Live-in care is a viable alternative to being cared for in a residential nursing or care home. As a client with a live-in carer, you would be supported 24 hours a day in the comfort of your own home with the level of care and support that meets your individual needs and preferences.
If you are experiencing difficulty coping with daily living tasks, this type of care allows you to continue to live at home and maintain your independence and remain close to your family, friends and neighbours. Additionally, if you have pets would not be parted from them.
Care packages vary to suit the needs of the individual. This type of care is in place for as long as the client needs the support. It could be for just a few days (while convalescing after an operation or hospital treatment) or for longer.
This type of care can be part of a respite package that allows the client’s family to holiday knowing that their loved one is well looked after in at home. Alternatively, it could also be part of a support package to enable the client freedom to go on holiday with the support of their carer.
What is live-in care?
Live-in care gives people a perfect solution to enable them to continue to live in their home even though they may have complex needs or require recuperation support to allow after an operation or hospital treatment or for convalescence after an illness.
If you have complex needs, a live-in carer is a preferable alternative to seeing several different carers throughout the day for various aspects of your care. Having one carer provides continuity and more scope for individual specialised support.
The carer would live with you in your home, adapt to your routines and your activities. The aim is to support you and to maintain your independence. Carers are specially trained to provide you with seamless support that focusses on you as an individual.
The support a live-in carer gives is dependent on your needs and how your illness or disability affects you. It will also depend on how you feel on a day to day basis, as you may feel able to do more on some days than others.
Support needs are assessed by a senior care manager. Their role is to look at a holistic approach and determine your preferences and tastes to find out about you as a person and to help choose the right carer. They also monitor the delivery of care.
Care managers can also signpost you in the direction of the different ways in which live-in support may be funded; this includes PIP, Attendance Allowance and other local government benefits that may be available.
What it’s like to have live-in care?
A package of live-in care may include:
- Personal care which includes washing, bathing, toileting, dressing and undressing; and helping the client to make choices about what to wear.
- Supporting the clients’ routines.
- Helping with medications and liaising with GP and other medical professionals.
- Help with menu planning, shopping, preparing and cooking meals.
- Housework, laundry and ironing.
- Visiting friends and family; attending social events.
- Assistance with outings.
- Assistance with mobility.
- Helping the client to keep fit; encourage hobbies and interests.
The carer will help the client to make decisions for themselves rather than make assumptions about their needs.
Who can benefit from live-in care?
This type of care could be provided in a care home, but in a 2014 poll, 97% of the respondents indicated that they would prefer to be looked after in their own home as opposed to moving to a care home. This is particularly important when it comes to support for specific difficulties.
Additionally, live-in care can:
- Support patients who have been discharged from hospital after an operation or treatment.
- Promote independence for the elderly to enable them to live in their own home and maintain a good quality of life.
- Offer respite care to allow the family to have a break.
- Provide palliative care.
Advantages & disadvantages of live-in care
Just like any other support or intervention, there are advantage and disadvantage to live-in care. If you are considering this type of care, it is important to realise that any disadvantages can be overcome through discussion and communication with a senior care manager.
- The client will have one-to-one care that meets their needs. This is provided by at least two carers that have been assigned to the client, who will work in rotation.
- If the client enjoys taking a holiday, their live-in carer can accompany them. This means that there is a continuation of care and knowledge that the client is in safe hands.
- Having a live-in carer means that there is less pressure on relationships with family and friends as the client will not feel they are a burden on them.
- By staying in their own home the client still has access to their family friends and neighbours.
- Staying in their own home is especially important if the client does not enjoy being in new places or is anxious meeting new people.
- Live in carers will have had specialist training in the different needs of the clients they work with i.e. the elderly; clients who have suffered a stroke or need palliative care.
- Some people may miss out on the social side of being in a care home. However, support from the right carer may motivate the client to socialise outside of the home.
- Very rarely there is the problem that the client does not get on with the carer. It may be that some people just take a little longer to adjust to a new environment.
- The living arrangements. This can take time and effort especially if the home is small or the carer’s room was used as a storage space and needs to be reorganised.
- Cost of having a live-in carer can be a disadvantage, but that needs to be weighed against the client’s continued independence;
- The carer will have needs of their own and will require short breaks. The agency that employs the carer will have a rota and access to short term cover.
What are the benefits of live-in care?
There are many benefits to having live-in care, here are some benefits that you may not have thought of:
Falls are one of the biggest problems that can occur as we age or if we are unwell or on medication. As we age, we become more likely to lose our balance easily and fall which can result in broken bones.
Research has shown that falls are less likely to occur when an elderly person has the support of a live-in carer. This is probably due to the carer having an increased awareness of the likelihood of the cause of falls.
Prevention is important, so by having another set of eyes around the home, it is likely that hazards can be relocated and other safety issues acknowledged and repositioned, mended or removed, but only with the permission of the client.
Peace of Mind. Having a live-in carer will give you peace of mind knowing that someone is always available should you need physical support or if you have a problem with your medication.
Having a live-in carer also provides companionship. When you live alone, it is difficult to discuss concerns that you may have about various issues; you could discuss your concerns with your carer who is impartial.
Some concerns you may have could be about food, shopping and what to eat. This is very important as some people who live on their own forget to eat or eat foods that are of little nutritional value.
Less pressure on relationships. If you have been supported by a spouse member of your family at some point, they will need a break no matter how much they want to support you. They may also be looking after their own family.
If you are being cared for by a friend or relative, you may feel obligated to go along with their suggestions as opposed to expressing your own views and opinions. Over time this can cause resentments which will affect your relationship with them.
It can be very challenging to accept personal care from a friend or family member. It is easier to accept help from a professional carer who will encourage you to make your own choices rather than feeling pressurised to do what they want.
This is probably one of the benefits that are not usually considered, yet it can be critical to everyone involved. It is just as crucial for a couple to stay together in their own home as it is for an individual.
There are many cases where a couple have been split up in their later years and been placed in separate care facilities. This is not because they or anyone chose that, it may have been all that was available. There are limited facilities for couples.
By having a live-in carer, there is the peace of mind that they are being looked after 24 hours a day. If one of them needs help then the other is not putting themselves in danger in order to help them.
When is it time for live-in care?
You may have considered the idea of exploring live-in care as an option or it may have been suggested by a friend, relation, or even your GP. It is important that when there is a need for live-in care that both medical and social needs are not under assessed.
Assessment of needs for live-in care
As different people respond to different illnesses due to age or overall health, it is important that the client’s needs and preferences be assessed accurately. An assessment will also help the care manager to decide which members of the care team are best suited to your needs.
The assessment will help determine how you are coping on a day to day basis, and what support family, friends and neighbours are already giving. They will also need to know about your pets and the level of care that they need.
It will also help the care manager get to know you as a person, understand your medical needs and how your illness or disability affects you personally and emotionally. It is also an opportunity to plan goals and make a wish list.
Questions you may like to ask the care manager.
- What expectations should I have about live-in care?
- What are your recommendations for my care package?
- What decisions do I or my family need to make about any of the aspects of the care plan?
- Will my carer take me to the activities/clubs that I enjoy?
- How will you monitor my live-in carer?
- Can you help me to organise the funding for my care?
- Can you help me look at the advantages and disadvantages of live-in care?
- What do I need to do to accommodate my live-in carer?
- How will my carer communicate with my GP and other professionals that work with me?
- What happens if the carer and I do not get on?
- What happens if I want to go away on holiday?
- What happens to my carer if I have to go into hospital?
What sort of care to expect?
Having a live-in carer means that you are looked after for 24 hours a day. The home is kept clean and tidy and you have general assistance throughout the day to help you remain as independent as possible.
The responsibilities of the carer will range from the provision of companionship to personal care, domestic tasks and encouraging you to take part in planning meals to socialising outside of the home.
The aim of the carer is to encourage and support the client not to take over their lives.
If things change
It is important that you know that your needs are reassessed on a regular basis. If live-in care is only needed initially for a short period, you need to know that it can be extended if need be depending on your needs.
You also need to know what plans are in place should your carer become unwell. You need reassurance about continuity of care.
Who delivers live-in care?
A good care agency bases its care philosophy on a person-centred approach. It acknowledges the fundamental principle that every client has different needs and a unique personality. This style of approach promotes client independence and encourages clients to have a positive attitude for them to live as full a life as possible.
Not every Care Agency or Care Provider can provide live-in care as they may not have the experienced staff to implement individualised live-in care. However live-in care has become increasingly popular as an alternative to moving into a care home, especially if being at home means that there are better resources that can accommodate changing needs.
Some people find it very hard to adapt to new surroundings, especially if they are elderly or have dementia so being cared for at home is a good option. This is also the case if they have particular interests or hobbies that they would not be able to follow if they moved.
How it works
Live-in carers usually rotate shifts every two weeks. Carers are usually assigned after the care assessment, and you have had a chance to meet some of them to make your own choice.
Your daily routine will remain unchanged as long as that suits you and your needs. You get to choose your meals and your meal times. Moreover, your pets will still be at home with you. It is your choice when you would like to leave the house for an outing.
Choosing a live-in carer
After your assessment with the senior care manager, they will suggest a few of their carers that may be suited to your needs. With your permission, the care manager will arrange for you to meet with some of them individually.
The purpose of the meeting is for you to decide which carers that you feel you could work with. Choosing the right carers may come down to their personality and the rapport that you may share as a basis on which to build a working relationship.
Ideally, you need to feel comfortable with your carer and have confidence in their abilities to spot the signs if things are not going right for you and to take appropriate action.
To help you to make your decision the most important traits to look for in a carer are:
The cost of live-in care.
The cost of live-in care may seem to be expensive, but it is significantly less than what it costs in a residential setting such as a nursing home. The cost for a live-in carer starts at £750 per week compared to the average cost per week is £1121 in a care setting. Additionally, live-in care is provided on a one-to-one basis, while in a residential care home the ratio is usually one carer to four clients.
The cost of live-in care can be funded in several different ways:
Government help (this includes local government). To determine your eligibility for funding, your needs are assessed using a nationwide criteria. If you are eligible, then the local authority has a duty to meet your needs, but they may charge you for that service. However, social services will then require a ‘means test’ to see how much you will need to contribute (if anything) and how much the local council needs to contribute.
Attendance Allowance. If you are over the age of 65 and need help with personal tasks such as going to the toilet; washing; eating; getting in and out of bed then you may be able to claim for an attendance allowance. Depending on how your disability or illness affects you will depend on which of the two levels of the allowance you may be awarded. The rates will depend on whether you just need help in the day (lower rate) or both day and night (higher rate)The attendance allowance is not means tested.
There are some additional benefits if you are eligible for this award: it is tax-free and it will not affect any other income you may receive; you may also be entitled to other benefits such as Pension Credit, housing benefit and a council tax reduction. If you are receiving an attendance allowance, this will be taken into consideration when you are assessed by social services for financial help for community care.
Personal Independence Payment (PIP). PIP has replaced DLA, but just like DLA it has two components; a daily living component and mobility. The PIP assessment is done through social services. However, the criteria for PIP is different to DLA.
Personal allowances/budget. Since April 2015 every UK citizen has a personal budget. Personal budgets have changed the way in which services are funded, so you have more control over the services that you receive. The amount of money that you have in your personal budget will be dependent on what has been identified in your care plan. The important aspect to consider when using your personal budget to buy into care is that if you choose to directly hire a carer as opposed to going through an agency, you are legally liable to contribute to the carer’s pension.
Equity release schemes. Advice is to always seek independent financial advice, as there can be pitfalls as well as positives. There are mainly two methods of equity release:
- Lifetime mortgages. This is a mortgage that is secured against your home.
- Home reversion. This involves selling all or part of your home.
Either type of equity release plan could provide you with a tax-free cash lump sum, regular income or both.
Paying for your own care. If you are not eligible for financial help from the local council, then you will have to pay for your care. However, you are still entitled to get advice from your local social services department on how your needs could be met.
NHS, continuing health care is often referred to as ‘fully funded care’. If your need for care at home is primarily due to your health, then the NHS has a responsibility to meet the full cost of that care i.e. if your needs are over and above what the local authority has a duty to provide. You need to make sure that the NHS provide you with a full assessment prior to you starting a claim for care and support from the local authority. If you do not have that assessment for ‘fully funded care’, you may find that the local authority will charge for care services that should be provided to you for free.
The senior care manager that assesses your needs can provide you with more information or signpost you to other options.