Post No8……The 3 types of dementia care available in care homes, and how they differ.

Introduction

When families are looking for dementia care, there is often an overarching concern about whether the care home will be able to manage the changing care needs that are linked to the persons dementia.

This a fair concern because not all care homes will be set up to manage certain care needs and behaviours, and as a result may serve notice to the resident. Hopefully, this post gives families some understanding about the broad way care homes categorise dementia care, which will help when re-searching.

Residential Dementia Care

This care type is probably the most common of the three, and is also the one most people refer to when enquiring about dementia care. Residents in this setting will have some or all of the following behaviours:

· Short term memory loss

· Confusion in time and place

· Difficulties reading, speaking and processing language

· Difficulties with decision making

· May ask repetitive questions in a short amount of time.

· May express behaviours of concern, but they can be managed safely by the team.

The good news is that the vast majority of care homes who are advertising they offer dementia care are offering care of this nature, making supply quite plentiful. A resident in this environment will often need prompting to eat and drink, and with personal care. They may also be quite mobile and walk with purpose, sometimes into other bedrooms.

The important thing to note here is that the setting is residential, which means there is no nurse on the floor. Because of this, there is a possibility the care home may have to give notice if the person needs nursing care, or move them into the nursing setting within the home.

Nursing Dementia Care

In a residential dementia setting the primary care need of the residents is their dementia. However, in a nursing dementia setting, the care needs will be more complex. In addition to the above behaviours, residents in this care type will also have some or all of the below care needs:

· Have limited or no mobility

· Require full assistance with personal care and oral health

· Require hoisting

· Be at risk of pressure damage

· Risk of choke

· Risk of falls

· Other medical conditions or complex medications

In a dementia nursing setting, the primary needs of the person are therefore both their dementia and their physical nursing needs. A care home may manage this in a specific dementia nursing setting, or within a normal nursing setting where some residents do not have dementia.

Specialist Dementia Care / Challenging Behaviour

If a person is assessed as requiring specialist dementia care it can make things quite complex for the family, mainly because supply of such homes is quite limited. Of the three care types listed, this one is the hardest to find and normally involves are more specialist home, with different staff ratios and more enhanced staff training.

Specialist dementia care / challenging behaviour is subjective, meaning one nursing home may view the care as challenging and one may not. However, most ‘normal’ nursing homes will consider some or all of the below challenging:

· Aggressive behaviour to staff or residents

· High risk of self-harm

· Risk of structural damage to the home

· Intense verbal aggression towards staff or residents

· Sexually inappropriate behaviour

· Requires restraint

If a ‘normal’ care home serves notice for some of the behaviours listed above, the family will often find it hard to place the person in another home offering similar types of care. Simply put, the person probably won’t pass through the homes assessment, and may require a more specialist setting who solely manage these behaviours.

As supply is limited, I thought I’d add some of the more specialist homes around the Southampton area, including Kitknocks Nursing Home, and around Portsmouth way there is also South Africa Lodge.

Conclusion

If you are seeking dementia care for a loved one it is always worth enquiring with care homes about the type of dementia care they offer and what behaviours they cannot manage. It is also advisable to seek a diagnosis of the type of dementia a person has, as this will be helpful information both to you, and to the care home.

Thank you for taking the time to read my blog, The Care Whisperer, talking about care in a way that no one else is. If you would like to be made aware of future content, please hit the subscribe button and I’ll look forward to seeing you next time.