Thinking it Over
If respite care is being considered, or is already taking place, then it may be time to consider whether a higher level of day to day care is needed either currently or in the future.
If possible, it is usually best to consider possible options for future care well in advance. This may allow the person with dementia to be involved in discussion about care options, avoiding misunderstandings at a later date. Having options thought out well in advance also helps to avoid the situation that care has to be decided hurriedly, in a crisis situation.
Planning for Emergencies
Even if the person with dementia's carer feels they can manage day to day without extra help, it may be worth putting provisional plans in place for emergencies. For example if the carer were admitted to hospital themselves, how would the person with dementia be cared for? Note however that this is something to plan for, but not something to worry about, as Social & Community Services would have a responsibility to organise appropriate emergency care in such a situation.
Carers emergency cards are available from the Carers Centres; these fold up to credit card size so that carers can keep them with them at all times. These cards have information to make emergency services aware about the person who is cared for, should the carer have an accident or be taken ill.
Care at Home
Stepping up the level of care for the person with dementia does not always mean admission to a care home, particularly if someone is going to be self-funding: the money a care home would charge could purchase a lot of home care each week. However this may require a friend or family member to do quite a lot of coordination.
In Oxfordshire a range of agencies exist who can offer care provision in your own home. This ranges from help with household tasks like ironing and gardening, through regular visits giving assistance with meals and dressing, to agencies who can provide full-time live-in carers. More details are available in our Help at Home section.
If a package of care is provided by Social & Community Services then it is the Care Manager's job to arrange this.
Care Homes
In lots of families the issue of "going into a home" is a sensitive one. Family members may have made promises in the past, e.g. that they would make sure the person with dementia was always able to stay at home, which make it difficult to think objectively about whether a care home may have become the best option for meeting the person with dementia's needs.
However as dementia progresses the person with dementia may no longer recognise their current house as "home", remembering instead a house from earlier times, perhaps a childhood home. In this situation it may be helpful to think of "home" as being a place of security, where the person is comfortable and their needs are met.
Sometimes respite placements become more frequent, as caring for the person with dementia becomes more demanding, until eventually the point is reached where it is time for them to move into the care home. (Ideally this would probably be the same home as respite has taken place in).
Sometimes families use respite placements as a way to get an "inside view" of a care home: it may be difficult to know if someone is going to be happy in a care setting until they have actually stayed there.
Another situation that sometimes occurs is that the person with dementia may settle into the routine of the care home during the respite placement, but then become unsettled on returning home. This will then require careful thought as to whether a permanent move into the care home might be less unsettling than repeated respite stays.
Everyone is different. What works for one person may not be the best solution for another.
More Information can be found in our Care Homes section.
Last updated: 23 Dec 2009
