By Samuel Court, Director at Nexus Care Services
For most people, home is where they feel safest and that matters even more for someone living with dementia, where familiar surroundings and faces can be a real anchor as memory and confidence begin to change. Dementia is now one of the biggest challenges facing families across the UK, with Alzheimer’s Research UK estimating that 982,000 people are living with the condition – around one in 11 people over 65 are affected.
The numbers are significant, but behind each of those figures is a family trying to work out what support is needed now and what might be needed next.
At Nexus Care Services, we support people across Sutton Coldfield, Lichfield, Tamworth, Shenstone and the wider Staffordshire area who have varying degrees of dementia.
A growing part of our work involves helping people with the disease to stay at home for as long as it’s right for them.
Dementia is often described as moving through stages, from early to late, which is a helpful way of understanding the condition, but in our experience, nobody moves through it in neat steps.
The Alzheimer’s Society points out that stages can overlap, so someone may need help with some parts of daily life while still managing others perfectly well on their own.
That is why it is really important to begin with the person rather than just a blunt diagnosis.
Before any care starts, we visit at home to understand routines, preferences, life history and the things that make a good day.
This assessment provides us with the information that will shape a person’s care plan and helps us find the right carer for them.
In the early stages of dementia, we tend to find that the support we offer is often a light touch.
A carer might help with medication prompts, shopping or preparing meals, or simply provide companionship and a reason to get out of the house.
Keeping someone connected to their community and their own way of doing things can make a real difference to their wellbeing.
As needs increase, visits tend to become longer or more frequent and might include help with washing, dressing, eating and getting about.
We ensure the level of support provided helps a person to live as independently and safely as they can.
However, at some point, a person may reach a point where being left alone is no longer safe and that’s often when families start to consider live-in care.
Our care packages run from 30-minute visits to 24-hour support, so care can grow with the person rather than forcing a fresh start each time their needs change.
A care plan written at the start of a package will not reflect someone’s needs a year later. National guidance is clear on this.
NICE recommends that dementia care plans set out how often they will be reviewed and that needs are looked at again after every transition, such as a hospital stay.
The Care Quality Commission expects assessments to be reviewed regularly and whenever they need to be, which is why we treat reviews as an ongoing conversation.
Planned reviews take place at agreed intervals, but our carers are also trained to notice the smaller changes that families may not see from day to day.
A new reluctance to eat, more confusion in the late afternoon, an unexplained fall or a change in mood can all be early signs that something needs attention.
When that happens, we update the plan straight away rather than waiting for the next scheduled date.
Families are an extremely important part of this process, whether they are a spouse providing support or children ensuring their parents are properly cared for.
They know the person best and research with family carers has found that seeing the same care workers and keeping in close contact with relatives are among the things they value most.
Continuity is also how subtle changes get spotted early, because someone who knows your mum well will notice when she isn’t quite herself.
At Nexus, we also employ the latest technology to create clear notes about a person’s condition, preferences and clinical needs, which is accessible to carers and family members.
For many families, the hardest moment comes when dementia sits alongside other health conditions or clinical needs.
That might mean support with swallowing difficulties, catheter or PEG care, pressure area care or managing diabetes alongside dementia.
Traditionally, this is often the point where people are told home care can no longer meet their needs and a move into a nursing home is the only option.
Our new nurse-led complex care service has been designed to change that and our registered nurses now oversee the clinical needs of the people in our care.
They carry out clinical assessments, write and review clinical care plans, train our carers in the specific tasks each client needs and monitor how care is working day to day.
They also work alongside GPs, district nurses, hospital teams and other professionals so that information flows properly between everyone involved.
The real benefit for families in our new approach is continuity. Rather than switching to a new provider at an already stressful time, the person can keep the carers they know and trust, with additional clinical oversight wrapped around them.
Moving between services is one of the points where people with dementia are most at risk of their needs being missed, so avoiding unnecessary handovers really matters.
That’s not to say home is always the right answer. There are times when a care home is the best option and we will always be honest with families when that point arrives.
However, it should be a planned decision based on what is best for the person, not one forced by a gap in the support available.
National attention on dementia is growing, with the Government committed to publishing a Modern Service Framework for dementia and frailty by the end of 2026. Whatever that brings, families can take practical steps now.
Talking early about wishes for future care, while the person can still take part in those conversations, is one of the most valuable things a family can do.
NICE recommends that advance care plans are revisited at every review and we encourage families to keep those wishes at the centre of every decision.
Our aim is simple. We want people living with dementia to stay in the place they call home, supported by people who know them, for as long as that’s the right choice for them.
To find out more about dementia care or nurse-led complex care at home, please get in touch.
We genuinely believe that our carers provide the best service available.
If you need care in Sutton Coldfield, Tamworth or Lichfield, please get in touch with our friendly and approachable team.
