With visiting care in many parts of England now costing £20 an hour during the week and £24 an hour at the weekend (and often up to £30 on Bank Holidays and at Christmas, New Year and Easter), then if a client is receiving an average of just 4.5 hours a day visiting care for 7 days a week, then the total weekly cost (£666 a week) is likely to be on a par with what they would typically be expected to pay for 24 hour live-in care.

If either you personally or a close relative is already receiving an average of 4 hours or more per day of visiting care, then you might like to consider the benefits of switching to 24 hour live-in care. The advantages of live-in care are many and varied and some of them are outlined below.

Support & Companionship

With a visiting care service, there is often a high turnover of care staff and a succession of regularly changing faces can be confusing for the person being looked after. By its very nature a live-in care service provides greater continuity of care and a good live-in carer will quickly gain an understanding of the person they are looking after and will be sensitive to their feelings and moods.

They will learn what to say and do to cheer them up if they are feeling low, but just as important, they will develop a sense of when they want company and when they want to be on their own for a time. A good carer will come to be valued as much for their companionship as for their care skills and many will find themselves treated almost like a member of the family.

Help with Personal Needs

Where an older person is suffering from painful arthritis or has other mobility problems, their carer will be able to help with their personal needs, such as dressing, washing and going to the toilet. A good carer will know how to offer their support in a sensitive and unobtrusive way, in order to preserve as far as possible the privacy and dignity of the person they are caring for.
Furthermore, in contrast to a visiting care service, where assistance is available at set times of the day, a live-in carer is 24 hours a day and can provide help and support as soon as it is needed.

Shopping & Cooking

As part of the care needs assessment which takes place before the start of a live-in care service, a person receiving care at home will be asked in detail about their likes and dislikes in terms of main meals, snacks and hot and cold drinks. Unless the family has made other arrangements, it will normally be the carer who does the shopping and buys in fresh food and then cooks it in the way the client likes it. If they are provided with meals they have chosen themselves and able to eat at a time which suits them, most older people will enjoy their food more and will tend to eat better than if presented with pre-prepared meals at set times by a visiting carer.

House-Keeping

A live-in carer will keep the house clean and tidy, clear up any accidents or spillages and make sure that food stored in the fridge or larder is not kept longer than it should be. A clean and tidy house is more pleasant for the person being cared for and more welcoming for family and friends who visit or come to stay.

Social Contact

When an older person still lives in their own home, it is much easier for family, friends and neighbours to drop in, even for a few minutes, than if they have moved into a care home, where visiting times are restricted and quiet facilities limited. Moreover, visiting someone in their own home is a much more pleasant experience for family and friends than visiting them in a care home, where there is little privacy and where they are just one patient among many.

Wherever practicable carers will encourage the person they are caring for to invite round and entertain family, friends and neighbours on a regular basis. The carer will help them plan and prepare morning coffee or afternoon tea and will then melt into the background, so that the client can enjoy their traditional role as host. In contrast, offering help with entertaining is not a service that visiting care agencies can reasonably offer their clients.

Health & Medication

Once an elderly person who has previously lived on their own starts receiving 24 hour live-in care, their health as well as their quality of life will generally start to improve. They will tend to feel happier and more secure, they will generally eat better and, with their carer’s assistance, they may take more exercise; even more significantly, they will start to take their medication more regularly, something which may fall by the wayside if calls are missed by a visiting care provider.

Protection from Accident or Harm

With the support of a 24 hour carer at their side to help them if need be with the more demanding physical tasks in life (getting dressed, bathing and/or showering, moving about the house, night-time visits to the toilet etc), people receiving care at home are less likely to suffer falls or other accidents and are also less vulnerable to burglars or intruders. They will feel safer, more relaxed, more confident and, in all likelihood, happier in themselves. Furthermore, the knowledge that an ageing parent, who was previously struggling to cope with living on their own, is at less risk of accident or harm can be a huge relief to their children, who may live too far away to be regularly on hand.

Trips and Outings

Where appropriate carers can be provided who drive and this will enable the person receiving care to go on trips and outings. They may want to attend church or be driven to see family and friends or visit a local beauty spot. Such outings can be important in helping maintain contact with the outside world and keep their spirits up. In contrast, time does not normally permit a visiting care service to take their clients on trips and outings.

Switching from Visiting Care to Live-In Care

Very few visiting care agencies offer live-in care, so if you are thinking of switching to live-in care, make sure you talk to a specialist provider of live-in care.

Care At Home are specialist providers of 24 hour care and operate across London, the South East and the Midlands. If you would like to explore the possibility of switching to live-in care, then please give us a call and ask us to arrange a free Care Needs Assessment Visit. You will then receive a visit from Diane Bowyer, our Nurse Risk Assessor or Sarah Vincent, our Care Manager, who will be able to advise you on the level of care required and the likely cost.

The upset displayed by John Suchet is a prima facie illustration – albeit a particularly harrowing one – of the feeling of desolation and isolationism that we as a company see only too often when people initially approach us for help in dealing with this condition.

Hugely helpful as the Admiral Nursing initiative is, as Mr Suchet points out, it remains unavailable to the vast majority of us and so the prospects for most sufferers of this awful disease continue to look ever more bleak – and even more so for their spouses or offspring who are almost invariably left to try and care for them.

The situation is not actually as bleak it might seem however.

By far the most significant factor in relieving the pressure and stress felt by relatives who would otherwise be left to deal with this condition on their own is having someone around who can basically shoulder a lot of the actual day-to-day burden of it on a hands-on basis rather than through counseling alone – or at all in fact. In other words, someone who can shoulder all the behavioural and physical demands of the person actually suffering from the disease and engage them emotionally also.

Time and again I have seen the lives of both sufferers and carers utterly transformed by this measure alone, and finally I have now experienced the benefits myself:

My own mother has for some while been afflicted with Alzheimer’s disease, a problem which was for a time exacerbated by her steadfast resistance to accepting any support at all outside of the family, which is often the case incidentally. But now we have a competent team of carers looking after her, it is hard to describe not only my own feeling of exaltation and well-being in seeing her being properly looked after by proper dementia-trained carers who take all this in their stride, but in witnessing also the distinct recovery in my mother’s own physical and emotional well-being.

And the moral of this story? Even the sufferers of Alzheimer’s disease don’t necessarily have to live a life of misery because of it.

1. There’s No Place Like Home

As people get older, their home tends to become even more precious to them. Any move away from this familiar environment, for example a holiday in a hotel, or even a short stay at the home of a son or daughter, can make them feel confused and disorientated. It is remarkable, however, how quickly they perk up when they return to the comfort of their own home!

Living in their own home, surrounded by familiar furniture, pictures, photographs and other objects, provides older people with a physical and emotional anchor and helps maintain their sense of identity.

In contrast, uprooting people and moving them into residential care can lead to a sense of confusion and hasten memory loss. Some older people can become depressed and apathetic and may even lose all sense of purpose when they are moved into a care home.

Furthermore, many older people still have a pet and the prospect of having to abandon their much loved cat or dog because they are moving into a care home can leave them feeling bereft and heart-broken.

2. Staying in Control of Your Life

Where older people remain in their own home, they maintain a sense of being in control of their own lives. They are able to determine their own daily routine and decide for themselves what time to get up and go to bed, what to eat and drink and what programmes to watch on television.

If they have had a long day on a Sunday, perhaps involving a trip out with members of their family, they can have a lie-in on the Monday without anyone expecting them to get up at a particular time, as would happen in a care home. This ability to continue to making decisions for themselves and stay in control of their life is important in helping older people to maintain their morale and remain in good psychological and spiritual health.

3. Support & Companionship

A good live-in carer will quickly gain an understanding of the person they are looking after and will be sensitive to their feelings and moods. They will learn what to say and do to cheer them up if they are feeling low, but just as important, they will develop a sense of when they want company and when they want to be on their own for a time.

A good carer will come to be valued as much for their companionship as for their care skills and many will find themselves treated almost like a member of the family. In a care home, on the other hand, there are just too many staff, each with too much to do, for individual patients to establish a close personal rapport with anyone.

4. Help with Personal Needs

Where an older person is suffering from painful arthritis or has other mobility problems, their carer will be able to help with their personal needs, such as dressing, washing and going to the toilet. A good carer will know how to offer their support in a sensitive and inobtrusive way, in order to preserve as far as possible the privacy and dignity of the person they are caring for. Furthermore, the help will be given as soon as it is needed, unlike in a care home, where patients will have their personal needs attended to at times which suit the busy routine of the care assistants.

5. House-Keeping

Eyesight and mobility problems will often prevent older people from maintaining the same standards of house-keeping as they did in their younger days. A live-in carer will keep the house clean and tidy, clear up any accidents or spillages and make sure that food stored in the fridge or larder is not kept longer than it should be. A clean and tidy house is more pleasant for the person being cared for and more welcoming for family and friends who visit or come to stay.

6. Shopping & Cooking

As part of the care needs assessment which takes place before the start of a live-in care service, a person receiving care at home will be asked in details about their likes and dislikes in terms of main meals, snacks and beverages and carers will always try to buy the food they like and cook it in the way they like it. Provided with meals they have chosen themselves and able to eat at a time which suits them, most older people will enjoy their food more and will tend to eat better than if they are offered the often unappetising food served up in care homes, which patients are often expected to eat much earlier in the day than they are used to at home in order to meet the home’s busy daily routine.

7. Social Contact

When an older person still lives in their own home, it is much easier for family, friends and neighbours to drop in, even for a few minutes, than if they have moved into a care home, where visiting times are restricted and quiet facilities limited. Moreover, visiting someone in their own home is a much more pleasant experience for family and friends than visiting them in a care home, where there is little privacy and where they are just one patient among many.

Wherever practicable carers will encourage the person they are caring for to invite round and entertain family, friends and neighbours on a regular basis. The carer will help them plan and prepare the refreshments and will then melt into the background, so that the client can enjoy their traditional role as host. By contrast, entertaining in care homes can be fraught with difficulties because of problems with visiting hours, catering and the lack of facilities for visitors.

8. Health & Medication

Once an elderly person who has previously lived on their own starts receiving live-in care, their health as well as their quality of life will generally start to improve. They tend to feel happier and more secure, they generally eat better and they may take more exercise; even more significantly, they start taking their medication more regularly, something which often falls by the wayside when they are struggling to cope with living on their own. Taking regular medication can often lead to significant improvements in their health and well-being, which in itself will give their family greater peace of mind. People cared for in their own home generally enjoy a better quality of life and may therefore live longer than people who move into residential care.

9. Protection from Accident or Harm

With the support of a carer at their side to help them if need be with the more demanding physical tasks in life (getting dressed, bathing and/or showering, moving about the house, night-time visits to the toilet etc), people receiving care at home are less likely to suffer falls or other accidents and are also less vulnerable to burglars or intruders. They will feel safer, more relaxed, more confident and, in all likelihood, happier in themselves. Furthermore, the knowledge that an ageing parent, who was previously struggling to cope with living on their own, is at less risk of accident or harm can be a huge relief to their children, who may live too far away to be regularly on hand.

10.Trips and Outings

Where appropriate carers can be provided who drive and this will enable the person receiving care to go on trips and outings. They may want to attend church or be driven to see family and friends or visit a local beauty spot. Such outings can be important in helping maintain contact with the outside world and keep their spirits up. By contrast, once people have moved into a nursing home, they often become so institutionalised that they rarely want to venture beyond the confines of the garden, even if given the opportunity to do so.

A stroke happens when the blood supply to the brain is disrupted. A blood clot restricting the flow of blood to the brain is the most common cause of strokes, but some are caused by bleeding in or around the brain from a burst blood vessel.

– In both cases the brain is starved of oxygen, damaging or killing cells
– Sufferers are often left with difficulty talking, walking and performing other basic tasks.

What are the symptoms of a stroke?

Not everyone will have the same symptoms and the symptoms may vary. The most common symptoms to look out for are:

– a sudden weakness or numbness of the face, arm or leg on one side of the body
– sudden loss or blurring of vision, in one or both eyes
– sudden difficulty speaking or understanding spoken language

In addition the following symptoms may also be apparent:

– sudden confusion
– sudden or severe headache with no apparent cause
– dizziness, unsteadiness or a sudden fall, especially with any of the other symptoms.

What are the clear signs that someone has suffered a stroke?

There’s three key things to look for.

– Facial weakness – Can the person smile? Has their mouth or eye drooped?
– Arm weakness – Can the person raise both arms?
– Speech problems – Can the person speak clearly and understand what you say?

What should I do if I think someone has had a stroke?

A stroke is a medical emergency. If you suspect a stroke call 999 immediately.

By calling 999, you can help someone reach hospital quickly and receive the early treatment they need. Prompt action can prevent further damage to the brain and help someone make a full recovery.
Delay can result in death or major long-term disabilities like paralysis, severe memory loss and communication problems.

What is a Transient Ischaemic Attack or TIA?

A TIA (sometimes called mini stroke) is similar to a full stroke but the symptoms may only last a few minutes and will have completely gone within 24 hours. Don’t ignore this because it could lead to a major stroke. See your GP as soon as possible and ask to be referred to a specialist stroke service. This should happen within seven days.

You can obtain further information from your local NHS direct or by calling the Stroke Association Helpline on 0845 3033100

For some this may only be small things such as appointments but in other cases it can be worse, such as forgetting the faces of loved ones or precious memories. This can be extremely distressing for those who are close to the sufferer.

There are a few things that can be done to help remember the appointment or perhaps even jog the memory into remembering some of those past events or faces.

Having a white board with the date and the events that are due to happen that day such as doctor’s appointments or friends visiting will be very useful.

Also, regularly looking through photos, letter or perhaps scrap books from the past may help bring back some of the memories that have been lost. Visiting as often as possible and asking questions about past homes, friends and pets may also help.

Also, music is a very powerful memory jogger and there are certain songs that will always take us back to a time when the same song meant something to us. It has also been discovered that music can be a help to dementia and Alzheimer’s sufferers.

A person must be able to give their consent to receiving direct payments and be able to manage them even if they need help to do this on a day-to-day basis.

Who is eligible?

If you already receive social services
Your local council is obliged to offer you the option of direct payments in place of the services you currently receive. There are some limited circumstances where you are not given this choice and your council will be able to tell you about these.

If you’re not receiving social services
To get direct payments you’ll need to contact your local council to ask them to assess your needs. Social services – and therefore direct payments – are normally available if you are:

– disabled and aged 16 or over
– a carer aged 16 or over, including people with parental responsibility for a disabled child
– an older person

If you’ve been refused social services
If your local council has decided that you do not need social care services, it will not offer you direct payments. If you think your needs or circumstances have now changed, ask your local council for a new assessment.

How much do you get?
The amount you receive will depend on the assessment your local council makes of your needs.

How it’s paid
Direct payments are made directly into your bank, building society, Post Office or National Savings account.

If you need someone who cares for you to collect your money, or you are registered blind, payment can be made by sending a cheque which can be cashed at the Post Office.

How to apply for direct payments locally
If you already get services, ask your local authority about direct payments.

If you are applying for services for the first time, your social worker should discuss the direct payments option with you when they assess your care needs.

The following link will let you enter details of where you live and then take you to your local authority website where you can find out more and/or apply online.

Find out more and/or apply for direct payments locally (opens new window)

What you can use direct payments for
The money is for you to use to pay for the services and/or equipment which will meet the needs the local council has assessed you as having.

As a general principle, councils should aim to leave you to choose how best to meet your assessed needs as long as they are satisfied that agreed support arrangements made, are being met.

What you can’t use direct payments for

You cannot use direct payments to:

– pay for permanent residential accommodation – but you may be able to use direct payments to secure occasional short periods in residential accommodation, if your local council agrees that is what is needed
– secure a service from your spouse or civil partner, close relatives or anyone who lives in the same household as you, unless that person is someone who you have specifically recruited to be a live-in employee (other than in exceptional circumstances, which your council may agree with you)

Record keeping
If you receive direct payments, you’ll need to account for the money you spend. Your local council will tell you what records you need to keep and what information you’ll be expected to provide: such as timesheets signed by personal assistants, or receipts for services from agencies.

The council will have to satisfy itself that the needs for which it is giving you direct payments are being met. They should tell you how they will go about this. This may involve a visit to your home.

Carers and direct payments
If you are a carer aged 16 or over, including people with parental responsibility for a disabled child, you may be eligible for direct payments.

However, you cannot use direct payments to buy services for the person you care for. They can only be spent on getting the support you, as a carer, have been assessed as needing.

Direct payments for carers – arranging care and services (caring for someone section)

Effect on other benefits
Direct payments are not a replacement of income and therefore do not affect any other benefits you may be receiving.

What to do if your circumstances change

If your social services needs change
If your needs change, contact your local council as soon as possible so that they can reassess the level of payments you require. It doesn’t matter whether the changes are long- or short-term.

For example, if you don’t need to spend the full amount because your condition improves temporarily, or you go into hospital, they may need to adjust your payments.

If you don’t want to continue with direct payments
If you decide you don’t want to continue, the local council will arrange services instead. If the council decides you cannot manage with direct payments, it might decide to stop making direct payments and provide services instead.

For details on this click this link to Direct.gov.uk

This is the question we at Care at Home recently asked ourselves and, as a result decided to launch a new 5-day week live in care service. So effectively providing part-time live in care for only 5 days a week.

We receive many calls from people looking for visiting care, where really and truely in a number of cases they may need full-time live in care. However, the cost of full-time live in care is sometimes cost prohibitive when the weekly start cost is £650 per week. However, our new 5-day week part-time service starts at £500 per week, which represents a 23% saving.

Visiting care could cost around £420 per week for three 1-hour visits per day, where this is for 7-days a week at a charge of around £20 an hour. The total charge would obviously be less if the visits were less than 1-hour each time, but could equally be more if say 4 daily visits were required.

The types of care where visiting care is perhaps more questionable is where the person has either Alzheimers or Dementia. A person might receive a visit at say 8:30am and not be re-visited until around mid-day. This means that the person is left on their own for long periods of time and being that they are forgetful and have a tendency to wonder there is a problem. In some cases the person is locked in their own home, which effectively becomes a prison. Being locked in their own home could become a real hazard, if a fire were to break out, for example. In these circumstances we believe that live-in care would be the preferred and safer choice.

Visiting care is fine, so long as the person being cared for is “Safe” to be left alone for long periods of time. However, it is important to note that the elderly are prone to falling and it only takes one fall at a time when they are alone to be a problem. This is not to say that visiting care is not good, it has it’s place, but when any relative is looking for care for an elderly loved one, it needs to be thought through very carefully.

The part-time live in care service would mean that the family will have to look after their elderly relative over the weekends, but it does mean that during the week they can still go to work in the knowledge that their loved one is being looked after and at a price which is more affordable.

We are hoping that with a reduced price for a 5-day week instead of the full 7-day week package, combined with the possibility of obtaining government help towards the payments by way of direct payment, our new service will be well received.

For more details visit our main site and contacts us for a free no obligation care plan and quote

Dementia is a term commonly used to describe various different brain disorders that have one thing in common – a loss of brain function which is usually progressive and eventually severe, leaving the person severely disabled and in most situations extremely frustrated.

The term ‘dementia’ is used to describe the symptoms that occur when the brain is affected by conditions, including Alzheimer’s disease, stroke and many other rare conditions.

Symptoms of dementia include problems with speech and understanding, a loss of memory, confusion and can lead to aggressive behaviour. Carers looking after people with Dementia need to have special training in this field and experience is vital.

A link to causes of dimentia (opens in a new window)

It is however, important to note that people with dementia can still be cared for in their own home, as compared to having to be placed in a care home.

The advantage of care at home with respect to dementia and in particular with Alzheimers, is that anyone with this desease very much benefits from having a set routine and familiar surroundings. It is therefore easier to acheive this in their own home.

For more help and advice on this subject and dementia care at home you can email Care at Home or visit Care at Home’s contact page.

A person must be able to give their consent to receiving direct payments and be able to manage them even if they need help to do this on a day-to-day basis.

Who is eligible?

If you already receive social services
Your local council is obliged to offer you the option of direct payments in place of the services you currently receive. There are some limited circumstances where you are not given this choice and your council will be able to tell you about these.

If you’re not receiving social services
To get direct payments you’ll need to contact your local council to ask them to assess your needs. Social services – and therefore direct payments – are normally available if you are:

– disabled and aged 16 or over
– a carer aged 16 or over, including people with parental responsibility for a disabled child
– an older person

If you’ve been refused social services
If your local council has decided that you do not need social care services, it will not offer you direct payments. If you think your needs or circumstances have now changed, ask your local council for a new assessment.

How much do you get?
The amount you receive will depend on the assessment your local council makes of your needs.

How it’s paid
Direct payments are made directly into your bank, building society, Post Office or National Savings account.

If you need someone who cares for you to collect your money, or you are registered blind, payment can be made by sending a cheque which can be cashed at the Post Office.
How to apply for direct payments locally

If you already get services, ask your local authority about direct payments.

If you are applying for services for the first time, your social worker should discuss the direct payments option with you when they assess your care needs.

The following link will let you enter details of where you live and then take you to your local authority website where you can find out more and/or apply online.

Find out more and/or apply for direct payments locally (opens new window)

What you can use direct payments for
The money is for you to use to pay for the services and/or equipment which will meet the needs the local council has assessed you as having.

As a general principle, councils should aim to leave you to choose how best to meet your assessed needs as long as they are satisfied that agreed support arrangements made, are being met.

What you can’t use direct payments for

You cannot use direct payments to:

– pay for permanent residential accommodation – but you may be able to use direct payments to secure occasional short periods in residential accommodation, if your local council agrees that is what is needed
– secure a service from your spouse or civil partner, close relatives or anyone who lives in the same household as you, unless that person is someone who you have specifically recruited to be a live-in employee (other than in exceptional circumstances, which your council may agree with you)

Record keeping
If you receive direct payments, you’ll need to account for the money you spend. Your local council will tell you what records you need to keep and what information you’ll be expected to provide: such as timesheets signed by personal assistants, or receipts for services from agencies.

The council will have to satisfy itself that the needs for which it is giving you direct payments are being met. They should tell you how they will go about this. This may involve a visit to your home.

Carers and direct payments
If you are a carer aged 16 or over, including people with parental responsibility for a disabled child, you may be eligible for direct payments.

However, you cannot use direct payments to buy services for the person you care for. They can only be spent on getting the support you, as a carer, have been assessed as needing.

Direct payments for carers – arranging care and services (caring for someone section)

Effect on other benefits
Direct payments are not a replacement of income and therefore do not affect any other benefits you may be receiving.

What to do if your circumstances change

If your social services needs change
If your needs change, contact your local council as soon as possible so that they can reassess the level of payments you require. It doesn’t matter whether the changes are long- or short-term.

For example, if you don’t need to spend the full amount because your condition improves temporarily, or you go into hospital, they may need to adjust your payments.

If you don’t want to continue with direct payments
If you decide you don’t want to continue, the local council will arrange services instead. If the council decides you cannot manage with direct payments, it might decide to stop making direct payments and provide services instead.

Exctract from Government website click here.

There is no doubt that once you get in to your later years things become more difficult and help is needed for some of the tasks that might ordinarily have been a lot easier a when you were a bit younger. There is help at hand with care in your own home with the privacy that this brings with it. It might be that you only need help at certain times of the day, for example, you might need help with getting your breakfast, lunch or dinner, but to have someone there will make all the difference.

If you only require part-time care then you need to employ the services of a “Visiting Care Agency” who will be geared up for this type of service. However, if you need more regular care throughout the day, for whatever reason, or you would like companionship, then a live-in carer is what is recommended.

A live-in carer from say Care at Home UK Limited will have the experience to deal with all eventualities with an elderly person living at home and will have the necessary training to mach the skills.

Both visiting care and live-in care are very expensive, especially full time live in care, becuase it is labour intensive. However, your local council should be able to offer help where this is concerned and the goverment are pushing for more private home care by offering “Direct Payments” to the person requiring the care.