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20 May 2020

What are the alternatives to a care home?

A large proportion of deaths during the coronavirus pandemic have sadly happened in care homes. While elderly people and those with underlying health conditions are more likely to become seriously ill from coronavirus, there are other reasons the crisis has hit care homes hardest.

Infections such as COVID-19 are able to spread quickly in settings such as care homes because of close contact between residents. And without adequate personal protective equipment (PPE) for carers, the virus can be unintentionally spread.

Most care homes have now introduced rigorous measures to protect residents and the government has issued guidance to reduce the risk of infection in care homes. But many people with older loved ones will be asking whether a care home is the most appropriate place for their relative to be looked after at the moment - and what the alternatives are.

There's no one-size-fits-all solution for adult social care. What's right for one person will depend on lots of different factors, such as age, health, where they live and their financial situation.

Home adaptations and smart tech

If you're starting to think that your loved one could benefit from some day-to-day help, a care home may well not be necessary yet. Most people want to maintain their independence for as long as possible. There are lots of solutions that can extend this window, such as stairlifts, grab rails, personal alarms and other clever gadgets.

While some adaptations can be expensive, they will often work out to be more cost-effective than other options, such as moving house or going into residential care.

Move them into your home

There are all sorts of reasons why your loved one might not find living by themselves as easy as it used to be. Running a household by yourself can be very demanding, it can also be lonely and some worry about having no one around in case of an emergency. Moving an older family member into your home could be a solution to these problems and provide benefits such as more quality time together.

It's a big decision, though (and won't be possible for many people). An arrangement like this will only work if it suits everyone involved.

Home care and live-in care

If your loved one is finding it hard to carry out personal care routines, such as washing and dressing, home care (or domiciliary care) may be worth looking into. If they'd prefer not to move into a care home, and their house is still suitable and safe for them to live in, it could be a good option.

Home care is care provided in your own home either from a home care agency or a private carer. The amount of care and support someone needs will vary. Your loved one might need care for only one hour a week, a couple of hours a day or full time.

Live-in care is a type of home care where the professional carer moves into their client's home to ensure their personal care needs are met. Some carers live in all the time, while others work a rota pattern of, for example, two weeks on, two weeks off.

If you arrange home care through an agency, although the aim is usually to provide consistency of care, sometimes different staff may be used in times when there is a shortage of carers such as holiday or sickness.

Sheltered housing and extra care

Sheltered housing is a type of accommodation specially designed for older people to allow them to live independently. Self-contained flats with communal facilities are typical of sheltered housing. All properties have their own front door, kitchen and bathroom, so residents can continue to live independently. Sheltered housing is usually available to people over the age of 60.

The main advantage of sheltered housing is that residents have help at hand if they need it, such as a warden who arranges maintenance and repairs. Plus, there's a 24-hour emergency alarm system within each property, so that residents can call for help if they need it.

Sheltered housing schemes don't usually offer any medical or nursing care, but there is a form of sheltered housing called 'extra care' that gives older people a higher level of support. Here, residents also live in self-contained homes, but care staff are available to help with activities such as washing, dressing, preparing meals and cleaning where needed.

Get a needs assessment first

If you think your loved one needs help to remain living independently or may benefit from support accommodation, the first step you should take is to help them arrange a needs assessment.

You can get this from the social care services department of your local authority. You have a right to this assessment and it's free of charge. However, during the coronavirus pandemic, there may a temporary delay in receiving one.

Unlike health care provided by the NHS, social care is rarely free. After a needs assessment, you'll have a financial means test, which will look at your relative's income, savings and assets to work out how much they will contribute to the cost of their care.

The Which? cost of care and eligibility calculator can help you cut through the complexity around how much care really costs and advise whether you might be eligible for local authority support, if you live in England.