Post No43…Dementia care, will I have to move my loved one?

Introduction

When it comes to finding a dementia care placement in a care home, there are often many things that concern families. Of these many things, the main areas of concern often centre around the possibility that their loved one may have to, at some point, move out of the care home.

For the purpose of this post I am looking at just two of them, finance, and changing care needs.

Finance

It’s worth noting that most care homes do not want to move any of the residents who live there, particularly those living with dementia. However, there may come a point where the person depletes their monies to £23,250, triggering a local authority assessment for their ongoing funding.

Dementia is very cruel. Not only by the symptoms that manifest themselves; often memory loss, confusion in time and place, loss of language and potentially all cognitive function, but also in its longevity. The grieving process is therefore extremely drawn out, because family members lose their loved ones over a prolonged period.

The longevity of dementia care can of course cause concerns when it comes to financing it. Usually, people can live well at home with dementia in the early stages, but sadly it does often reach a stage where this is no longer feasible, and families look to a care home placement for their loved one’s safety and wellbeing.

Financing long term care in a care home is often done via a depleting pot of money, hence families are concerned about what happens when this depletes.

It is always worth speaking to the care home about their policy on fund depletion, and also ask them if they know how the relevant local authority views this. The latter is extremely important; all local authorities are different and all have varying pots of money available for care home capital depleters. This means that where one local authority may contribute the required amount, a neighbouring authority may not.

Changing Care Needs

Changing care needs are usually something families fear because they have heard stories about people who have drastically changed and become violent due to dementia. Indeed, when it comes to aggressive behaviour (linked to dementia or otherwise) the choice of care homes shrinks to those providing Specialist Nursing Dementia care, of which there are not that many.

If we put the more specialist dementia care aside for now, then we are left with two other types of dementia care, Residential Dementia care and Nursing Dementia care. The important thing to remember here is that a residential only home cannot provide nursing care, meaning if nursing needs develop (say after a fall, a prolonged hospital stay, or a bad infection) then the residential home may serve notice.

Another scenario where a person may have to move is if they are living in either an assisted living complex or care home that does not cater for dementia care. In most cases the person moves in before they develop dementia, or their dementia is very mild, but as the disease progresses both establishments will be quite quick to serve notice.

If you find a care home that is duel registered as nursing, they may offer a care type called Nursing Dementia care. This means the person has physical nursing needs as well as dementia-based care needs. In homes that offer this type of care, there will be very limited reasons why they cannot manage the changing care needs, although the person may have to move from one floor to another.

Nursing dementia care homes can cater for most if not all of the clinical aspects of dementia care, but they will seldom manage care needs linked to aggressive or psychiatric natured behaviour. If a resident becomes extremely aggressive physically towards staff or other residents, the majority of nursing homes will have to serve notice. Most, however, will try identifying trigger points or reviewing medication before reaching this point, unless the aggression is uncontrollable.

If a resident is given notice by a dementia nursing home due to aggressive behaviour, it becomes very difficult for the family to find a placement in another home offering the same type of care. Upon assessment, it is likely they will refuse to admit because of the recent history of aggression. This is where Specialist Nursing Dementia homes come in, and although sometimes more clinical in aesthetics and feel, they provide a safe environment and can often meet the persons more complex behavioural care needs due to the specialist nature of the home.

Conclusion

Although there are a few reasons why care homes may have to give notice due to changing care needs, the truth is if you ask the right questions during the research stage you can often find the right home for the person for life. These questions should centre around how the home manages changing care needs, and whether the home is a duel registered nursing home that offers Nursing Dementia care.

There are of course many other aspects to choosing a care home, but for dementia care, changing care needs and long-term financing are topics that need to be discussed as soon as possibly with the homes you are viewing.

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