Alternatives to day centre dementia care

The Guardian today features a depressing report from the Alzheimer’s Society on care for people with dementia: “Sub-standard care will mean 50,000 people with dementia will be forced into care homes earlier than necessary, racking up a preventable monthly bill of £70m to the taxpayer.” Whilst most people with the condition prefer to live and be cared for at home, there is inadequate help for everyday tasks such as shopping, washing and dressing, leaving family carers unable to cope.

There are day centres for people with dementia, but it was common when I was working with unpaid family carers to hear that the person with dementia found the day centre environment so stressful and came back so disorientated, that the experience was not a break for anyone concerned.

A number of Shared Lives schemes are offering an alternative to day centres.

ASA Lincolnshire’s At Home Day Resource for people with dementia, established with carer’s grant funding, provides support from 10am – 3pm, delivered in the Shared Lives Carer’s home and local community. The ASA matching process ensures the participants are compatible, with one carer supporting up to three people at a time, depending on people’s needs. Some people use it to maintain skills such as cooking, gardening, or simply eating together and using cutlery. Isolated older people welcome the manageable social experience in a consistent, familiar setting.

The service also provides a break for family carers. One family member used the time to change her mother-in-law’s bed: if her bed was changed whilst she was at home, she thought it was being stripped in readiness for her to leave. Family carers and providers use a communication book to share information about any issues and to share the clients’ activities during the week, which assists conversation when the client returns home.

The service is offered to clients with mild to moderate dementia, but clients often build up a rapport with the provider, which means that support can continue as their dementia progresses, in one case for eight years. All providers receive training in Moving and Handling; Basic First Aid and Dementia Awareness Training, which is Alzheimer’s Society and Skills for Care approved. All providers, who are self-employed, are CRB-checked, as are any family members who will be involved in support. Providers are insured and their homes are Health and Safety checked. They receive monthly supervision and are re-approved every two years through the panel process.

There are a number of examples of this kind of support around the UK (including Falkirk Time to Share, as featured in Community Care magazine), based on the Shared Lives ethos of care provided to a professional standard in a family household environment. They are cheaper than day centres and offer the kind of flexibility and homeliness that people with dementia and their carers are crying out for.