Carers of people with dementia

Home care

People who were assessed as being in need of home care usually had carers to come into the home to help with washing, dressing and sometimes meals. A few people said that the home carers were excellent, efficient and friendly. Some people are lucky enough to have access to an emergency response team that can provide help within an hour.

Many carers who had experience of home care were critical of at least some aspect of the service, even if they liked and trusted the individuals. High staff turnover also meant that there was little continuity, which could be particularly difficult for the person with dementia. Sometimes the person with dementia flatly refused to have help from a stranger. Other common criticisms were that the home carers were untrained, too rushed, lacked knowledge about dementia and were not allowed to be flexible.

Carers sometimes felt that either the care plans, or the organisation of specific services were not sufficiently flexible to meet the needs of their relative. One woman described several problems with 'Meals on Wheels' and the home carers, who would often arrive to get her mother ready for the day some hours after she had dressed herself. This daughter also said that what her mother needed was emotional and social support, which was arranged via friends since the home carers never had time to chat.

People we talked to were often aware that home care services had been privatised and none said that they thought services had improved as a result. Some blamed the need to make a profit as responsible for the low rates of pay, lack of training and high turnover of staff. One man explained that he thought that paid carers need to be particularly well trained and relatively well paid because they are dealing with vulnerable people.

The care plan states how long it was expected that these visits would last, but several carers thought that their relative was not getting as much time as they were entitled to. This could be particularly difficult if the person with dementia was living on their own as they would not always be able to recall with accuracy who had visited and for how long. One family, convinced that the home carer was not doing what had been agreed, had waited outside and timed how long they were in the house.

Very occasionally the family has greater concerns about a carer. One daughter became aware that her mother seemed to losing money from her purse. She tells how she eventually realised that it was a home carer who was taking money, and how she worked with the police to establish proof of her suspicions.

The Department of Health has also introduced ‘direct payments’. Direct payments are local council payments for people who have been assessed as needing help from social services, and who would like to arrange and pay for their own care and support services instead of receiving them directly from the local council. None of the people we interviewed had used the scheme.

Last reviewed March 2015.

Last updated October 2010.

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