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Deciding that an elderly relative or friend has to go into a care home is a major decision, so what do you need to know to get it right?
You need to find the right nursing home but that search can be a traumatic experience. The quality of accommodation and level of care can vary significantly between each home and exploring the various options is often a long and arduous process when time is at a premium.
The key is to plan well in advance so you can make a balanced decision based on your own information. There are some old perceptions of care homes (formerly known as residential homes) and several myths which need dispelling;
Myth: No one likes living in a care home for any length of time
Truth: Some people do prefer to live in a nursing or care home, rather than living at home and trying to gain access to the services they need. Some older people find it reassuring to have the support that they need provided by a good nursing home. Not only are they provided with medical care, socialisation, and a safe environment, they can also be assured that their families are confident about their care. This can make the experience of moving into a care home a positive one for all concerned.
Myth: You should only start looking into nursing homes when you really need one.
Truth: Don’t wait. Explore your options before you or your loved one need a Care Home. This then allows you ample time to ask questions and make informed choices. Ask about registration, staff credentials, availability of primary healthcare providers, cost, activities, and facilities. Talk to residents, staff, and residents’ relatives. A lot of the best care homes have long waiting lists. If you have a loved one who does not need a nursing home yet, but has a progressive illness such as Alzheimer’s, it can be a good idea to get on a waiting list well ahead of time. It also gives you time to work on financial planning.
Myth: Once you enter a nursing home, you will stay there for good.
Truth: Older adults take longer to recover from illness and injuries than younger people. Therefore some may not be well enough to be at home following surgery or conditions such as heart attacks and strokes, even though they may be well enough to leave the hospital. For these people the convalescence provided by nursing homes is a temporary option for a few weeks or months. They will in most cases be able to return to independent living or to living with their family.
Myth: There is nothing to do when you are in a nursing home
Truth: A good care home will provide a lively social environment with plenty of activities, including trips for those who are able. Care homes will also actively encourage you to spend time with friends and family. Depending upon your medical condition, overnight and weekend visits may be arranged.
Myth: Most older adults will live for many years in a nursing home and eventually die there.
Truth: The truth is that at this time, fewer than ten percent of older adults need nursing home care.
Here is some general advice on factors to consider when choosing a Care Home. There are two types of home:
Residential Homes provide assistance with personal care such as dressing and washing if required, staff can care for residents during short periods of illness.
Nursing Homes are better suited where more constant medical attention is needed.
What to expect
Good care homes should provide care and security within a comfortable setting. Residents are usually reasonably mobile and can manage most things for themselves. Assistance with personal care is provided. Limited nursing care, if needed, is provided by the District Nurse. Care and community spirit within a care home may vary. In some homes, residents are encouraged to have an active role within the home, to some extent it depends on the type of residents at the home and the attitude of the Matron and her staff.
Each person has their own room, sometimes furnished as they wish, often with their own bathroom. Public rooms provide hotel like facilities.
Advantages
- 24 hour assistance available
- Help with personal care if needed
- Activities/outings organised
- Company and companionship
- Safe Environment
- Meals provided
- No worries about maintaining house/garden and paying household bills
Disadvantages
- Some loss of independence
- Rooms sometimes small therefore not able to take many personal belongings / items of furniture
- The home ownership may change or the home may close
- Other residents may not be congenial
Financial issues
Legislation under section 47 of the Community Care Act states that anyone requiring care will be assessed by their local social services and if that assessment confirms care is required a means test will be carried out, during which you must disclose full details of your assets. These will include property currently or previously owned, whether jointly, or as tenants in common to determine if you or Social Services should pay for care and nursing home fees.
Local government broadly speaking pays your nursing home fees if you have assets of less than £21,000 in England and Northern Ireland (£21,500 in Wales and £20,000 in Scotland). However if you have been prudent and managed to save for your later years, own your home or have savings it is likely that you will be liable for the majority of your Long Term Care costs.
A Local Authority may exercise its right of investigation to confirm that your home or assets have not been gifted in an attempt at avoiding Nursing Home Fees (known as Deprivation of Assets). They have far reaching powers to recover any assets disposed of in this way including the right to demand the return of those assets.
There general solution to this complex problem is a combination of Legal and Financial planning.
Unpaid carer numbers rising
Millions more people will be forced to care for elderly and disabled relatives because of a lack of investment, disability campaigners have said.
The Disability Rights Commission (DRC) estimates that the number of unpaid carers will increase from six million to nine million over the next 25 years.
Commission Chairman Sir Bert Massie blamed the government’s failure to invest in public services and the Commission has launched a Disability Agenda, calling for change.
Social care
Sir Bert made his comments as the commission launched its Disability Agenda, which aims to achieve “reform, investment and culture change” in public services.
The agenda focuses on 10 areas including equal rights, child poverty, education, employment, health and housing. It calls for reform of anti-discrimination law to make it clearer and fairer, and a new law on social rights such as independent living. The DRC believes there is a link between disability and child poverty, and that child poverty can be eradicated by 2020.
The commission also wants action taken to give disabled people of all ages the skills needed for participation in society, independence and employment. It targets an employment rate for disabled people of 60% by 2014.
Unrecognised work
Imelda Redmond, chief executive of Carers UK, said providing care to family and friends often went unrecognised. “We need to reverse the trend of poor investment in social care and the very low levels of state benefits available to carers,” she said.
The Local Government Association has already warned that care would have to be withdrawn from 400,000 people unless funding was increased.
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