Living in a Care or Nursing Home

 Moving an elderly parent into a residential care or nursing home is a major decision and not one to be taken lightly. There are financial, welfare and psychological aspects to be considered and very often it is a last resort. Sending elderly parents to a care or nursing home often makes people feel very guilty, quite apart from the effect it has on the parent, so think very carefully. It is also a decision that has to be taken together, so include you, your parents and any other relatives and close friends of your parents who are likely to be affected.

The difference between care homes and residential homes is the type of need your elderly parent has. If they need help in doing things because their mobility is restricted or for some other reason, they will require a care home. If, on the other hand, they have a  condition that requires medical supervision, they will need a nursing home. Understandably, the latter are more expensive.

Under the Care in the Community legislation, elderly and disabled people have a legal right to a full assessment of their needs and a written care plan from Social Services, so if you want this help, contact your local Social Services office. The assessment must look at help that can be provided to keep the person in their own home and, if services such as home help are required they must be provided. Read the two pages in this Guide, Living in their Own Home and Living with You to learn a bit more about what this might involve.

The advantages of care for older people in care or nursing homes are:

• Handing over responsibility for their care to professionals means that, when you go to see them, you can spend quality time with your elderly parents.
• There is the social element to nursing, or residential, homes in that your elderly parents can make friends with the other residents.

The disadvantages are:

• The guilt that is associated with it.
• Finding the right home can be difficult and stressful.

The payment rules and arrangements for care or nursing homes are complex and you will need to contact your local Social Services office, who will explain them to you. Basically, they will help pay towards the cost of homes run by your local council or by independent people providing your elderly parent has less than £21,500 (2007 figure). The financial situation will be part of the assessment that is mentioned above; you can choose not to have the financial part of the assessment but that means that your elderly parent will receive no financial help.

Choosing a Care or Nursing Home

Choosing the right nursing home is obviously the most important decision you have to make, once you have all decided that your elderly parent should move into a home. You must do your research and make sure, as far as you can, that you make the right decision; having to move from home to home can be very traumatic for elderly people and it is not something that they should have to do. Personal recommendation is obviously the best way to find a home but even then you must go and look at it carefully, question the staff and make sure that it is suitable for your parent.

There are a number of guides to care and nursing homes and you will find them if you go to Amazon.co.uk and type in 'Good Care Homes Guides'. Your local Social Services department should be able to supply you with a list of homes in your area and there are a number of agencies that can help:

• Quality Care Commission – www.cqc.org.uk. The CQC will assist your search for a care home by offering free independent reports on the quality of your local homes and care services to help you make an informed choice.

• The Elderly Accommodation Council, a charity offering advice about residential and nursing homes
• Counsel and Care for the Elderly, a charity that offers general information and can advise on particular homes in the London area
• Age Concern and Help the Aged who both publish information sheets on the subject of homes and housing for the elderly. Also, your local group, whose number should be in the phone directory, should be able to provide information about homes in your area.
• The online UK Nursing Homes Directory

You should also go to the laterlife page on Nursing, Residential and Care homes, which has some more very useful information.

When you are looking for a home to care for your elderly parent, it's worth drawing up a list of criteria against which you can measure the homes you look at. People will have different criteria for their elderly parents, but below are some that you might want to think about:

• Is the home close to shops, relatives and friends and is it close to transport links?
• Is it all on one level and, if not, does it have lifts?
• Does it have single bedrooms and/or will it accept married couples?
• Does it have a garden the residents can use?
• Does it appear bright and lively and does it have regular activities?
• Are residents able to follow their own hobbies and interests?
• Are residents able to choose which doctor looks after them? Are they consulted about their medicines?
• How well trained and qualified are the staff and are there people on duty at night?
• Can residents keep their own furniture?
• What provision is there for them to keep their belongings safely and privately?
• How is residents' money handled?
• How much freedom are they allowed and how much privacy are they afforded?
• What are the visiting arrangements?
• What are the mealtimes and how varied are the menus? Can residents make their own snacks and drinks?
• What are the rules about alcohol?
• Can residents make telephone calls whenever they wish in privacy?
• Is there a suggestions and a complaints procedure?
• What is the ratio of staff to patients?
• what is the staff turnover rate?
• How much time each day do staff spend with the residents?
• How are emergencies handled?
• If the home turns out to be unsuitable, how easy will it be for your elderly parent to leave?

Get as much information as possible on all of the topics that are important to you and your elderly parent and then match each of the homes you see against that information. Don't be taken in by grand furnishings and facilities; they are important but so are atmosphere, care and the lifestyle that is on offer. You should be able to get a feel for the home the moment you step inside it - the atmosphere, the smell and so on. The key thing is that your elderly parent will feel at home. Don't forget to ask other people, too, if they have any recommendations. Talk to friends and relations, your local doctor and anyone else who might have some experience of homes.

It's a huge decision to send your elderly parent to a care or nursing home. You will probably feel guilty that you are making it/have made it. However, if you can honestly say that you have done everything possible to find the best home for your elderly parent, depending on them and their personality, then there is no need for guilt.

One other thing you can do is to let the staff know who your elderly parent used to be, not who they are now they are perhaps old and frail.

Now read the pages of the Guide that you haven't already read in order to get a comprehensive insight into caring for elderly parents.