Do also check out our related blog posts on the Cost of Care in Devon and Health Check for Your Home Care.

What are the different levels of support?

💜  Support for Quality of Life  💜

Why struggle with changing sheets or turning the mattress? Why dread having to lug the vacuum cleaner upstairs or avoid favourite meals because peeling and chopping are getting harder? Care doesn’t only have to mean personal care. A little extra help can add hugely to quality of life for older people by taking on chores and errands as they get harder. The right support can maintain all the positives in life while quietly taking on some of the challenges of aging.

💜  Support for Independent Living 💜

This goes further while still helping older people to continue to live independently. It might involve more regular visits to help with taking medication on time, personal care (washing, dressing etc) and so on. This may also be the time that elderly people stop being able to drive. So, to remain in their own home, they sometimes need assistance to appointments and  maintaining their social lives. The internet is a wonderful resource as so much shopping can be done online now. Your elderly relatives might need help to get set up and develop confidence online. This is a larger commitment than the support needed for quality of life, but it is still possible to support our older loved ones to continue their independent lives in their own homes.

💜  Support for Day to Day Living 💜

There is a point where independent living becomes hard, even with the best support and care at home for older people. Cognitive impairments or specific needs can make daily life more challenging, or even risky. This is the time to look at the benefits of a care home for your loved one, particularly when the challenges seem set to continue for some time.

When is support needed?

Nobody knows your parents or older loved ones as well as you. So, families are often best placed to know what is normal for them and what might be an increasing concern. However, there are some signs which might flag up underlying difficulties of aging becoming more serious.

💜  Support for Quality of Life  💜

• • You might notice that the house seems too big for them to be able to keep up with the chores

• • Similarly, you might see increasingly meals and snacks are ready made, and their nutritional value might be declining

• • There might be worries developing about driving to particular places or at particular time, so that a lift is increasingly appreciated

These kinds of issues are easily addressed. You may start popping in more regularly, offering lifts or inviting your loved ones around for meals more often. If you live further away, you can consider looking for local help such as a Hub Personal Assistant. This has the additional  benefit of being a regular, ongoing relationship. You have someone ‘on the ground’ who knows your parent and will let you know if they are not managing.

Whilst they may be grateful that you have noticed and offered a solution, your parents may also feel that they are coping just fine. You can remark on what you notice, and suggest the kinds of support you feel they might need. 

💜  Support for Independent Living 💜

At this point, you may have some nagging concerns about your elderly loved ones which indicated they need more care. Offers of help may be welcome, but they may also become secretive or play down difficulties for fear of losing their independence. It can be helpful to raise specific issues you have noticed. Offer suggestions as to how they can be addressed in order to keep them living in their own home. You may notice a combination of different changes as they age:

Physical Changes

• • Lower levels of energy – this is quite common as we age, but has many knock-on effects. Increasingly, your loved ones may feel that they can manage less in a day. They begin to budget their energy accordingly, even for simple tasks. 

• • Weight loss – it’s not unusual for older people to eat less, especially as it becomes another tiresome chore. As shopping and cooking both become harder it’s easy to resort to eating more (unhealthy) snacks and prepared foods. You notice weight loss along with a general lack of interest in food.

• • Poorer mobility and balance – many older people find it increasingly difficult to get up from being seated, and need help to do so safely. Becoming less mobile affects confidence. You might see them avoiding getting up, for instance to make a meal, or even to get to the toilet. Alongside this, balance issues increase. You may notice more frequent bruises and scrapes. The NHS estimates that 30% of people aged 65 or more and 50% of people aged 80 or more will fall at least once a year. These can be serious, with the same source suggesting that about 1 in 20 of these falls results in a broken limb or hospitalisation.

It is worth contacting an Occupational Therapist to look at how the home can be physically adapted to make life there easier. Small changes at home can hugely improve life at home and maintain their continuing independence.

Self Care

• • Wearing the same clothes – washing, drying, folding, tidying away and ironing clothes can seem like a lot of work, especially as we go out less often. We also can become very attached to particular, comfortable clothes, and simply not want to change them. Help may be needed dressing and undressing.

• • Declining standards of hygiene – falling energy levels can sometimes lead to bathing or cleaning teeth less often (or forgetting to put dentures in!). You may notice soiled or stained clothing or suspect personal hygiene is not what it used to be. They might have fears about falling in the bathroom when there is nobody in the house. It might be harder to step over the edge of the bath. This is the time to consider adaptations to the bathroom, like a walk-in shower or higher level toilet. 

Declining standards of self care can be an indication of both physical and mental challenges for older people. Support can be both practical – help with washing or dressing, and also holistic – more frequent visitors may provide an incentive to take better care.

Organisation

• • Keeping old and out of date food – some people may worry about money and dislike throwing out food, even if it is past its sell-by date. Alternatively, low energy levels may mean that they simply can’t get to a big job like clearing out and cleaning out the fridge, without help.

• • Build up of chores – you might notice that jobs around the house and garden are no longer being done, or not to the same standard as before. Whether it’s keeping the lawn mown, changing light bulbs or hoovering upstairs, you may notice the change. Dust on high shelves and cobwebs might be due to failing eyesight. They are just noticed any more, but it can also reflect that physically these things are becoming just too hard.

• • Unexplained dents on the car – spatial awareness and reaction times decline as we age. Nowhere can this be more apparent than on the road. At the same time, modern lives revolve around driving. It can be very hard to admit that we are no longer safe to be driving. It is a huge step back from independence mentally as well as practically.

• Poor organisation and judgement – keeping the bills paid, remembering when you are coming or taking medication on time, there are many ways that declining organisation can have an effect. Missing appointments can be a matter of organisation but it can also be a desire to avoid the changes that might follow on from, say, a medical appointment. 

Decline in Mental Health

• • Feeling low – having less energy and being able to do less can lead to feelings of a loss of control and even mild depression. This in turn can make even small day to day activities seem impossible, overwhelming, or simply unimportant. Becoming more isolated can also lead to moodiness and snapping as we simply fall out of practice at socialising.

• • Lack of interest – withdrawing from previously enjoyed social and community events, no longer keeping up with hobbies and activities.

• • Increasing confusion – we all lose our train of thought from time to time but it is more pronounced and more frequent as we age. There will be a point at which it becomes a concern, particularly when it raises safety issues.

This can be a time of change, sometimes rapid, sometimes slower. Practical measures like down-sizing or refitting the bathroom can help – and free up money to help cover the costs of increasing care. Keeping your loved one stimulated and interested in life becomes as important as supporting their physical needs. Loneliness can be debilitating in its own right, and affects all aspects of health and wellbeing.

If your loved one feels strongly that they wish to remain independent and living in their own home, then it is possible to put together visiting support and care, possibly combined with family support. There are many ways to provide care at home for older people. How options are combined is as individual as everyone’s exact circumstances, and will, of course change over time.

What are the options for support?

There are a range of options open to people as they age, and each decision is inevitably unique to the particular circumstances and personalities involved. These range from a little extra help for older people as they stay in their own homes, through care and support at home to decisions about the best location for ongoing care.

Visiting Support

Visiting support is ideal for supporting Quality of Life and Independent Living. It can be tailored to individual needs, providing exactly the kind of help that’s needed, when it is needed.

• • A Personal Assistant, such as those working through Hub Care Support, can make a world of difference – whether it’s a home-cooked meal, help around the house, assistance to a hospital appointment or social event or just a chat over a cup of tea. It may be easier to ask a PA than family for some tasks, especially when family work or do not live very close. Having somebody who becomes known well develops a special kind of relationship which can boost mood and enjoyment of life just as much as help to keep on top of practical tasks. They can also help with more personal care, such as washing and dressing later on. This is a very flexible option for providing the kind of care and support at home that is needed and wanted.

• • Agency Staff can visit regularly, although you are unlikely to consistently have the same person or time, so that support can feel more functional than personal. However, agencies can be useful at short notice, for short ‘check in’ visits, or visits at less sociable hours of the day and weekends.

Family Support

• • Regular check-ins are great if you live near enough and can spare the time. Whether it’s changing the sheets, a trip to the supermarket (or help with online shopping) or a meal together, spending more time with older relatives can be very rewarding. You can find yourself with the time to become closer than you have been for years. 

• • Sharing a home is a great solution for some families as a way to care for their older relatives. Multi-generational living has its own rewards, if you have the space and time to make it work. This could be a ‘granny annex’ on your own home, converting a dining room to a downstairs bedroom or spending time living with your elder in their home. 

Live-in Support

Live-in support can be a good solution when your parent feels very strongly that they wish to stay at home, but you feel they should not be alone.

• • Hub Care Support can also introduce live-in PAs who will then take on all of the usual tasks, in addition to sleeping on site. Working through an introduction service like the Hub means that your parent can choose the person they will be living with which is reassuring and empowering.

• • Agencies will also provide live-in assistance. They can be useful when your need is urgent or immediate, but you are unlikely to be able to choose your carer. They are often more expensive and the carer will receive a lot less of the money you are paying.

When thinking about live-in care, be mindful that the carer or PA will need to have breaks of a couple of hours a day. Consider whether your loved one can safely be left during that time or whether you will need to make another arrangement, either being there yourself or possibly another form of visiting support. Some agency carers will want you to provide a separate food and laundry allowance for them.

Care Home

Some elderly people look positively at the move to a care home, appreciating no longer having to worry about keeping up the house and chores and looking forward to the company, in-house activities and routine. For others, however, the move to a care home is daunting, particularly when they are unable to remain at home, even with support.

Moving to a care home is a process. Try to speak with your loved one as far in advance as possible. Remind yourselves that it is an option even when you all know you are going to follow other avenues at the moment. Ask around ahead of needing to make the move so that, ideally, you can identify a few care homes locally that have a good reputation and you feel would be a good fit. 

It can be useful to begin a relationship with a care home with shorter visits, maybe to recuperate after hospital treatment, or whilst family carers take a break. Consider whether it makes sense to keep your loved ones where they have friends who will visit them regularly or to move them closer to family who want to take on that responsibility.

💜 Support for Day to Day Living 💜

For many people, support at home, either from Personal Assistants or from family or a combination of both, can be enough to keep them living in their own homes, even as their health deteriorates. Increased support at home, whether live-in Personal Assistants or carers, or with family, can enable and enrich daily life. It is even possible to arrange palliative care at home, in some circumstances. However, where this is not possible, or not wanted, it may be time to consider moving into a care home (support for day to day living) or nursing home (also nursing care provided). If you are unsure whether an elderly relative is still safe living at home, then you can ask for a Social Services assessment to guide you all as to the reasonable options.

Every one of us is different and we all age in different ways. For some of us, remaining independent is paramount, and many people feel strongly about wanting to stay in their own homes. Others relish the release from responsibilities offered by down-sizing and feel more financially secure knowing that they have funds available to care for increasing needs.

Care at home for the elderly means we have a good range of ways to meet those needs. Visiting support and care can be very flexible in meeting needs as they change over time, so that not everyone has to move into a care home towards the end of their lives. Sometimes, however, health challenges make this the only reasonable option, so it is always worth keeping this in mind as well. At the end of the day, each decision is unique to the people involved and their current circumstances. e are fortunate to have a good range of provision options to choose from.