Guide To Live In Dementia Care
If you care for someone with dementia, you know how hard it can be. As their condition progresses, you may need more support. If they need extensive care and want to stay at home, live in dementia care may be the solution.
In this guide, we’ll take a look at what live in dementia care is, what your responsibilities would be, and how you can find support for your loved one.
For more dementia carer resources, have a look at our Dementia Carer Resource Hub.
Contents
- What is live in dementia care?
- The benefits of live in dementia care
- How do I find a live in carer?
- What are my responsibilities for live in dementia care?
- Paying for live in dementia care
- Alternatives to live in dementia care
What is live in dementia care?
Live in dementia care is where a carer stays with your loved one and looks after them in their own home.
It’s a great option for lots of people with dementia, because it avoids the need to move out of a familiar environment, whilst also ensuring that they get consistent care and companionship.
The person with dementia may need live in care for a short while, while their usual carer takes a break, or as a long-term arrangement.
How can a live in carer support someone with dementia?
A live in dementia carer can provide emotional and practical support for someone with dementia.
Your loved one may need personal care, including:
- Help with washing, including bathing, showering, cleaning teeth or washing hair
- Dental care, such as cleaning teeth or looking after dentures
- Support getting dressed
- Help with going to the toilet, or continence care
- Medication support, including reminders or medication administration
- Catheter or stoma care
Their personal care needs will depend on their overall health and mobility.
They may also need domestic support, such as grocery shopping, housework and meal preparation. These tasks may become difficult for someone with dementia, especially as their condition progresses. This will often fall under the category of domiciliary care.
A major benefit of live in care is companionship care. Whether your loved one wants someone they can share meals with, go out for walks, or just spend time together, companionship care may be helpful.
The support provided by a live in dementia carer will be flexible and tailored to the individual’s needs. Shortly after diagnosis, they may need more companionship care, but as their condition progresses, they may need more support.
The benefits of live in dementia care
Live in care can improve life for everyone concerned—the person with dementia and the family carer can both benefit.
Staying in their own home
For someone who needs a lot of support, live in care is a great alternative to a care home. Moving to residential care can be stressful, especially for someone with dementia. Being able to stay in their own home means that they can avoid that trauma and remain in a familiar environment. This might be especially important if your loved one lives with a partner or family member, or has pets.
Someone on call
Lots of people with dementia struggle with anxiety, and having someone around can help. Even if they don’t need care throughout the day and night, knowing that someone is there to help them can be invaluable.
It can provide immense peace of mind, both for the person with dementia and for you as a family carer. If you currently have to field a lot of middle-of-the-night phone calls or know that your relative is anxious when you’re away, this could be a real help.
Companionship
As people age, and especially if they have dementia or mobility issues, they are at increasing risk of loneliness. It can be harder to safely leave the house alone, meaning that they miss out on community activities, meeting up with friends, and even day-to-day interactions in shops, cafes and public transport. If the person with dementia lives alone, they may feel especially isolated. Having a live in dementia carer can reduce this isolation.
Consistency
Unlike drop in care, where your loved one may see different carers at each visit, a live in carer provides consistency—the same person will care for them each day. If the person you support is anxious around new people, this is a huge benefit.
Professional care
While many people feel that no one can care for family members like they do, most professional carers are excellent at their jobs. Lots of carers have many years of experience, and have training in supporting people with dementia and other complex health conditions. They’ll know what to expect as dementia progresses, and can support the whole family through this journey. They will also have done training in moving and handling, so they’re less likely to injure themselves while supporting your loved one.
Support for family carers
Caring for a family member with dementia can be stressful and time-consuming. You may feel as though you’ve put your life on hold to look after them, and this might mean that you’ve neglected other areas of your life.
A live in dementia carer for your loved one can give you a much needed break.
How do I find a live in carer?
There are two main ways to arrange care. You can either use a care agency or hire a personal assistant directly.
When you are arranging care for your loved one, remember to mention any particular needs that they have—for example, if English isn’t their first language, would they prefer a carer who speaks their native language?
Care agencies
A care agency will provide a live-in carer for your loved one. If the carer is unable to work or is on annual leave, the agency will arrange cover.
You’ll usually receive a visit from a care manager or supervisor, who will assess the person with dementia. They’ll ask about their needs and how you currently help them. Along with your loved one and the care agency, you’ll work together to produce a personalised care plan.
Your loved one should meet their carer (and any regular relief carers) before they start providing care.
Even if the carer only supports one person, the agency is their employer. This means they’re responsible for recruitment, background checks, payroll, taxes, and so on.
Personal assistants
A personal assistant (PA) is similar to a carer, but they only work for one person. Your loved one (or their appointed guardian/person with power-of-attorney) will be their employer.
There are a number of advantages to employing a personal assistant. Your loved one can choose the person who is the best fit for them, and has more control over their responsibilities. However, in turn, your loved one (or you, if they don’t have mental capacity or struggle to understand) will have more responsibilities.
Not only will your loved one be in charge of recruitment (including job descriptions, interviewing, and background checks), but they will have the responsibilities of an employer once the PA is hired. They must arrange payroll and taxes, employer’s liability insurance, and cover in the event of the PA being unable to work.
What are my responsibilities for live in dementia care?
Whether you choose to use a care agency or a PA, there are some responsibilities that you’ll always have towards a live in dementia carer.
Insurance
Your loved one’s home will be your carer’s workplace, so it’s important to have the appropriate insurance in place in case of accidents or injuries. If you use a care agency, they will be able to advise on this, but if you hire a PA, you should start with employer’s liability insurance.
A safe and comfortable working environment
A carer deserves to feel safe at work. It’s important to ensure that the home has working smoke alarms, carbon monoxide detectors, and burglar alarms, for example. There should be a working phone line, and appliances should be in good working order.
If you use a care agency, they may want to inspect the home before the live in carer begins work.
Facilities
The carer needs a bedroom where they can sleep and have some time alone. At minimum, this should be clean, and contain a bed, adequate lighting, and some storage space. If you don’t have a spare bedroom, you may need to look at alternatives to live in care.
A live in carer doesn’t need a private bathroom, but they need access to a bathroom with toilet and working bath or shower.
They will also need access to cooking facilities. A live in carer may prepare meals for your loved one, but they may have their own dietary requirements or preferences and need separate space to store food—for example, if they have food allergies, keep kosher, or are vegan.
Breaks and leave
Live in carers are entitled to regular breaks. If your loved one needs 24-hour care, or care very regularly throughout the day and night, you may need a second carer to ensure that the live in carer gets to take a break. Alternatively, you or another family member may be able to cover this time.
Carers also have annual leave requirements, as well as sick leave and maternity or parental leave.
If you’ve hired a carer through an agency, they will be able to arrange cover. If you and your loved one hire a carer or personal assistant directly, you need to be prepared for what you will do if the carer is not able to work.
Paying for live in dementia care
Live in dementia care can be expensive.
Some people may be able to pay out of their savings or income. However, many people are entitled to financial support for social care from their local authority.
You can apply for a needs assessment for the person with dementia. This is a free assessment that looks at how much help your loved one needs. Someone from your local authority will talk to you and your loved one about their needs and how they manage on a day-to-day basis.
If they decide that the person needs care, the next step is a financial assessment to see if the council will pay towards the cost, and how much. If your loved one stays in their own home, any means testing does not take the value of their house into account—only their income and savings.
Many people who receive funding will be given a personal budget. This means that they can use their direct payments to arrange the care they want, and top up with their own money if necessary.
Depending on the person’s needs, the local authority may determine that they do not need care at this stage. If this is the case, they will not provide any funding. However, you and your loved one can still choose to pay for care yourselves.
Alternatives to live in dementia care
If your loved one would prefer to avoid live in care, there are other options.
If the person with dementia needs regular care throughout the day and night, they may need to move to a care home that caters for dementia. Many care homes specialise in supporting people with dementia or other complex health needs.
For people who don’t need as much care, home care could be a good choice. Carers or a personal assistant visit people with dementia to provide support for a short while. Home care for people with dementia might involve a pop-in visit a few times a week, or regular daily care.
If you usually support your loved one but need a break, respite care is an option. This may involve brief stays in care homes, visits to day centres, or funded support from home carers.
Live in care for people with dementia
As a family carer, you work hard taking care of your loved one. However, the time may come when it’s better for all concerned to bring in a professional carer.
If your loved one needs a lot of care but doesn’t want to move to residential care, a live in dementia carer can be a great choice.
