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Is Live-in care the ideal solution to the burgeoning social care crisis?
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The United Kingdom has an increasingly older population, with the 85+ age group as the fastest growing. This cohort of older people is predicted to double to 3.2 million by mid-2041 and treble by 2066. Evidence highlights that this ageing group is also expected to have a high level of dependency, dementia and comorbidity and subsequently will require some form of social care support. Access to social care can be via a number of routes and will depend on a number of factors including availability of family and friends, finances, the local care market and personal choice. Formal care (term used to refer to paid care and support) can be one of two types; residential and home care. Both types can also include equipment and adaptations should the person require it. There are approximately 400,000 older people in residential care in the UK and the concern is that supply will not be able to keep up with demand. Analysis of the current care home market shows that the UK is already short of 100,000 market-standard beds. The No place like Home report found that 97 percent of people do not want to go into a care home if they become ill or less able to cope. With this in mind and the current level of care homes beds, society needs to consider what the alternative options are. 

Reducing cost and providing better quality of life?

There is a growing drive from local authorities to reduce spend on residential care for a number of reasons; cost and quality of life are two cited by many of them. Residential care can be disabling and is often the first choice offered to families, who when already at crisis point and wanting to do the best for their loved ones, feel they have no other choice but to accept. Research by the Live-in care hub (www.liveincarehub.co.uk) found that one of top concerns for 70% of people they surveyed about dementia was the worry that their parent or elderly relative would have to go into residential care. Live in Care, although less well known than residential care is one option that can support individuals and their loved ones ensure that the right care and support is being given in a familiar and comforting environment.  

Why live in care?

Care in a residential home is available 24/7, and live in care offers the same level of reassurance. Live in care is having someone living with you in your own home, providing personal care and assisting with other daily living tasks. Living in a care home, you share the facilities and the staff with other people. Although individuals have their own rooms, there are shared living spaces such as a lounge and dining area. Having people around can be comforting to some but for others it can prove overwhelming, especially if those individuals have significantly higher needs and are not able to engage. With a live in carer, there is always someone to talk to, if that is something you want to do, otherwise the live in carer would just support you with the tasks that you needed help with including leaving the house to meet up with friends and family. 

Staff in a care home will work a shift/rota system and where possible individuals are assigned the same key workers. Unfortunately, the rate of attrition in care homes is high, therefore despite best intentions, it is not always possible to ensure consistency. Care home staff also have to adapt to the changing needs on a daily basis of all their residents whereas a live-in carer only has the one focus. 

High turnover of staff could mean inconsistent care

Challenges with recruitment and retention is one of the main reasons for care home closures. Having a live in carer allows for a relationship to develop between the cared for and the carer and is likely to be beneficial in more ways than one for both parties – person receiving the care and loved ones would always know who is proving the care and who to talk to if there were issues and for the carer it would mean security, a degree of flexibility and consequently more likely to want to stay. If live-in care is the chosen route, organisations work to make sure that the carer assigned is well matched to the care recipient. 

Keeping the family together

One of the concerns about going into a care home relate to being separated from a partner/spouse and/or any pets the person has. For a person who had dementia this can be twice as cruel. Having a live in carer not only means the care recipient can be with those they love but they can, if their health and care needs allow, be supported by the carer to continue to look after and do things for those they love i.e. make a sandwich, walk the dog. Very few care homes allow pets and with funding pressures, it is becoming increasingly difficult to care home staff to assist individuals with other everyday tasks they may enjoy. 

Financial advantages

The cost of a care home bed varies dependant on the local care market and the individual's care needs. There can also be a difference in what people pay if they are entitled to support from the local authority versus what you pay if you are privately funding care. Due to decreasing care home beds and an enthusiasm to maintain independence and quality of life, the argument for live in care can be justified even if you are local authority funded. In some cases, live in care may actually be cheaper than a care home placement. Having a dedicated carer and the positive effects of being in your own home can improve people's health and wellbeing, reducing the need for recurring intervention from statutory services, saving money in the long term.

For some people a care home placement will be the right choice for them, whether because of their specific needs or because of personal choice. However, where availability of care home placements is scarce, Live-in care offers the same peace of mind but with additional benefits such as the safety and comfort off being in your own home surrounded by loved ones. 


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