Care at Home

While this Insider Guide aims to provide useful advice about Care at Home, please note that every individual’s situation is unique. For advice tailored to your specific needs, you may wish to seek professional advice.

When an older person starts to struggle with the tasks of daily living, the preferred option is usually to arrange suitable care at home; this will enable the individual to live in his or her own home for as long as possible.

At present, approximately four out of every five older people needing care arrange to receive assistance in their own home. This currently equates to some two million people receiving care at home. Types of Care at home Care provided at home can be medical and/or help with the everyday tasks of living.

There are three types of care at home:

Personal care for the older person

Examples of which are:

• Washing / dressing
• Toileting
• Feeding
• Meal preparation
• Mobility assistance
• Prompting of medication

Medical help in the home

Examples of which are:

• Changing dressings
• Administering medication
• Artificial feeding
• Bowel and bladder management
• Monitoring symptoms

Domestic help in the home

Examples of which are:

• Cleaning
• Shopping
• Bed making
• Laundry

Levels of care at home

These types of care can be delivered at a number of different levels, for example:

• Visits starting from 15 minutes
• Visits two or three times daily
• 24 hour care by rota, with separate day and night shifts
• Night sitting
• Live-in care (one carer resident for a pre-determined period of time)
• Occasional escort duties
• Day sitting for respite care

Assessment of needs

When deciding on what type and level of care at home is desired, there are a number of issues that will need consideration.

These may include the following:

• The precise care or assistance required
• Any personal or social needs not covered by medical assessments
• Where to find the right assistance
• Evaluating the respective benefits of different types of care
• Ensuring the older person is comfortable with the care provider
• What a fair price is for the service being provided
• How to fund the cost of care
• The State Benefits an individual is entitled to
• The availability and suitability of any assistive devices required
• Whether care at home is indeed the best option or whether residential care might be more suitable.

There are a number of organizations that can help with the process of selecting the right type and level of care at home. If the older person is a patient in hospital, the multi-disciplinary hospital team will carry out an assessment.

If the older person is not a patient, the local Social Services department or members of the local Primary Care Team can carry out an assessment of an older person and make recommendations. Social Services will also advise on any State funding entitlements.

An occupational therapy assessment, which can be arranged via the hospital or community social services department, will help to determine what adaptations and equipment may be required to promote independence and ensure safety at home.

Alternatively, this assessment can be arranged privately.

Care in your own home

The older person may find himself weighing up the benefits of receiving care at home as opposed to moving into a care home. Each situation is unique and there can be no general answer.

However, the following can act as a general guide to the advantages and considerations of care at home:

Advantages

• The older person can choose their own routine
• The older person is in familiar surroundings
• The older person can choose how much help is provided (within financial restraints)
• The older person can receive domestic assistance and/or help with personal care
• If and when needs increase, so can the level of care.

Considerations

• The older person may not have one regular carer 
• Long-term expense
• Being at home can sometimes be lonely
• The house must be maintained and bills must be paid in addition to care costs

The amount of care delivered under Social Services funding will be determined by the Social Services assessment and it may be as little as 15 minutes twice per day.

The type of care delivered by Social Services will also vary by area – for example, Social Services do not arrange domestic help nationwide.

Decisions regarding the type, level and funding of care at home are clearly not to be taken lightly and expert advice should be sought at all stages of the process