Staying Independent - Care in my Own Home

Many of us want to live independently in our own home for as long as possible, but may be in a position where we need a little help. There are many options available depending on the type of help you need, from assistance with the garden and Meals on Wheels through to a live-in nursing carer.

The first step is to ask your local social services department for a care assessment. As an older person, you are entitled to an assessment which will consider your situation and highlight the type of extra care which is most appropriate. Even if you are not reliant on the social services for funding an extra care, it is worth getting the assessment which can serve to give a better understanding of your own care needs.

I don’t need care, just a bit of company…
There are many day care centres or social clubs and groups who can give your carer a break and give you a chance to socialise. If your care assessment supports your preference for a day centre, your local social services should arrange this for you. Some centres arrange transport and many provide meals, entertainment and professional services such as hairdressing, chiropody or keep fit. Contact your local social services to find out about groups in your area.

I just want a little help with the house and garden…
It is unlikely that all local councils would be able to offer this level of service, but all should be able to refer you to local voluntary organisations who can help. Many volunteering organisations offer a choice of services including visiting at home, shopping services, volunteer drivers and escort schemes and gardening.

WRVS run many schemes to help older people retain their independence, including a Good Neighbour scheme offering friendship along with a little help with errands, Meals on Wheels, a Home Library service and a Home from Hospital scheme for a little more intensive support.

Check your local library for more information about local volunteer services, or visit our useful links page for details of national organisations who could help. Equally, you could choose to hire someone privately to help with the home and garden.

I need help with getting in and out of bed, washing and preparing meals…
If your care assessment suggests that you need help in the home with daily living, you may be eligible to have part or all of the care funded by your local council (your local social services will verify this after a financial assessment). Social services can then help arrange varying levels of support.

Care assistants carry out tasks such as cleaning, shopping and preparing meals.

Domiciliary care workers provide more personal care, such as helping people go to the toilet, get in and out of bed, have a bath and get dressed.

Social services can also help with adaptations to your home, such as grab rails, stair lifts and bath seats.

Meals at Home can be arranged via social services who may provide the service themselves or through a private or voluntary organisation. They can be hot meals or frozen, and should offer a range of dietary options including special requirements like soft foods or diabetic meals.

I need nursing care at home…
Following your care assessment, social services can get in touch with your local NHS who can help provide continence advice and equipment, medical equipment such as hoists, special beds and wheelchairs, and can arrange visits from medical practitioners including occupational therapists, physiotherapists and chiropodists. Your GP can arrange for NHS services, such as a district or community nurse, to visit to give injections and change dressings. NHS services are free, but services provided by social services may need to be part or fully paid for.

A number of hospice and palliative care teams now provide a hospice at home service, which complements and supplements the service provided by a person’s district nurse. Some teams can offer 24-hour nursing care. Talk to your GP or health visitor if you feel this type of care is appropriate.

How do I choose and pay for home care?
The council may provide your care itself, or ask an approved agency to provide it on their behalf. Many councils are now offering personal budgets which would give you more choice and control over your care. This could also be spent using a direct payment - cash given to you by the council to arrange your own care.

If you are buying your own services (either using a personal budget from social services or your own funds), you can either buy services from a regulated homecare agency or take on the responsibility of employing your own personal assisant (PA). Home care agencies are inspected by the CQC (Care Quality Commission) and have to carry out staff training, health and safety audits, suitability and police checks on all staff and arrange all pay and tax issues for their staff. If you employ your own personal assistant, all these checks and tax issues would need to be arranged by you and the individual would not be regulated by the CQC.

Written for yourcarehome - author: Mark Sadler