Long term careLong term care options

There are several long term care options available if you want to stay at home

According to our long term care survey, 88% of you want to stay at home as you get older, even if your needs change. But changing health needs could make daily life more challenging, from changing a light bulb to managing stairs.

It’s then that you, or someone you support, might consider what compromises you’re prepared to make to stay independent – such as adapting your home or accepting support workers.

Long term care at home

Assistive technology

Governments across the UK have put money into providing people with ‘assistive technology’ to help keep them safe and independent.

Emergency or ‘community’ alarm systems are provided by councils (or health and social care trusts in Northern Ireland), charities and commercial organisations. These systems alert a monitoring centre when a person pulls a cord in their home or presses a button on a pendant or wristband.

The monitoring centre knows their address, may hold a set of keys and organises help by calling a relative or the emergency services. In our survey, the public thought these would make the biggest difference to helping them stay at home.

More sophisticated systems use sensors placed around the home, or on the person, to identify and summon help in circumstances such as fire, falls or floods – even the bath overflowing. See our Assistive technology section for more information about some of the gadgets available.

Support and information

Most people get their support from family or friends, but many carers experience difficulties as a result – such as poor health, a lower income or problems holding down a job. See Support for carers for information about the financial and practical help available.

43% of people who had been involved in another person’s care told us they had problems getting information to make care decisions, finding friends, relatives and charities the greatest help. Fewer than one in four rated local authorities as very useful, and 86% thought the Carer's Allowance was too low.

Margaret Wallace, author of Which? essential guide Care Options in Retirement , says: ‘Make sure you get as much independent information about your options as possible, so that you can evaluate them realistically. The person who needs the care should have the maximum input, even if decisions are made in a crisis.’

Long term care: Which? says

Social care – and how it’s financed – is the subject of change in England, Wales and Northern Ireland, with Scotland already providing free personal care.

We want to see care systems providing what people tell us they want to remain living independently in their homes, such as more financial and practical support for carers and help with day-to-day jobs. But there is an urgent need for clearer information about care services and options, at national and local level, so that people can navigate the system easily.

Long term care options at a glance

These are the types of long term care that might be available to you, from getting support in your own home to retirement housing or care homes.

Support services at home

If you want to stay at home, there’s a variety of support services available. These could include paid home carers, assistive technology equipment, home adaptation grants, meals delivered to the home, day centres, and services to meet health needs such as incontinence. And don’t forget local support such as family, friends, neighbours, clubs and faith organisations.

Respite care

A short period of care, in a care home or at home with paid carers. It can give a carer a break, or be an opportunity to try a care home.

Retirement housing

Paid home carers can help you to stay independent at home

Sometimes called ‘sheltered housing’ or ‘assisted living’. You have your own front door, communal facilities and support available – such as a warden, alarm system or even an on-site care home. It may be rented or bought, and could be part of a ‘retirement village’.

Extra care or ‘very sheltered’ housing

An increasingly popular type of retirement housing for people who are becoming more frail, with facilities such as a scheme manager or warden, personal care, meals and 24-hour support when needed.

Care homes

There are two types of care home: those providing personal care, sometimes called residential or retirement homes, and those providing nursing care, though some homes include both.

Homes may have specialist provision for people with mental health problems and/or dementia. All have to be registered and inspected by the National Independent Social Registration Authority, with inspection reports publicly available. See the Which? guide to choosing a care home for more information.

NHS continuing healthcare

The NHS in England pays the full cost of care – wherever it is provided – for people with complex healthcare needs. Similar systems operate in Wales, Scotland and Northern Ireland, with differing assessment tools and guidance.

Which? long term care survey

We interviewed 2,639 Which? members online between August and September 2008, and 1,007 members of the general public aged 45+ in October 2008.

For more guidance on the care options available in retirement, including how to arrange funding, housing and care services, buy Care Options in Retirement by Margaret Wallace and Phillip Spiers.