accompanied by a number of difficult emotions.
The transition from home to care home can be overwhelming, even if you know deep down that it is the right thing to do.
Often families of someone with dementia feel guilty about moving them into a care home and away from their familiar home environment.
The emotional challenge
Some people who experience behavioural changes as part of their dementia symptoms can be distressed by the whole transition experience.
As a carer, this can be very difficult to watch without wanting to intervene and change plans.
However, you must try to remain objective and consider the bigger picture of their health and wellbeing, as well as your own.
How to make the decision?
Moving to a care home is an emotive topic for many families.
It often follows a crisis point in the provision of care by family members.
In some cases, the decision to move your loved one into a care home is made for you.
This can happen in the event of being hospitalised, for example, and then cannot be discharged back home.
This can be especially difficult if you have never discussed what your loved one with dementia would like to happen to them in this event.
If it is still possible to have a conversation about what is a care plan, it is important to help them make those plans known.
Care plan details
- Where they would like to receive nursing or dementia care
- At what point they would like to move to a home
- Any wishes or needs regarding their care facility
- How they will pay for their care – whether through personal finances, a care plan, or NHS continuing healthcare funding
- Options for palliative care such as a Do Not Resuscitate (DNR) order
- Details of their accounts, for the LPA (Lasting Power of Attorney).
Who decides when should someone with dementia go into a care home?
If someone has a cognitive impairment decision making can be difficult.
While, ideally, the person with dementia would be able to make the decision that they want to go into a home, this is not always possible.
As the condition progresses, the mental capacity to make these kinds of decisions is reduced.
For example, a person with dementia may not understand or be able to communicate what is in their best interests.
In this next section we will discuss Lasting Power of Attorney.
This is a legal right for someone to make decisions on your behalf.
It is used in the event that you lose mental capacity to make decisions or handle your assets on your own.
If there is a lasting power of attorney
There are two different types of Lasting Power of Attorney (LPA).
An LPA for Property and Financial Affairs covers decisions about money and property.
The LPA for Health and Welfare covers decisions about health and personal welfare.
The LPA for Health and Welfare is responsible for deciding when should someone with dementia go into a care home.
But a Property and Financial Affairs power of attorney is also helpful in this situation.
And this person will legally be able to arrange the payment for a care home from the person’s estate.
What if there is no money?
If the person doesn’t have property or savings to pay for a care home, this does not prevent a move to a care home.
The LPA will liaise with the local authority to arrange a socially funded care home place.
As this decision can be extremely emotive, there is the possibility of conflict and difference of opinion amongst family members.
A situation may arise where neither party will change their stance and a deadlock occurs.
Here, your local authority will appoint a social care professional to decide on the person living with dementia’s behalf.
There is no lasting power of attorney appointed, what now?
If they have not arranged an LPA, whatever the individual has previously decided will be used as a guide.
If the person has decided on a particular care home or type of facility in advance, this is extremely helpful.
It is preferable to specify in advance at what point your loved one is prepared to move to a care home.
This will both remove the need for decision from the family, and put the older person in control of their care.
The decision will fall to close family members if the person hasn’t made their wishes known.
They will choose what sort of care home, and crucially, when they move to the care home.
Should a person have no close family or LPA to advocate for them, the authorities must get involved.
A trained social care professional will decide about when a patient moves into a care home.
They will also decide what level of care is appropriate for the patient based on their medical needs.
Final thoughts on when should someone with dementia go into a care home
There’s no denying that leaving the family home is a huge emotional wrench.
But there does come a point when living with dementia can become so challenging that only a care home can provide the safety your loved one needs.
This is NOT an admission of failure on your behalf, quite the opposite, you are taking positive action that is in the best interests of your loved one.
And in fact, moving to a care home can be a very positive step.
Indeed data shows that life expectancy can increase and quality of life improve for many people who get this extra support.
Crucially, try and plan for this next stage in dementia disease management long before it might be needed.
Your loved one may never need to move to a care home, but if that point does come, you will be well prepared.