Care Home or Care at Home?

It's a massive decision that needs HUGE amount of thought and consideration from many viewpoints.

Growing old presents its unique set of challenges, not least how to maintain independence whilst body and mind have other and sometimes opposing ideas!

For those living alone, care and support may be provided in a number of ways:

1. Support from family and friends.
2. Carers visiting you in your home via the Local Authority or privately.
3. A complete care solution in a Residential Care Home.

There are of course pros and cons of each, so we thought it would be useful to share our latest experience to help you decide which might be right for you or a loved one...

Care at home (known as Domiciliary Care)

The biggest driver for many people when seeking care at home is that they want to stay in their own home, but this does come with many risks!

Pros

• You stay in your home.
• Cost effective for the Council to fund (compared to residential care) as you cover the costs of keeping your home (accommodation, food, heating, lighting, etc).
• Private domiciliary care providers do exist.
• Systems are available to alert for assistance in the case of emergencies (as long as they are kept in working order and are easily in reach).

Cons

• Costs around £15 per hour and the number of hours required is likely to increase as care needs grow. Care at night, on weekends and during holiday periods will increase costs substantially.
• You have to pay for all bills; heat, light, food, etc and maintenance to keep up your home.
• Daily chores from cooking to changing a light bulb become more challenging.
• You may have security worries about living alone.
• Time allocated for a care visit can be from just 15 minutes, which does not leave much time for quality care and if any additional assistance is needed, the carer is put under additional strain as they are only allocated a fixed amount of time.
• You should be assessed on a regular basis so any changing care requirements can be met. These assessments are often delayed, meaning things may deteriorate but care needs are not adjusted to match.
• Carers have to travel between jobs so any traffic delays will have a knock on effect, with visits being shortened or sometimes missed altogether
• Staff numbers and quality can sometimes be compromised as providers strive to keep up with demand. Carers who are not familiar with the care needs of an individual will need to spend time to establish the care that is required and this will erode care time.
• You may not have time to establish a rapport with an ever changing group of carers and the provision of personal and sometimes intimate care by a stranger is never welcome.
• Carers may not recognise important changes in someone, because of the lack of continuity in care.
• Medication may sometimes be delegated to visiting carers to administer and given that many will be in a rush the possibility of medication errors increases.
• Friends and family are faced with an increasing level of worry and sense of guilt.
• Overall lack of time and flexibility to provide high quality care.

The Care Home option

The benefits of residential care overcome many of the issues associated with care in the home. People often worry they will have to sell their property to pay for residential care, but the lettings market is active and many properties can be let to help generate an income to contribute towards care costs and of course, you won’t have all the bills and food to worry about!

Pros

• A personalised Care Plan, reviewed on a regular basis to reflect the changing care needs of each resident, with their involvement and wishes being considered.
• Costs for private care are around £4.50 per hour.
• All living costs such as food, heat, light etc, are included.
• 24 hour care is provided 7 days a week, 365 days a year. Night staff look in throughout the night.
• Health normally improves as residents are looked after properly and doctors visit whenever needed.
• Staff are well trained and residents get to know them properly.
• Improved quality of life, with entertainment, activities and companionship from staff and other residents as well as regular visits from family and friends.
• A warm and cosy environment (heated rooms with controllable central heating).
• The option to bring your own furniture and belongings to make yourself at home.
• Privacy when wanted but with assistance on hand if needed.
• Alarm call bells in room and on a mobile basis.
• Management of all day to day medication, by trained staff.
• Nutritious meals provided.
• Complete security at all times.
• Peace of mind for friends and family.

Cons

• It can be hard to leave home at first.
• Perception of high overall costs until the true costs of maintaining a house and living costs are compared.

We too often hear the bad news stories about conditions in some care homes but there are wonderful stories too. All care homes are monitored by the Care Quality Commission (CQC) and they publish their findings so you can read the reports and choose a good home. 
See www.cqc.org