Home Care For People With Dementia

What is dementia home care?

Home care is also sometimes known as domiciliary care or care at home. A care worker or personal assistant will come to your loved one’s home and support them. This can give you the chance to take a break from your caring responsibilities for a while. 

Around two-thirds of people with dementia live at home, rather than in a residential facility. Many of these people receive home care to help them and their families cope. 

There are lots of options for dementia home care. Whatever you and your loved one need, care services can support you. 

Personal care

Lots of people with dementia need support with personal care tasks, especially as their condition progresses. They may struggle to remember what they need to do, or they may have additional health issues that make it harder to care for themselves.

Personal care for someone with dementia may include:

• Help with washing, bathing or showering
• Help with going to the toilet or continence care
• Help with getting dressed
• Help with hair care, shaving or makeup
• Dental care
• Foot care
• Reminders to take medication, or help administering it
• Meal preparation and feeding support

For some people, personal care may also include some nursing tasks, such as changing a stoma bag. 

Personal care is tailored to an individual’s needs. As their needs change, it can grow as needed. The person you care for might just need someone to pop in every few days, or they may need care throughout the day and night. 

Domestic support

Your loved one may struggle to keep up with everything that needs doing when living independently. For example, they may find it hard to go shopping, do their own laundry, or keep the house clean. These might be tasks that you regularly do for them, which can be time-consuming. 

A home carer can support them with these domestic tasks, either as part of a service including personal care, or simply as a service on its own. This often falls under the label of domiciliary care.

Companionship care

Even if your loved one doesn’t need practical support, lots of people with dementia may not want to be left alone. They may be unable to go to appointments alone, or want some support attending events such as church services or community meetings.

A companionship carer can visit the person with dementia and spend time with them. This might involve having a cup of tea and watching TV or chatting together, or going out with them. 

Live-in care

If you need more extensive support with your loved one’s care, live-in care could be a good choice. A live-in carer stays in the home and can provide both companionship and personal care.

Night care

If your loved one wakes regularly and needs a lot of support during the night, it can be hard to get a good night’s sleep – which, in turn, makes it hard for you to have enough energy during the day. 

Even if you want to continue caring for someone with dementia, employing someone to provide night care may make you a better carer during the day. 

Short-term care

Dementia home care can often be arranged on a short-term basis. 

If you’re the main carer for someone with dementia but need a break, you could arrange for a care worker to visit your loved one for a short period of time. This is known as respite care.

Alternatively, you may need extra support in caring for your loved one if they have just been discharged from hospital, or have another short-term need. 

For some people, short-term care is a good stepping stone to a longer-term arrangement. It may help family members, or even the person with dementia, decide that home care is a good idea. For others, it’s useful for a short time until a crisis or period of ill-health has passed.

Benefits of dementia home care

Looking after someone with dementia is hard, there’s no question about it. If they’re a family member, partner, or friend, you may feel like you’ve lost your previous relationship – everything is now seen through the lens of being a carer. 

This is often difficult for you and the person you support. Dementia home care can help you both. 

Home care avoids the need to move into a care facility, which can be traumatic for people with dementia. Instead, they can stay in their own familiar home, keep to their usual routine, continue to live with family (including pets), and keep their own possessions around them. 

How home care can help your loved one

Your loved one may feel more comfortable receiving personal care from a professional. Lots of people with care needs say that this helps them maintain their dignity. Plus, numerous studies have found that the toll of dementia care has a far heavier impact on family caregivers versus professional carers, so it may be best for your mental health, too.

If you work during the day, or don’t live with the person you support, having a carer visit or stay in the home can give your loved one extra peace of mind. Especially if they have mobility issues, it’s reassuring to know exactly when someone will be coming to help them.

Many people with dementia are at risk of loneliness or isolation. Seeing carers regularly can reduce this. Additionally, if your loved one wants to attend events when you’re not available, a home carer can help. 

How home care can help you

Arranging dementia home care for a loved one can mean that you get a much-needed break. Whether you use this time to rest, work, or look after other family members, it’s important.

If the person with dementia needs regular personal care, this can be very physically taxing. If you need to lift them or help them move, you’re at risk of injuring yourself. Professional care workers have regular moving and handling training, to reduce their risk of injury.  

As a family carer, home care can give you invaluable peace of mind. Knowing that a professional is seeing your loved one regularly means that some of your worries can be put to rest. You can spend time with your loved one without always thinking about providing care. Although their diagnosis is still life-changing, your relationship can return to being a family relationship, rather than constantly being their carer.

Paying for dementia home care

We know that families often wonder: do dementia sufferers have to pay care home fees or home care costs? Unfortunately, there is usually a cost for these services. Not everyone will pay the full amount, but many people do end up paying towards care – especially if they have savings and an income. 

Arranging home care can often work out cheaper than a specialised dementia care home, especially if the person you look after doesn’t need 24-hour care. 

There are several ways to pay for dementia home care. 

Local authority funding for dementia home care

Your loved one may be entitled to funding from their local authority. This may cover all or part of their home care. If the person you care for needs or wants more support, they can usually pay for this themselves.

Most people start their search for dementia home care by arranging a care needs assessment through their local authority. You can apply for a needs assessment online (in England and Wales).

Needs assessments are free, and even if your loved one isn’t entitled to funding support, they will still be given information on what services may help them.

If the person you look after only needs light support with domestic tasks, this may not be covered by the local authority. However, some tasks such as companionship care could be funded as respite care if you have a carer’s assessment. 

If you or the person you support are entitled to funding, you will probably be able to arrange their care and pay for it through direct payments. Read more about direct payments arranged care and what you need to know about this process.

NHS continuing healthcare

Some people may be eligible for NHS continuing healthcare (CHC), a completely-funded service. This is available for some people with a primary health need.

This is not given based on a diagnosis, but an assessment of the person’s needs. If you think that the person you support may be eligible, speak to their GP, social worker, or another professional involved in their medical care for more information.

Self-funding dementia home care

You or your loved one can self-fund their home care. This means that you or your loved one would pay a care agency or personal assistant directly. 

Even if your loved one is eligible for some funding from their local authority, you may choose to self-fund additional hours or services. 

Finding dementia home care

Once you and your loved one have decided that domiciliary care is the best choice, you need to decide who should deliver that care.

There are two main options:

• Care agencies, who will be responsible for employing carers, arranging and delivering care 
• Personal assistants (PAs), where you or the person you support will directly employ the person who provides care

Whichever option you and your loved one choose, there are some things to consider when contacting care agencies or talking to prospective PAs. 

• Does the person with dementia have any additional requirements? For example, if English is not their first language, would they prefer someone who speaks their native language? 
• Are there any additional areas where the person needs support? They may primarily need personal care, but also occasional transport to appointments, for example.
• Does the person with dementia have any additional medical conditions that should be discussed? Will a carer or PA need to liaise with other healthcare professionals as part of their care?

Care agencies

You can contact care agencies directly to arrange dementia home care. 

If you use a care agency, a lot of the difficult admin is taken out of your hands. You just need to choose the agency and communicate your loved one’s needs to them.

When looking for a care agency, make sure that you look at CQC ratings and local reviews. 

There are many advantages to using a care agency:

• Care workers are employed by the agency, and you don’t need to worry about background checks, salary, or payroll.
• The agency will be responsible for recruitment and training.
• The agency will provide cover in the event of holiday or sick leave.

However, agencies may send different carers at times. Having unexpected people in the home can be distressing for people with dementia. 

Personal assistants

You will need to recruit a personal assistant directly.

There are lots of advantages to using a personal assistant. You and your loved one can choose exactly who will support them and how, and you can guarantee that they’ll see the same person each time. It may also cost less than using an agency, depending on the amount of support needed.

However, if the person you support uses a PA, they will be the PA’s employer. This means that they (or you, if the person with dementia is not able to do so) will be responsible for recruiting, background checks, training, payroll, arranging holiday or sickness cover, and taxes. 

Your loved one will also need to have employer’s liability insurance if they’re the PA’s employer. This will cover them against claims if their PA gets injured while supporting them. 

This may be an additional hassle, when dementia home care is meant to make everyone’s life easier. 

Dementia home care

Many people living with dementia are supported by family or friends. However, this can be very stressful – being an unpaid carer is a difficult job, especially if you also have other family or work obligations. 

You can make life easier both for you and the person you support by accessing dementia home care.