Guide to eldercareoptions in the UK

Guide to eldercare in the UK

Thanks to a more vibrant and active lifestyle, people are living longer and healthier lives. However, there may come a time when you begin to worry about your elderly relatives and their ability to remain independent. Whether this is as a result of a short-term illness or long-term medical condition, the options can be confusing and complicated. Understanding what is available for affordable in-home, residential or respite care is incredibly helpful. This Parental Choice guide to eldercare gives you an overview of the choices.

IntroductionWhether your elderly relative has been hospitalised and needs care quickly, or they are experiencing a slower decline in mental and physical ability, recognising that they need professional care can be overwhelming. There are a vast number of considerations to take on board, including the nature of their condition, their care options, helping your loved one maintain their independence, and working out how to pay for the care. You need to look after yourself during this time, too.

Receiving care can be a scary, dramatic lifestyle change. It can take some mental adjustment, both for them and for you. To keep the process positive, try to ensure that your parent or loved one feels consulted as much as possible.

In this guide, we look at the principal care options and the pros and cons of each, helping you work out which is the most appropriate. We offer advice on having the ‘care conversation’ with your parents in the most positive way. Finally, we help you identify where to go for legal information and discuss financial support for long term care costs.

What to do when you are concerned for an elderly relativeIf you start to notice a decline in the health of an elderly relative then the first thing to do is have them assessed by their local senior social services for a needs assessment.

Everyone is automatically entitled to a Section 47 assessment, no matter their means, income or savings. A care advisor will visit your loved one at home, go through care options with them and draw up a care plan. It’s worth noting that your local council may not always put forward all forms of elderly care; live-in care for example. It’s a good idea to ask them questions about additional options that you’re interested in, at this point.

Attending this meeting provides extra support for your loved one and enables you to get a sense of what each type of care entails, and what the next steps are.

How to discuss care with your loved one

Talking about care with a loved one can be difficult, especially if they are scared and uncertain of what their future may hold. Having to take on the role of carer to a parent or elder figure can bring on a number of mixed emotions that make having meaningful conversations tricky to navigate.

Whether you need to talk about moving, giving up driving, or bringing in live-in care, knowing which words to use, and which to avoid, can improve the chances of moving towards a positive solution. Effective communication is essential, but it’s advisable to first collect information and research possible solutions so you can discuss all the options, including care in your loved one’s own home.

Ultimately, the goal is to solve the problem together through helpful discussions, not to dictate or to persuade too forcefully. What’s more, if you gather solid facts first, you’ll be able to help in a way that’s better informed.Before you jump straight into the discussion, it might be helpful to test the water with your loved one. This should be a nonthreatening conversation without criticism or directly trying to solve the issue. For example, “It must be hard keeping up with cleaning and housework,” or, “How are you finding getting up and down the stairs these days?”

If the conversation is well received, perhaps move on to asking how you can help or suggest discussing it more when you’re next with them. Asking their opinions and feedback on the situation keeps the conversation positive and collaborative.

If the discussion is more resistant, consider bringing in a more authoritative figure like a doctor or family friend, and ask them to lay the groundwork.

When moving to the more serious part of the conversation, the key is to not criticise or dictate a preferred solution. Take time to observe your loved one’s feelings, sit together in person if possible, and discuss the pros and cons of the various options. Try to remain upbeat and supportive, even if you’re frustrated.

Your care optionsWhen an elderly relative becomes unwell it can often be a shock, but being prepared and understanding the options of care available in the United Kingdom can help an individual with making the best choices for their family.

If the illness is minor, and requires simple care, e.g. arranging a schedule of visits from local neighbours and friends, arranging meal deliveries, hospital appointments, then Parental Choice can provide advice on how best to manage these issues from a distance. We can also provide advice on how to have conversations about Power of Attorney and making long term plans on future care. If they require care, be it short term or long term, Parental Choice can provide options for choosing home care or housing care, depending on the family’s circumstance and decision.

For many families with care responsibilities thrown upon them, residential care can seem like the only option available. It’s worth considering all other forms of care, as there are other options that can enable your loved one to remain in the family home they love, whilst still receiving the companionship, care and support they need, at a comparable cost. These include domiciliary (hourly) care and live-in care.

Hourly care

Hourly care, also known as domiciliary care, is care for the elderly in their own home, provided on an hour-by-hour basis. Hourly care is ideal for those who need only a short amount of assistance per day, perhaps with personal care like getting dressed or washing, house work or meal preparation.

Hourly care is a flexible approach to home care and can be booked from 15-minute visits to 24-hour assistance, although this elderly care option is less suited to long term live-in care.

Benefits of hourly care Considerations of hourly care

Your relative can remain in their own home, retain independence and keep any pets they own.

Your relative remains part of their local community and friendship circle.

Peace of mind that your relative receive regular visits and care.

You are in control of organising the care required and therefore able to manage costs effectively.

Care is only provided for the hours arranged and therefore not 24/7.

Staff provided by a care agency may work on rotation and the lack of continuity can be unsettling for an elderly person.

Your options of care are limited by what is available in your local area.

Costs are charged at an hourly rate and therefore the greater requirement of care, the higher the costs incurred.

Live-in care:If your elderly relative needs round-the-clock care, but you’d prefer them to stay in their home surrounded by familiar belongings, live-in care is an excellent option. It helps people live independently at home for longer by providing specialist care in the comfort of their home. It can be arranged quickly at short notice, so live-in care is ideal for those with high priority care needs.

Live-in care agencies enable people to be cared for every minute of the day by a carefully chosen and trained carer, usually matched based on personality, interests and overall needs such as dementia or stroke. Live-in care can often be a more affordable long term care option. It is less suitable, however, to those residing in small properties like one-bedroom apartments.

It is important to ensure that any carers provided have met the standards set by national regulatory bodies and that they are qualified to provide the level of care required by an elderly relative.

If you’re unsure of what level of care your relative, find out the level of care your relative needs then arranging a Section 47 assessment, will help you make the best decision moving forwards.

Benefits of live-in care Considerations of live-in care

Your elderly relative remains in their own home and cared for 24/7 in familiar surroundings and with daily interaction and stimulation.

A live-in carer provides constant companionship and assistance for getting around and undertaking daily activities.

Costs are fixed for round the clock care, with no hidden additional charges.

You need to ensure that there is a spare room available for a carer to reside in with your relative’s home.

The living conditions for a carer need to meet certain standards in order for a carer to move in.

Having a carer live-in full time can take a little while to get used to, particularly if a relative has been living on their own for a long time.

Care is provided by one or two dedicated professionals, providing continuity of care and companionship for your relative.

Elderly couples with differing requirements can be cared for together in their own home.

Your loved one’s home may need to be adapted to make it more comfortable for a carer, which can mean unexpected costs.

Residential care

Residential care is a long-term assisted living option in a residential setting away from their home. It is one of the most commonly known forms of elderly care. Care homes may be privately owned or run by charities or councils. Some will be small, based in domestic dwellings, while others will be large centres.

Most residential care options offer support for basic personal needs like meals, bathing, going to the toilet and taking medication. These facilities are not required to have nurses, certified assistants or doctors on staff. This level of care and supervision is for people who are unable to live by themselves but who do not need 24-hour medical care.

Some care homes are registered to provide nursing care. These are often referred to as nursing homes. For example, a care home might specialise in certain types of disability or conditions such as dementia.

Why is residential care helpful?Residential care can be useful for someone who needs round-the-clock care rather than periodic and has no space for a live-in carer.

If you or your relative are paying the fees you will need to arrange and pay the cost directly. Your local council should provide advice to support you.

Getting help and adviceAlongside all the complications of finding the right type of care for your loved one, being able to pay for elderly care can be challenging. There are various types of funding that can help but understanding the eligibility criteria can be confusing.

If you’re unsure where to look for help with funding your loved one’s elderly care, it’s best to first discuss the options with your local council. If your relative’s needs meet the eligibility criteria and they have a limited ability to pay for the services, your local authority may pay for some or all of their support.

If your relative is assessed as having ‘eligible needs’ that can only be met with professional care, and he or she wishes to apply for financial help, the council will then carry out a financial assessment. Note that in some cases, a local authority can begin providing services before a care needs assessment has been carried out, if they believe you need support urgently.

Financial support maybe available to your loved one, whether they need help to live safely and comfortably in their own home with live-in care or domiciliary care, or if they prefer to move into residential care.

For further information see our factsheet on “Understanding the costs of care”.

Benefits of residential care Considerations of residential care

Staff are on site 24 hours a day, 7 days a week.

Residents tend to have rooms of their own for privacy and independence.

Meals are provided by the facility.

Other residents provide companionship and social activities.

Any support with medication and personal needs can be carried out by support professionals.

All costs are included in the care fee, so no additional concerns about financial admin are required.

Availability for the most popular care homes can be limited due to demand.

New surroundings can be disorientating for the elderly.

Most care homes do not accept pets.

Downsizing to an individual room may result in having to sell beloved possessions and furntiure, which may be upsetting.

A move to a new environment can lead to a loss of independence and social stimulators.

The cost of residential care can be very expensive and worry over paying for care can lead to stress for the family.

Remember to check the care home’s most recent Care Quality Commission inspection report. This will identify any concerning facts on the facilities and staff.

Lasting Power of Attorney is more appropriate for an aging or elderly parent. It can be put in place at any time, as long as the individual is capable of making their own decisions when the document is signed. LPA can be appointed for two types of affairs:

1. Property and finances: for the practical management of finances, debts, benefits and buying or selling property.

2. Health and welfare: for medical treatment, care and housing issues. Your loved one may feel uncomfortable discussing this step, so it can be helpful to frame it as a backup measure rather than a vital step in his or her ongoing care.

It is vital, meanwhile, to plan ahead and act sooner rather than later to prepare LPA; registration can take up to eight weeks. If it is not registered while your loved one has full mental capacity, their affairs pass to the control of the Court of Protection; applications to which are an expensive and time-consuming process.

ConclusionsAs has been shown by this guide, there are several issues to consider when looking into care options for elderly relatives and that care options can vary from small interventions to long-term permanent solutions. What is important to remember throughout the process of finding care for a loved one is to remain supportive and positive about the whole experience.

Recognising that your parent needs professional care can be a difficult process for you and for them. Before you make any care decisions, it’s important that they feel as consulted as possible throughout the process, to minimise the worry that comes with it.

Researching all the possible solutions in advance, so you can discuss all the options together in a positive way is key to a positive dialogue. The goal should be to solve the problem together through helpful discussions.

Ensuring they feel supported and consulted throughout will make it easier to come to a solution together, collaboratively.

It is also important to find the right level of care to support your relative and the best way to do this is by ensuring that they have a needs assessment provided by their local adult social services.

Power of AttorneyPower of Attorney is a legal agreement made to enable you or other close family members to act on behalf of your elderly relative if they develop decision-making impairments.

There are two principal types of Power of Attorney — Ordinary (OPA) and Lasting (LPA). OPA is a short term solution for an individual who is either overseas, have suffered an accident or have a physical illness, preventing them from managing their own financial affairs for a certain period of time. Ordinary Power of Attorney is not used for an individual with impaired decision making, a degenerative illness like dementia, or a reduced mental capacity.

Whatever the ultimate care choice for your parent or loved one, financial support like Attendance Allowance and Personal Independence Payments will often be available. These benefits are not based on income or savings and will help cover the costs of a live-in carer, to receive domiciliary care, or if your loved one prefers to move into residential care.

Your local authority will complete a Section 47 care assessment to establish your relative’s needs, but you can help them claim benefits directly by downloading and posting the relevant forms.

Ultimately the best way to remain positive and calm throughout the process of finding eldercare is to be as informed as possible about the different options available to you and your family. Care does not always mean having to move out of one’s home or be separated from family, and there are numerous charities and social centres that provide support, activities and companionship to people as they get older.

How can Parental Choice help?Parental Choice are experts in supporting families and helping companies to support their working parents through complete childcare and eldercare solutions. We provide a one stop shop to help parents find the right type of care for their family, whatever their needs, relieving the stress and taking the hard work out of the search. Whether it’s a for childcare or eldercare, from nurseries to nursing homes, we can source the right option for individuals. With clear, comprehensive information and advice on all possible family care options, parents can make informed choices that really work for them and their loved ones.

Making a difference for working families

+44 20 8979 6453info@parentalchoice.co.uk

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