Transition into 24-hour Care – The Live-in-Carer Option
Most people believe there is a binary decision when it becomes time to focus on finding care for a loved one; residential care or domiciliary care. My priority is trying to help families understand the many different ways that someone can be supported as they become frail; too often the public thinks you either have to have domiciliary care coming in or send someone into full-time residential care, but there are in fact many options and many gradations of care, including live-in care.
However, I am focusing, in this blog, on Live-In-Care for individuals living with dementia. This is when a professional carer moves into someone’s home to care for them and maintain their safety allowing that individual to remain at home until their final day. Due to the lack of knowledge and the stress people feel when forcing a relative into residential care against their wishes, I often find myself advising families about live-in care as an option when they are looking for 24-hour care.
What is live-in care?
A live-in carer can be a good alternative. Moving towards, what we call, complex care is delicate and there is a right time and a wrong time to think about needing 24-hour help (before that time there are many less intrusive ways to ensure safety and good support).
The financial cost implications between 24-hour live-in care and the alternative of going to live in a high-quality residential care home are similar. Both are expensive but roughly the same price.
To have a live-in carer you do need a spare room and ideally ensuite facilities and you should invest in a bathroom with some moving and handling equipment (i.e. a bath chair to get in and out of the bath). Unlike in a residential care home, the live-in carer is alone and therefore needs the correct lifting equipment available to move someone without placing their own physical health at risk. It, therefore, goes without saying that live-in carers are only possible if the person doesn’t need 2 people to move them.
Ways to find a live-in carer
Although almost all domiciliary care agencies offer live-in care it is best either:
- To look for a company that only offers live-in-carers. There are some national companies that specialise in this and that means their staff are trained to live & work in people’s homes. They are more easily able to quickly find a carer or replace them, and they have huge experience in this more niche area.
- Or alternatively, you can be fortunate and know or find a self-employed carer. There are an increasing number of professional carers who work for themselves, often specialising in live-in care and can build long and trusting relationships with families. The downside is that if they don’t have a friend/colleague who can cover for them. You or your family will need to cover their holiday & rest time. On the plus side, you get to vet them, to know them and if they are good they can be with you for years on and off. I have found this process is often done by referral or a friend of a friend refers someone.
- That said you can approach your local Domiciliary Care Agency, but be mindful this isn’t their specialism so you want to be clear in what you want and quick to pull them up if they aren’t delivering. They’ll also probably recruit for this particular job and so may take time to organise.
Drawbacks to live-in care
There are some negatives to having a live-in carer just as there are negatives to going into a care home. No care solution is perfect and each family has to decide what works best for them. Probably the biggest negative to live-in care is adapting to having someone living in your space the whole time, and if you don’t like them, or there is a character clash then this solution quickly collapses (in care homes there are enough staff for this to not be an issue).
The way around this is to be very clear and honest to both the individual and the company about what works for you. The carer will not know the routines and the norms for that household and will need clear instructions. The very best carers are those that are very aware that this is your space/home, they need to adapt to your routines and ideally be as visible or invisible as suits that person (with a larger house this is easier as you don’t have to share the same rooms). They should offer the individual space but be available when needed. A fine balance that not all carers understand.
Live-in carers normally do a certain number of weeks on and then time off. If they are sole workers that can be negotiated (sometimes 6 weeks on and 2 weeks off), if they work for a care agency, I have heard that is often 2-week stints before a new person rotates in for 2 weeks. Each person and company manage this differently, so this is something to discuss when you are first talking to a company or carer. However, everyone needs time out and also time off each day, so families may have to organise a 2-hour period in the 24-hour day when the carer can do their own thing (again this depends on the individual and family), some come to us to give their live-in carer that respite.
How we can help
At The Ness, we offer a variety of services that might be suitable for your loved one and their carer to use as respite. Whether you are looking for 2 hours each day, or a whole day every week, we can accommodate you.
Learn more about our services, and get a complimentary consultation by getting in touch with our expert team.
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