Delivering personal care and practical support to older people living in their own homes.
We know that by providing early interventions to support quality of life for people diagnosed with a dementia, we can reduce the need for care.
There are 11.4 million people age 65 and above in the UK, and currently the Alzheimer Society estimates that over half a million people live in the community with dementia.
Therefore it is important when considering the personal care for the older person living in their own home to remember that a significant proportion of those people will be living with dementia.
The NICE guidelines, though aimed at all older people, not specifically those living with dementia, do address several of the above enablers to improve the quality of life.
1.Ensure the care is person centred.
Focus on the person’s strengths, goals and past experiences to tailor support for the person living with dementia. DSDC, throughout our work, stress the importance of person centred care and with the focus on developing meaningful relationships.
2.Provide information about care and support options.
Ensure information is available on options, finance, rights as a patients. The information should be made available in a timely fashion and digestible format, consider languages, delivery formats, and continuous access. It is also important to consider information made available to family carers.
Another helpful tool that supports people to remain in their home as long as possible is telecare, for more about telecare and dementia download the free guide Telecare and dementia: using telecare effectively in the support of people with dementia.
3.Planning and reviewing home care and support.
The guidelines recommend integrated care and support and specifically mention the incorporation of dementia advisers for those living with dementia.
Consider the need for independent advocacy if the person lives alone, has difficulty expressing their views and aspirations or lacks capacity. When working with a person living with dementia this should be considered.
When planning for home care for a person diagnosed with dementia it is important to ensure the physical environment is considered with regard to practical support. Understanding the principles for design in relation to dementia and how even low cost changes to the environment can promote safety, increase the opportunity for independence and reduce service cost.
4.Delivering home care
When delivering person-centred home care it is important to recognise that major change can make people feel unsafe, and this feeling might be amplified for a person living with dementia. At DSDC we recommend that all those who are involved in the care of support of people living with dementia have an understanding of dementia. DSDC's best practice programme enables a wide range of support staff to undergo this training to better understand the potential needs of an individual with dementia.
5.Joint working between health and social care
Ensure regular liaison between all those involved in the continuous care. This will also ensure the monitoring of changes to the person living with dementia is shared and appropriate steps can be taken to ensure the care and the environment continues to supports the person in their home.
6.Ensuring safety and safeguarding people using home care services
Here it is important to recognise that the home care worker may be the first person to spot abuse and neglect (including self-neglect) and should respond proportionately
7. Recruiting, training and supporting home care workers.
An important aspect is the recruiting and supporting of the home care workers, the guidelines do emphasise the need for the home care worker to recognise and respond to dementia, the best practice in dementia care for Domiciliary, re-ablement, home care and the community programme offered by DSDC provides a proven way to train those involved in the care.
Read the full set of NICE guidelines Home care: delivering personal care and practical support to older people living in their own homes