Dementia care at home

The house is doing some of the work

Someone with dementia living in the home they've been in for thirty years is running on more than memory. The hand knows where the light switch is. The feet know the way to the bathroom in the dark. That kind of knowing sits deeper than the recall that's going, which is why a person who seems entirely lost on a hospital ward can still be competent at their own kitchen bench.

Move them and it goes. That's the real argument for care at home, and it's why the question is rarely whether home is better. It's how long home can be made to work.

What our carers do

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  Personal care from someone who can talk a person through a shower without it becoming a fight.
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  Prompting rather than doing, so whatever someone can still manage stays theirs for longer.
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  Meals, drinks and an eye on weight, since eating is often the first thing to slip.
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  Medication prompted or administered, with nursing where there's a clinical need.
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  Company with a shape to it: music from the right decade, photographs, the same walk on the same route.
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  Supervision through the hours of the day that reliably go badly.
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  Continence support handled without embarrassment or fuss.
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  Overnight cover, so the person doing this full time gets to sleep.

Dementia care isn't its own funding category

There is no dementia service in Support at Home, and a provider implying otherwise is describing something that doesn't exist. What's funded is personal care and social support, which sit in Independence and carry a moderate participant contribution, plus nursing and allied health, which are Clinical supports and fully funded. Dementia changes how those services are delivered and who delivers them. It doesn't add a line to your budget.

Which means the question to ask a provider isn't "do you do dementia care", because everyone says yes. Ask who specifically will be coming, what training that person has had, and how often the roster changes.

Continuity stops being a preference

Everyone prefers a regular carer. With dementia it holds the whole thing up. A person who can't reliably form new memories can't build trust with a new face each week, so every visit restarts from nothing, and a shower that takes ten minutes with a familiar carer takes forty with a stranger, if it happens at all. Resistance recorded as difficult behaviour is very often a sensible reaction to being undressed by someone you don't know.

So we keep the roster still. Same carer, same time, same order of doing things.

People go back to their first language

A language learned at thirty is frequently the first one lost. A woman who has spoken English for fifty years can end up understanding only Greek, Italian, Arabic or Vietnamese, and families are usually caught off guard by it, particularly where the children speak the second language well and the mother tongue barely at all.

Language matching is worth more here than almost anywhere else in aged care. Our carers between them speak a wide range of languages, and in the catchments we work in this comes up constantly. Tell us on the first call.

The bad hours

Late afternoon is difficult for a lot of people with dementia: more restlessness, more agitation, more wanting to go home while sitting in their own lounge room. Our carers don't argue with it. Correcting somebody who's looking for a mother who died forty years ago achieves nothing except distress on both sides. Acknowledging the feeling and moving on to something else works better, and it works best when the carer already knows what "something else" is for that person.

The person doing this full time

Nobody in home care gets worn down faster than a spouse caring for someone with dementia, and the nights are usually why. Respite, including overnight, exists for exactly this and is the thing most families should be using well before they do.

Getting started

Call 1800 434 002 or send the form below. Tell us the diagnosis if there is one, what a bad day looks like, and what time of day it goes wrong. Tell us as well whether the person knows we're coming and what they've been told, so the first visit doesn't open with a surprise.

Other services

• Respite care — hours, nights or a week off for the family carer.
• Personal care — showering, dressing and the morning routine.
• In-home nursing — medication management, wounds and clinical monitoring.
• Care management — one person coordinating the whole arrangement.