Care homes seem to be dreaded currently, but they should not be
A good care home is a reward for a life well lived
Care homes help combat loneliness in older people
One alternative to care homes is multigenerational living spaces
In the heat of the Covid-19 crisis in care of older people, more of us are starting to have hard conversations with our children, a lawyer, a friend or adviser about how we want to live out the later years of our lives.
Avoidance of talking about care
So many people joke with their family, “If I get dementia, just shoot me.” That’s just avoidance of the issue. It isn’t funny to trivialise the dilemma of the people who may have to make decisions about you and give them no sensible clue as to what they can practically do, or what you want. Shooting, quite rightly, is not an option. They are as likely to joke back, “Dad, if that was an option, we’d have done it already.”
Social dread of care homes
The social dread of care homes that seems to have increased during lockdown is something that I don’t share, though I understand why it exists. A good care home is a reward for a life well spent. It is a preferable alternative to being on your own at home for most of the day, with sporadic visits from low paid home care workers who are under pressure to get you fed and off to bed before rushing on to their next lonely client. It can offer the privacy of an ensuite room, warmth and good food. Watchful care workers will be sure that you’ll get a doctor or dentist if you need one, and a hairdresser or barber. The optician will come to your door to test your eyes, so you can read or watch TV. It is more affordable than having live-in carers for 24-hour care. It is even paid for by the state if you’ve got no resources.
A good care home
A good care home is preferable to your family having fifteen phone calls every night, as you wonder what time it is and where they are. You know you don’t want your daughter scouring the countryside or city when you get lost. If there is personal care that is needed, you’d be glad for someone trained to do this with dignity and skill rather than your son. You know in advance you don’t want to put your friends and family through it, and you should not plan this sort of suffering for yourself. In the last years of life, it is better if the interaction you have with those you care about is positive, and something they’d like to remember. You might not need care… most of us won’t. But it is always worth talking about it in case. At the time care is needed it is a bit late for making arrangements.
Living longer means more likelihood of dementia
From time-to-time people hark back to days when families “cared for their own”. Actually, most of the care we have to give now is for people who have dementia, and, in the past, there were not so many people who were affected by dementia. For one thing, few of us lived long enough. For another, the way we handled dementia in the past meant that people did not survive with it as long as they do now. They rapidly wasted away and died. You might be astonished to think that we have nearly half a million people in care homes in the UK right now and the largest number of them have dementia, and live there, happy and contented, for years. The publicity about unhappy incidents is accurate but represents a minority. And when people talk about cultures that “care for their own” they are usually referring to cultures where women do not go out to work to earn money but are at home with entirely home making responsibilities. As any culture develops and the roles and ambitions of women change, the need for formal elder care increases.
Multigenerational living adaptable for older people
For those who have the resources, home builders are selling more houses designed for multigenerational living. The extra spaces are often called ADU’s or ‘accessory dwelling units’. If you have already made separate accommodation for an Airbnb type of income stream, that space is there for a day when another member of the family needs to live nearby. New houses have floor plans that incorporate space on the ground floor to accommodate a home-office or home-schooling space, and that can make a space that is adaptable for an older person. There are companies that will install an ADU in the grounds of your house if you have space, and there are even companies that will place the “cottage” and remove it when you no longer need it. People are comparing the cost of this with the cost of care home care or in-home care. If you choose a design with wider doors, a wet room, non-step thresholds, and lots of daylight and interior no-glare lighting, a perfect environment can be created allowing some independence for the person who lives there, but with the closeness that gives reassurance.
Care Homes: When, Why and How to Choose a Care Home
My book Care Homes is not just about how to pick a care home, but also about how to avoid it, and an ADU might provide the sort of compromise that you need. There is more about it in the link to my book page above or below and if you would like more information about dementia, the link for specific dementia advice is below.
If you would like more information, you can buy my book Dementia, the One Stop Guide or Care Homes: When, Why and How to Choose a Care Home. I am available for consultancy for families or organisations. And if you have any further queries or questions, or suggestions for something you’d like to see me write on, please contact me via the Contact Page
See my new course on Dementia the One Stop Guide on Policy Hub here
