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How do you know if someone needs to move into a care home?

Advice and things to consider when deciding whether to move a person living with dementia into full-time care.

Care homes: when’s the right time and who decides?

If you are a family member or carer, or the person’s attorney or deputy, you may have to decide whether you think the person with dementia needs to move into a care home. You may find it difficult to make this decision, seeing both advantages and disadvantages to each option. If you’re struggling, don’t worry – it’s normal to feel confused or unsure.

You should ask yourself, first and foremost, what is in the best interests of the person. If you feel you can no longer provide the care that the person needs to help them to live well, then it may be better for them to move somewhere where professional care staff can do this. Similarly, if the person cannot live independently any more – for example, cannot care for themselves or stay safe – then it might be the right time to think about alternative care.

However, moving someone into a care home doesn’t have to be the only thing you should consider. You might want to think about other care options that would enable the person to stay living at home – for example, seeing what other care and support can be provided within the person’s home, or whether different housing options might be better.

Other care options to consider

Respite care (sometimes referred to as short-break or replacement care) is one option, and could be the first step towards longer-term residential care. Respite care is temporary care for the person with dementia that aims to give the carer a break, as well as giving both the carer and the person with dementia some time away from each other.

Some respite care will be in the person’s home, but some care homes also offer short stays. This offers the person with dementia a chance to experience a care home for a temporary period. Some people use a respite stay as a ‘trial period’ and many care homes are willing to offer a short-break as they find that people who like it there may eventually move in permanently when they are ready.

If you think extra support in the home or respite care may be a good option, you should contact your local authority for a needs assessment. This is where they make a full assessment of a person’s needs and decide what support they are eligible for.

The benefits of moving into a care home

Deciding that someone needs to move into a care home is often a very difficult decision. It is common to feel a sense of guilt at making this decision. You may feel that you should be able to do more to support the person, or that you are letting them down. However, it’s important to remember that you are doing this because it is right for the person, and that there can be lots of positives to moving into a care home.

A care home will have staff who can provide continuous, 24-hour support, which may be more than you are reasonably able to do. A care home with nursing will also have a registered nurse on site 24 hours a day, for example. There are also important social benefits of living in a care home. Residents can meet one another, and join in group activities.

And just because the person moves into a care home, it doesn’t mean they will have to stop doing the things they enjoy. They will still be able to see family and friends, or do things that are meaningful to them. When the person is living in a care home, some people find it allows them to visit and spend quality time with the person, without having to focus on providing day-to-day care.

What things should you consider?

If you are finding this decision difficult, it might help to think clearly about the following things. It might also be useful to write everything down as this can help you to weigh everything up and get other people’s help.

  • Is the person able to make a decision about their care, and where to receive it, for themselves?
  • Has the person been given all possible support to make a decision themselves?
  • Have you considered other options, such as care at home, that may help the person to get the care they need?
  • Would some respite care or a short break help you to feel more able to cope, or to see how the person with dementia gets on in a new environment?
  • Would sheltered or extra care housing be a better option for the person than a care home?
  • What would be the benefits for you and the person with dementia if they moved to a care home?
  • In what ways might care staff be able to provide better care than you – for example nursing or 24-hour care?
  • If the person with dementia goes into a care home, how could you still be involved in their care?
  • What things make the person feel comfortable, safe and content? Does the care home you are considering offer these?
  • If the person goes into a care home, what would the impact be on them, you, and other people?
  • Do you think your feelings (good or bad) about placing the person with dementia in a care home could change over time?
  • Is there someone you can discuss your feelings with?
  • Has the person ever expressed any opinions about going into a care home?
  • Have you spoken to the person about the move? Even if they don’t seem to understand it or are unable to make the decision themselves it is important to involve them as much as possible.
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