Alternatives to a care home

Making decisions about the care that you or an elderly relative needs, and how to pay for this, can be stressful and confusing.

Everyone's care needs are different and there is no set solution for everyone.

For some the most appropriate care can be delivered at home, known as domiciliary care.

Short-term / respite care

Some people need the help of a carer or nurse to recover from an illness. In other cases, the person providing care at home needs a break and so a temporary carer or nurse is required. The NHS funds intermediate care services at home or in a care home for a short period (normally up to a maximum of six weeks). The aim is to make sure people who would otherwise be admitted to hospital, or who would need to be in hospital for a long period, are as independent as possible.

Intermediate care may also reduce or delay the need for long-term residential or nursing care.

The Department of Health defines intermediate care as those services which meet all five of the following conditions:

1. They must be targeted at people who would otherwise face unnecessarily long hospital stays or in-patient care or long-term residential care when this is not appropriate.
2. The services provided must be based on a thorough assessment. This should result in a structured individual-care plan agreed with each user and, if relevant, their carer. The plan should involve active therapy, treatment or the opportunity for recovery. Intermediate care will always include a programme of active rehabilitation involving one or more of occupational therapy, physiotherapy, and speech and language therapy.
3. The services should plan to make the person as independent as possible. This should usually mean that the person can stay living at home.
4. The services should be limited to a certain time - normally for no longer than six weeks and frequently as little as one to two weeks or less. If this time is extended, there should be a full reassessment, authorized by a senior clinician and including a review date within the six-week period.
5. The services should work together within a single assessment framework. There should be one set of professional records and shared ways of working.

Care in your home

There is a wide range of different services which can be provided by your local authority, charities and private care agencies. You may have to pay for some of these services.

Many people get help with:

• Bathing
• Housework and shopping
• Taking medication
• Healthcare
• Food, for example weekly or daily meals services

The needs assessment and care plan may have identified that you qualify for your care to be provided in full or in part by the local authority.

You may choose for that care to be arranged by social services or you may wish to take advantage of "direct payments", which are local authority payments available if you would prefer to arrange your care yourself.

Adapting your home

If you need improvements and adaptations to your home, you can speak to your local authority about an assessment of your home. It is also worth exploring what financial help is available.

Examples of equipment, adaptations and smaller everyday items to help you live independently include:

• stair lifts
• grab rails
• emergency alarms for use if you fall
• ceiling hoists
• powered or manual height-adjustable beds
• powered leg-lifters for people who have difficulty lifting their legs into bed
• wheelchairs or walking frames