The cost of living in a care home is likely to swallow up half the value of a family house, say researchers.

They found the bills for a typical stay in a home were likely to be between £50,000 and £93,000 – and that the total would mean a loss of between a fifth and a half of the value of an average house.

The estimates, for an insurance firm, measure a family’s loss from the inheritance they would otherwise have expected when an elderly relative needs to go into a care home.

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The cost of living in a care home is likely to range between £50,000 and £93,000 - up to half the value of an average home. Around 160,000 pensioners have to pay their own bills (file photo)

Around 160,000 people living in care homes have to pay their own bills, and in many cases their property is sold or pledged to meet the costs.

The sacrifice of a house is demanded of care residents who have assets or savings above £23,250 – a threshold that means all homeowners must pay their own care home bills.

The analysis for Royal London showed, on average, someone who goes into a care home lives there for two-and-a-half years, paying bills that vary from £554 a week in the North East to more than £700 in the South East.

In the North East, care home bills can cost as much as 56 per cent of the price of a home. But in London, where the average house price is almost £500,000, bills are only 17.9 per cent of a house

The price of that stay in an average home in the North East would take up 56 per cent of the value of a typical house. In the South East the price would be just under a third of the value of an average house.

Researchers said that in some cases residents live in care homes for longer periods, and one in ten stay for six-and-a-half years. Long-term residents are in many cases likely to spend the entire value of their house and more.

The estimates have been drawn up at a time when Theresa May’s government is struggling with the growing difficulty of paying for social care for rising numbers of older people.

Royal London’s Debbie Kennedy said: ‘These figures are a shocking reminder of the huge costs which growing numbers of us will face if we need residential care later in life … The whole system is a lottery and we need to find better ways of supporting people to cope with these large and unpredictable bills.’

Steve Webb, a former Liberal Democrat pensions minister, who now works for the insurance firm, said: ‘Successive governments have failed to grasp the nettle when it comes to care costs … The Government’s plans for yet another discussion document on social care later this year are far too slow.’

SOURCE: Steve Doughty, Daily Mail

Charity finds 'stark variation' in quality of care homes in England

Older people are victims of a postcode lottery when it comes to the quality of their care homes, with the North West being the worst performing region and London being the best performing, according to a new report.

The analysis, based on CQC inspections of care homes, by Independent Age, the older people’s charity, revealed that the North West contains seven of the eight worst performing English local authorities on care home quality, with one in three care homes across the region performing poorly.
In the North West, 33.6 per cent of care homes perform poorly, in Yorkshire and The Humber, it is 32.2 per cent and in the South East, it is 28.2 per cent.
The best performing regions are London with 20.3 per cent of care homes being rated highly by the CQC, the East of England with 20.8 per cent and the South West with 21.1 per cent.
Simon Bottery, director of policy at Independent Age, said: “No one should be forced to live in an unsatisfactory care home but our analysis shows this is the grim reality in some parts of the country.

“The market is simply not providing a decent choice for older people and their families but there is little indication that local authorities or the Government are giving the problem the attention it deserves.”
He believes the reasons for the poor quality homes are a lack of funding as well as low pay and difficulty in recruiting staff and the lack of a good support mechanism for improving care homes that are struggling.
“The Government has an opportunity to address this in its upcoming Green Paper on social care but, in the meantime, councils must demonstrate that they understand the reasons for care home failures and are working to resolve them,” he added.
The difference between various regions can be huge
Stockport, Salford, Tameside, Manchester and Kensington and Chelsea have over more than half of their care homes rated as Inadequate or Requires Improvement.
While in the Isles of Scilly, Islington, Rutland, Richmond upon Thames and Thurrock, less than five per cent of their homes are rated Inadequate or Requires Improvement.
In response to the report, Martin Green, chief executive of Care England, said it "clearly shows that in areas dominated by local authority funded care, the level of funding is having a significant impact on quality".

However, Caroline Abrahams, charity director at Age UK said that lack of funding cannot be used to excuse poor quality care and added: “It is horrible to think that in some areas the choices are so limited.
“This is a frightening situation for older people and their families who above all want their loved one to be somewhere caring and safe – and this really shouldn’t be too much to ask in an advanced economy in the twenty first century.
“In the worst affected areas the social care infrastructure is now so threadbare that there's a real risk of vulnerable older people and their desperate relatives waiting endlessly for a good and affordable local care home place that no longer exists.”
Independent Age wants the Government to tackle variation in care home quality in its forthcoming Green Paper on social care.

In addition, it wants local authorities to look at the drivers for variation in the different areas.
Independent Age offers a free advice guide, ‘How to find the right care home’. The guide looks at what to consider and essential questions like location and cost, what you want from a home and whether a care home is actually the best option.

SOURCE: carehome.co.uk, Sue Learner

How to interact with someone who has dementia

Family members and caregivers often have a very difficult time communicating with someone with dementia. Many times, miscommunication actually creates negative behaviors. It is important to remember that people who have dementia are not being deliberately difficult. They can be reacting to stress or a frustrated attempt to communicate with you. If you don’t know how to connect and communicate with them, frustration will affect you as a caregiver and in them. It is our job to provide comfort and to learn how to connect with each person we meet who has any type of cognitive decline.

Dementia robs the person of speech, dignity and so much more. We will add more to their list of losses if we do not know how to communicate and connect.

As caregivers, we must step into their world of dementia. Pulling them into our reality will only create mistrust and potential behaviors. One common mistake is in handling a resident who continuously asks for his mother. If we tell him his mother is dead, we make him angry, depressed, upset and mistrustful. However, if we step into the dementia world instead and say, “Your mother called, and she will be here at 6:00 this evening,” this proves to cause less stress and makes them more comfortable.

I have had many people tell me that they could not possibly “lie” to the person. My response is, “This is not about you. It’s about the resident.” When that response is finally absorbed, staff and even family members become more connected and at ease. The resident may continue to ask this question 20 times a day, but when everyone provides the same answer, the resident can move on and have a better day, participating in activities and interacting with others.

Tips to improve communication

·         Create a calm environment. Take things slowly and smile whenever possible. If the resident seems upset, show care and concern.

·         The tone of your voice and your facial expression are very important, since residents pick up on nonverbal cues easily. Try not to over-react to a situation.

·         Always assume residents can understand what you are saying. Never talk about the person as though he/she is not present. If you do, a behavior could occur and then you have more issues to deal with.

·         Avoid quizzing the person on names and dates. Not knowing the answer can be very embarrassing for them. This quizzing also can increase distrust and the belief that you are “testing” them. Often when we give a cue, the confused person can answer.

·         Draw their attention by providing a gentle, reassuring touch on an arm or shoulder, or by holding hands. When you provide touch, you demonstrate security, a caring nature and your compassion.

·         Get down on their level—sit next to them, bend down or kneel down so you are not hovering over them.

·         Try lowering the pitch of your voice. Do not shout but deepen your voice as it appears easier for them to understand.

·         Make eye contact and slow down. Do not talk too fast and do not rush them. This in itself will create a behavior.

·         Observe the resident’s body language and imagine what he/she might be feeling or trying to express. Is she hungry, tired or in pain?

Using interactions to preserve dignity

·         Be reassuring but never be condescending. Praise their actions but do not patronize. Appeal to their sense of humor—but never laugh “at” them.

·         Do not argue or correct their “facts.”

·         Do not speak for them. So often, this occurs due to time constraints or with family present. However, if we always speak for them, they will eventually cease speaking altogether.

·         Give them adequate time to respond. Dementia can slow down response time and being rushed through a response or choice just causes additional frustration.

·         Do not do everything for them. If they need assistance with activities of daily living, find a way to keep them involved in the process. For example, if they can no longer dress themselves, let them point to the clothes they want to wear. I do not recommend showing an entire closet, but perhaps two articles of clothing that they can even point to. This offers them choices and provides the feeling of having some control over their lives.

·         Tell the resident it is time for her shower instead of asking if she wants to take one. Many times, you will get a negative answer if you ask a yes/no question. Be sure to have everything ready for the shower or bath though ahead of time.

·         Do not treat them like children or as if they are stupid. Giving them respect is crucial to a successful connection.

·         If they become angry, do not respond with anger. Be calm and try to get them involved in something they enjoy, like music, a change of environment or a snack.

·         Take the time to listen to them even if you cannot understand them. They still have something to say, and they still want to express themselves and be heard. As dementia progresses, speech becomes more and more difficult to understand.

We often chastise the negative behaviors from those with dementia. In all actuality, we are the ones instigating many of their frustrations and behaviors. If we learn to step into the world of dementia and remember that our residents only live “in the moment,” quality of life and care will increase for them every day. Those days of frustration for you as a caregiver will be minimal.

SOURCE:iadvanceseniorcare, Diane Mockbee

Maybe 'living in the moment' is something we should all think about doing as we miss so much of what is present in our daily lives and going unnoticed. Taking more time to listen, even when communication is really difficult and frustrating for all concerned, allowing someone the time they need without being pressured is essential. Learning to see things from their point of view is surely the way forward in improving interaction.

Lack of exercise might invite dementia

Parking yourself in front of the TV may make you as likely to develop dementia as people genetically predisposed to the condition, a Canadian study suggests.

In a study of more than 1,600 adults aged 65 and older, those who led a sedentary life seemed to have the same risk of developing dementia as those who carried the apolipoprotein E (APOE) gene mutation, which increases the chances of developing dementia.

Conversely, people who exercised appeared to have lower odds of developing dementia than those who didn't, the five-year study found.

"Being inactive may completely negate the protective effects of a healthy set of genes," said lead researcher Jennifer Heisz, an assistant professor in the department of kinesiology at McMaster University in Hamilton, Ontario.

However, the study didn't prove that lack of exercise caused dementia risk to increase. It only found an association between the two.

The APOE mutation is the strongest genetic risk factor for vascular dementia, Lewy body dementia, Parkinson's disease and, especially, Alzheimer's disease, the researchers said.

People with a single APOE "allele" may have a three to four times increased risk of dementia than non-carriers, the study authors said.

How exercise may reduce the risk for dementia isn't known, Heisz said.

These study results, however, suggest that your physical activity level can influence your dementia risk as much as your genetics, Heisz said. "You can't change your genes, but you can change your lifestyle," she added.

The kind of exercise that's best isn't known, although the people who were physically active in the study reported walking three times a week, Heisz said.

"Which means you don't have to train like an Olympian to get the brain health benefits of being physically active," she said.

The report was published Jan. 10 in the Journal of Alzheimer's Disease.

Dr. Sam Gandy directs the Center for Cognitive Health at Mount Sinai Hospital in New York City. He said the study findings aren't "really a surprise, but it is good to see it proven."

Other scientists showed some years ago that people with the APOE mutation could virtually erase the risk of developing amyloid plaques in the brain if they became regular runners, Gandy said. Amyloid plaques are one of the hallmark signs of Alzheimer's.

"That was an amazing report that, I believe, has been underpublicized," Gandy said.

However, this new study suggests that if you are blessed with genes that lower your risk for Alzheimer's, you could lose that benefit if you don't exercise, he said.

"I cannot understand why the fear of dementia is not sufficient to induce everyone to adopt a regular exercise program," Gandy said.

"I tell all my patients that if they leave with one, and only one, piece of advice, that the one thing that they can do to reduce their risk of dementia or slow the progression of dementia is to exercise," he said.

About 47.5 million people around the world are living with dementia, the researchers said, and that number is expected to surge to 115 million by 2050. With no known cure, there's an urgent need to explore, identify and change lifestyle factors that can reduce dementia risk, the study authors said.

SOURCE: Steven Reinberg, wflx.com

How to Help a Parent That is Refusing Elder Care

One of the most heartbreaking things that adult children deal with is an aging parent that refuses in-home care. Not only is it heartbreaking, but it can also be the most frustrating. You’ve heard these stories before. Mom claims she doesn’t need help bathing and dressing, even though she struggles to do it herself. Dad doesn’t want anyone driving him to his appointments even though the doctor recommended it.

You know your parent needs help, but how do you help a resistant loved one get the personalized elder care that they need? On one hand, you don’t want to force the issue until they completely shut down, and on the other, you’re worried that something might happen if they don’t.

Freedom Home Care, Highland Park’s in home care agency, knows that this is a difficult situation. Fortunately, there are a few things our home care experts suggest that could be helpful in starting the conversation with your senior about outside care in a way that feels right to them:

Help Can Be Empowering

Many times older loved ones feel like accepting care diminishes their own power. But if you’re able to help them see that a little help around the house actually frees them up to do more of the things they love, then there’s a good chance they won’t feel like there’s a decrease in personal power.

Figure Out Their Motivation

Boston-based Geriatric care manager, Suzanne Modigliani says to try to determine what’s motivating your mom or dad’s behavior. Is this just a habit they’re displaying? Perhaps there’s a larger underlying issue.  Could it just be a fear they’re expressing?

Try To Put Yourself in Their Shoes

Another thing experts recommend is thinking about how it might feel if you thought you were going to lose your independence. Would you also be inclined to push back and resist change? Seeking to understand where they’re coming from allows you to approach the situation with a little more empathy toward your parent.

Listen to Their Concerns

Set aside a day to join your loved one in doing something they like to do. While you’re enjoying the moment and everyone’s defenses are down, ask your mom or dad what concerns them most about aging. This not only helps break the ice, but it also gives you more insight into how your loved one feels about care giving.

Utilize Your Resources

Research different agencies that offer help for adult children with aging parents. An organization like the Area Agency on Aging has trained elder advisers that can help you locate the resources in order to best serve your loved one. These agencies are also there to remind you that you’re not in this alone.

Is This a Battle Worth Fighting?

Donna Cohen, Ph.D. a clinical psychologist and author of “The Loss of Self: A Family Resource for the Care of Alzheimer’s Disease and Related Disorders” says to pick your battles. If your parent is not at risk of endangering themselves or anyone else, allow them to make certain decisions about their life. They may in some ways still be capable of taking care of themselves. Make time to sit down with them and decide what those things are.

 SOURCE: Freedomhomecare

Some really helpful points to consider in this.It can be really difficult to put yourself in someone elses shoes especially when emotion is involved.

Taking part in academic research empowers residents with dementia and 'gives them a sense of purpose'

The role of dementia research and how it is borne out in reality can be a contentious issue, with some experts believing that it does little to benefit people currently living with dementia. But participating in projects can actually enhance the wellbeing of care home residents.

Professor Mary Marshall, a senior consultant with HammondCare, writes and lectures in dementia care and is dubious of exactly how effective dementia research is at present.

Expressing the issues she has around the topic at the UK Dementia Congress in November, she told congress attendees that she is “a bit depressed about it,” adding: “I’ve become really unhappy about the rhetoric of evidence-based and the reality of expediency.

“There’s got to be more than research, there’s got to be a campaign or something as well.”

Yet there are ongoing partnerships between care homes and academic institutions where those affected by dementia are directly involved in research and contribute by providing first-hand evidence and experiences.

These partnerships provide a wealth of benefits for residents and care teams alike. Getting involved in research can provide additional stimulation for residents as they take part in new activities and talk to new people.

It also gives residents a sense of purpose and self-worth, helping them to feel like they are contributing to their future as well as the next generation, while staff gain additional training and an increase in job satisfaction, thereby creating an encouraging atmosphere of excellence and improvement.

‘Their experiences are what really matters’

The University of Worcester’s Association of Dementia Studies (ADS) carries out research to improve the lives of those with dementia by involving people with dementia, care workers and families directly in their projects.

Isabelle Latham, a PhD student and senior lecturer at ADS, explained: “Their experiences are what really matters when we wish to discover what affects people’s experiences, quality of life and care in care settings.”

Despite complex and in-depth ethical processes, ADS makes every effort to involve people living with advanced dementia, particularly if they are unable to be involved in more conventional research projects.

Ms Latham added: “We do this because it is important that their perspective is also considered in any findings.

“[Previous projects] have used observations of people’s daily lives and care experience to try and capture their point of view even though a person may have limited verbal communication.”

‘Outsiders’ help care home staff reflect better

While contributing to research, care home staff reap the benefits of participating in often ground-breaking projects, allowing them to provide better care for residents living with dementia.

Ms Latham said: “In our experience, care homes, staff, families and people living in care homes are very positive about the impact of taking part in research, reflecting that it can feel empowering to be able to share experiences and opinions with others and know it may make a difference in the future.

“They often report that it increases their reflective abilities about the care they provide and that having ‘outside’ researchers coming into the home or discussing an aspect of care can help them think about changes they can make.”

Care homes, researchers and families can find information about ongoing and upcoming projects via Enabling Research In Care Homes (ENRICH), a National Institute for Health Research (NIHR) toolkit which provides information and networks for those involved or who wish to be involved in research.

The Orders of St John Care Trust (OSJCT) has been part of the ENRICH Research Ready Care Homes Network for three years. The network brings together care home staff, residents and researchers to facilitate the design and delivery of research, with the hope of improving the quality of life for residents.

Victoria Elliot, principal care consultant for OSJCT, said the group became part of the network because they are passionate about research and helping their residents and thought it would be a “positive experience” for them.

While the research they are involved in doesn’t always directly impact residents’ lives, it certainly enhances their general well-being.

‘For the greater good’

Ms Elliot explained: “They feel like they’re helping someone else, future generations, and it gives them a sense of purpose.

“They know that they’re doing some good that will benefit people in the future. They’re doing it for the greater good.”

She also noted that participating in research projects helps to counteract negative press that the social care sector often receives by improving staff morale.

She added: “They’re proud of the work they do and being involved in the research helps to reinforce this pride.”

Anna Hicks, a roaming home manager for OSJCT, took part in a five-year programme, WHELD (Improving Wellbeing for Health for People with Dementia), which assessed the most effective therapies to reduce the prescription of antipsychotic drugs and improve mental health and quality of life for people with dementia.

Taking part in this research not only benefitted staff and residents, but also inspired her to initiate new projects and innovations in the home to help those living with dementia.

She told ENRICH: “It was so successful that I started a dementia café, a knock-on benefit from the project. I also developed a ‘getting to know you’ process where every single member of staff now spends 10 to 15 minutes, once a week with a different resident – that includes the cooks, domestics and me.

“I felt my staff got a lot out of it – because now they understand much more about dementia and look at residents’ reactions in a different light.”

‘As academics, keep shouting’

Despite the positive outcomes for care homes collaborating with academic institutions, there remains the issue of disseminating findings and spreading awareness of the results to other care homes which have not participated in research.

This is an important issue at the Association for Dementia Studies because they “aim to make a difference to the lives of people living with dementia and their carers.”

Ms Latham explained: “We ensure that our research reports are available to the public via our website, we run free events to share the findings from our different projects and we integrate our latest evidence from research into the teaching and education programmes we offer.

“However, care homes, their staff and visitors are very busy and as such, I think we always need to work hard to make sure research findings are easy and simple to find out about and apply to practice.”

Dave Bell, an Admiral Nurse who works for Admiral Nursing Direct, the national dementia helpline, highlighted the importance of spreading awareness of dementia research.

He said: “People do want to be involved in research. We get questions: ‘How can I get into a drugs trial?’ or something like that.

“Evidence-based for us as nurses is really important but it often gets presented at conferences and we say ‘oh that’s interesting’ and then we carry on doing what we’re doing.

“So keep shouting, as academics, keep shouting because it’s really important to get through to us as nurses and other practitioners.”

SOURCE: carehome.co.uk, Charley Walker

Lack of exercise might invite dementia

Parking yourself in front of the TV may make you as likely to develop dementia as people genetically predisposed to the condition, a Canadian study suggests.

In a study of more than 1,600 adults aged 65 and older, those who led a sedentary life seemed to have the same risk of developing dementia as those who carried the apolipoprotein E (APOE) gene mutation, which increases the chances of developing dementia.

Conversely, people who exercised appeared to have lower odds of developing dementia than those who didn't, the five-year study found.

"Being inactive may completely negate the protective effects of a healthy set of genes," said lead researcher Jennifer Heisz, an assistant professor in the department of kinesiology at McMaster University in Hamilton, Ontario.

However, the study didn't prove that lack of exercise caused dementia risk to increase. It only found an association between the two.

The APOE mutation is the strongest genetic risk factor for vascular dementia, Lewy body dementia, Parkinson's disease and, especially, Alzheimer's disease, the researchers said.

People with a single APOE "allele" may have a three to four times increased risk of dementia than non-carriers, the study authors said.

How exercise may reduce the risk for dementia isn't known, Heisz said.

These study results, however, suggest that your physical activity level can influence your dementia risk as much as your genetics, Heisz said. "You can't change your genes, but you can change your lifestyle," she added.

The kind of exercise that's best isn't known, although the people who were physically active in the study reported walking three times a week, Heisz said.

"Which means you don't have to train like an Olympian to get the brain health benefits of being physically active," she said.

The report was published Jan. 10 in the Journal of Alzheimer's Disease.

Dr. Sam Gandy directs the Center for Cognitive Health at Mount Sinai Hospital in New York City. He said the study findings aren't "really a surprise, but it is good to see it proven."

Other scientists showed some years ago that people with the APOE mutation could virtually erase the risk of developing amyloid plaques in the brain if they became regular runners, Gandy said. Amyloid plaques are one of the hallmark signs of Alzheimer's.

"That was an amazing report that, I believe, has been underpublicized," Gandy said.

However, this new study suggests that if you are blessed with genes that lower your risk for Alzheimer's, you could lose that benefit if you don't exercise, he said.

"I cannot understand why the fear of dementia is not sufficient to induce everyone to adopt a regular exercise program," Gandy said.

"I tell all my patients that if they leave with one, and only one, piece of advice, that the one thing that they can do to reduce their risk of dementia or slow the progression of dementia is to exercise," he said.

About 47.5 million people around the world are living with dementia, the researchers said, and that number is expected to surge to 115 million by 2050. With no known cure, there's an urgent need to explore, identify and change lifestyle factors that can reduce dementia risk, the study authors said.

SOURCE: Steven Reinberg, wflx.com

Dementia patients should be fitted with GPS trackers to find them within seconds of going missing, expert claims

Professor June Andrews, OBE, is adamant the chip under their skin could save many families the anxiety and distress if their relative goes missing

Gadgets of this kind are inserted underneath the skin and are used in some countries but not currently in the UK.

Professor Andrews, who has written numerous books on dementia, has since signed over her power of attorney to her daughter for when the 'time comes'.

She said: 'A huge amount of family anxiety is caused when someone goes missing, to the person and the family.

'A huge amount of police money is spent on it and in many ways it’s actually wasted time.

'The devices can also alert you if the person stops moving for a long time. You can have a movement sensor into it. 

'If someone bumps into something or falls over, it alerts you. They are getting more and more sophisticated.' 

Professor Andrews, who now works independently to improve the lives of people with dementia, is in favour of subcutaneous trackers (stock)

There is a growing economy of elderly tracking and tagging devices, from pocket GPS trackers to wearable soles.

The increasingly popular gadgets can be bought online for as little as £40 and require a battery and mobile phone SIM card. 

But critics have previously responded in fury to the tracking device suggestions, calling for the 'human rights' of each person to be 'thoroughly considered'. 

However, Professor Andrews hit back at the claims. She said: 'We know there’s a news story that says, old people are being tagged like criminals.

'The general, sensible response to that is, actually it’s better than being hunted like a dog.'

It is estimated that more than 60 per cent of people living with dementia can at some point start to wander off.

The disease, which affects around 850,000 people in the UK and more than 35 million worldwide, can cause disorientation. 

Dr Hilda Hayo, chief executive at Dementia UK said: 'We believe the use of GPS tracking systems can in some situations be useful to safeguard a vulnerable person, but must only be implemented on a case by case basis. 

'The decision to use GPS technology should be based on the best interests of the person’s safety and ideally having gained their consent. 

'Dementia UK stresses that there are civil liberties and ethical issues to take into account when monitoring an individual’s movements, which must be balanced against the significant harm that may come to them. 

'Their human rights, including their best interests and consent, or that of their carers, should be thoroughly considered.'

ARE TRACKING DEVICES ALREADY USED IN BRITAIN?

Many tracking device schemes are already underway across Britain, including one announced last week by the Metropolitan Police.

It said it was behind vulnerable patients wearing the state-of-the-art technology as a necklace, bracelet or key ring to locate them within seconds.

Sussex Police became the first force to fit patients with GPS tracking devices in 2013, making the move to try and save time and money when they go missing.

While a similar scheme announced by Hampshire County Council last year has proven to be a success.

The number of missing person episodes in this region of the country for people fitted with the trackers has more than halved, figures show.   

In Japan, health officials in one city have gone one step further and allowed people to add barcodes to the thumbnails and toenails of dementia patients.

These record their name, address and who to contact in case they are found walking the streets disorientated by police.  

SOURCE: MailOnline, Stephen Matthews