When should someone with dementia move into a care home?

Caring for a family member living with dementia is hugely challenging and sooner or later you will probably be faced with the decision of when is the right time for someone with dementia to move into a care home.

If you are in a position where you are struggling, you may have thought about alternative options to help you cope such as getting in care to help or even respite residential care.

But when is the right time for someone with dementia to move permanently into residential care? How do you make this decision and who should make the decision?

These are tricky and tough decisions to make, both for practical and emotional reasons. It is common to feel guilt and that you are abandoning your loved one. It is also a question of who should make the decision as it can be difficult to know what the person living with dementia wants, depending on their mental capacity.

On this page you will find advice on moving someone with dementia into a care home; when it might be time, who should make decisions, what the benefits are and more.

When is the right time for residential care?

Knowing when someone with dementia should move into residential or nursing care can be difficult. The main thing to think about is whether your loved one’s needs are met at home and whether moving into a care home is in their best interests?

If a person’s dementia has progressed far enough that they need more care and support than you can provide, it may be time for them to go into a care home. At this point, they may need 24-hour care.

There is no cure for dementia and the physical and mental state of a person living with the condition will only worsen.

When should a person with dementia go into a care home?

Dementia is progressive, meaning the person with the condition will require more care and support as time goes on. As your loved one’s condition declines, their needs increase and you may not be able to fully meet these needs despite your best efforts.

This is one example of the number of reasons why it might be time for people with dementia to move into a care home. Other reasons include hospital admissions, worry about your loved one’s safety or their behaviour becomes unmanageable.

There will never be a perfect time because of the stress and emotional difficulties, but if they need 24-hour supervision and support to stay safe and to ensure good quality of life, the only option may be to move into residential care.

Increased care needs

One idea is to write a list of your loved one’s care needs and if you are able to support them. For example:

My wife cannot safely go outside on her own – I can only take her outside in the mornings

Can I guarantee she won’t leave the house without me? – No, it worries me when I’m not there

If you go down the list and notice that you are unable to provide the care and support necessary for your loved one, taking into account your other commitments in life, it may the right time to consider residential care.

If your loved one is unable to live independently and cannot care for themselves anymore, moving into a residential setting will give them the benefit of 24-hour care and support. This will give you peace of mind that your loved one is safe and that they receive the right level of care.

To read David’s story about his wife Catriona who has dementia and moved into a care home click here.

Caregiver burnout

In addition to considering the person with dementia’s needs, think about what is best for you as a full-time carer and other people involved. Caring for a loved one with dementia is always going to be an uphill battle that becomes more challenging as time goes on and the stress on the caregiver can be huge and lead to burnout.

The physical and mental exhaustion takes a toll on everyone involved and the relationships between each other. Finding a suitable care home can take the stress away and enable you to make the time together positive and happy.

Behavioural changes

Ian Burton, who was diagnosed with Behavioural Variant Frontotemporal Dementia, moved into a care home after his wife Wendy felt that they could no longer keep him safe due to his behavioural changes.

“He would spend nearly all day coming in and out and walking. He was in and out of other people’s houses and the whole experience was very stressful,” Ms Burton said.

“We’d got carers coming in and taking him out, but they were finding it increasingly difficult to cope with him when he was out. He’d rush ahead and rush into pubs and order drinks and he’d got no money for them and he shouldn’t have been having them anyway.

“We missed him but it was a relief to know he was safe and well-cared for.”

Social isolation

People living with dementia can get very isolated as they can find it hard to talk and communicate with other people so tend to socialise less. They can find rooms full of people too noisy and overwhelming so can withdraw from social situations.

Care homes have activity coordinators and put on activities to encourage residents to interact with each other socially. These are invaluable for people with dementia who may be struggling to connect with others.

Benefits of care homes

There are many benefits to moving into a care home for people with dementia. Depending on how far gone the disease is, there are different options.

During the early stages, residential care could be a good option as the person may not yet need specialist care and support and will be able to still have a good quality of life. As the dementia progresses, changing to a setting that provides dementia nursing care or specialist dementia care is advised to ensure they get the right level of care.

• Care and support from professional care staff 24-hours a day
• Care home staff can supervise your loved one and ensure they stay safe
• Living with others enables your loved one to take part in social activities
• Visiting your loved one rather than caring for them allows you to enjoy time together without the added pressure
• As their family member, you can still provide support and influence their care

Many care homes specialise in dementia care and have dedicated dementia units for residents with Alzheimer’s and other forms of the condition. In addition to experienced staff, facilities at these care homes can include sensory rooms, memory cafes, reminiscence rooms, special lighting and more. They are exceptionally well equipped to provide long term care.

Who should make the decision?

Ideally, the person with dementia should make the decision to go into residential or nursing care themselves. They should always, as far as possible, be offered any help to do so.

However, sometimes this is not possible as people with dementia often lack the mental capacity to know what is in their best interests and to communicate this to others.

Also, they may not understand the implications and consequences of moving away from home or they do understand, they may not be able to make this known.

If your loved one lacks the ability to make decisions about their care on their own, having a Lasting Power of Attorney (LPA) in place can allow you to make these decisions for them. A Health and Welfare LPA allows you to decide when your loved one should move into a care home.

With a Property and Financial Affairs LPA in place, you can organise the move because you have the legal power to make financial decisions and pay for their care.

The decision to put someone in a care home usually happens in an emergency or at the very least at short notice. This can make the move more difficult as the added pressure of time constraints is a major factor. If you are short on time, you have less time to find a home that you are happy and feel comfortable with.

Even if it is difficult, planning in advance is advisable as it gives you the opportunity to involve your loved one as much as possible, even if they are unable to make the decision themselves when the day comes.

Regardless of who makes the decision, it has to be made in the person’s best interests and they should be involved in the process as much as possible.

Finding the right care home for someone with dementia

To find the best care home according to your loved one’s needs, the first thing to do is to request a needs assessment from your local council’s social services.

Your local authority will make recommendations about your loved one’s care. They will also conduct a financial assessment as they may contribute to some of the costs.

As mentioned earlier, planning in advance will make the choice of care home easier. It will mean you will have more information about your loved one’s preferences and wishes.

A residential care home will be able to provide personal care, such as washing and dressing. A nursing home has a qualified nurse on site 24-hours a day.

See our Finding a care home for someone with dementia article with tips and guidance to help you choose a setting that is right for your loved one. For advice on how to pay for your loved one’s care and how you can get help with care costs, read our Care home fees advice.

You can read about the costs of dementia care here.