A growing proportion of the people we advise on care are looking for placements for a relative who has dementia. Dementia often makes the search for care particularly challenging. Sometimes, families are told a care home they like will not take their relative due to their dementia. Many families I have worked with find it difficult to quickly establish which homes specialise in dementia care and those which do not.
A starting point is checking the care home’s registration. Each care home is registered in different categories, one of which is dementia care. However, being registered for dementia care does not tell you the exact level of support the home provides for people with dementia. Many homes which are registered for dementia will not accept people whose dementia results in very challenging behaviour, such as aggression and tendency to wander. It may depend upon the residents already within the care home – if they already have several people with challenging behaviour, they may not be able to cope with another.
It is very important that you have a full and frank conversation with the care home manager, describing all of your relative’s behaviour patterns and discussing how they could be managed. Placements for people with dementia can and do break down and when this happens, it is very distressing for both the individual and their family. I recall working with a man who had very sudden, aggressive onset of dementia. His wife wanted her husband to go to a home with wonderful facilities, but it did not specialise in dementia care for most challenging behaviours. The placement broke down within 48 hours, the man had to return to hospital and it was several months before he was ready for another placement. Happily, the new care home specialises in the level of dementia care needed and he is now getting on very well.
If your relative has recently been diagnosed with dementia, you may wonder how to choose a care home not knowing how the condition will progress. It has been our experience that where the dementia is early onset (sixties or early seventies) we often see people with an aggressive form of the condition which requires care in a specialist dementia home who can manage the care as the condition develops. A later onset dementia which causes memory loss and withdrawal, rather than particularly challenging behaviour, can be managed well by good care homes.
There are currently an estimated 750,000 people in the UK who have dementia and this number is predicted to double by 2040. Clearly, the challenge that dementia presents to the care system is a very important issue, not just in terms of the day-to-day care of a person with dementia, but also in terms of supporting families making the choice about care homes.