Is a Care Home the Only Option? Exploring Care at Home

When an older parent or loved one begins to need more support, moving into a care home can sometimes feel like the natural next step.

Perhaps they are struggling to manage alone. Maybe family members have been providing more and more support and are beginning to feel exhausted. Or a fall, hospital stay or change in health has made you question whether living at home is still realistic.

In these situations, it is easy to assume there are only two choices: continue managing as you are, or move into residential care.

But there may be other options. In this episode of The Care Podcast, Jo Cleary speaks with Stacey, Client Experience Manager at Unique Senior Care, about the different ways care can be provided at home, why loneliness does not necessarily mean someone needs residential care and how the right support can often help a person remain in familiar surroundings.

Why can a care home feel like the only option?

Families rarely begin thinking about care because everything is going well. Usually, something has changed.

An older parent may be finding everyday tasks more difficult. They may have experienced a fall, become less confident going out or started relying heavily on a son, daughter or partner. Sometimes the family member providing support gradually takes on more and more responsibility without realising how much their own life has changed.

They may be helping with:

• Shopping and preparing meals
• Medication
• Washing and dressing
• Housework
• Appointments
• Getting in and out of bed
• Providing companionship
• Checking that their loved one is safe

Over time, this can become difficult to sustain alongside work, children, relationships and other responsibilities. At that point, residential care may seem like the only way to make sure the person has enough support.

However, before making that decision, it can help to understand the different types of home care services that may be available.

Can someone move home after going into a care home?

In the podcast, Stacey shares the story of a family who found themselves in exactly this situation. A mother had decided to move into a care home because her daughter had become her main carer. Her daughter was exhausted and trying to balance caring for her mum with her own family and responsibilities.

The mother felt that moving into residential care would give her daughter her life back. But once she moved, things did not work out as the family had hoped.

Her daughter noticed that her mum's mental wellbeing appeared to be declining. She was unhappy and lonely and wanted to return to her own home, surrounded by her belongings and familiar memories.

The daughter began researching other possibilities and discovered that support could be provided at home. Following conversations about what her mum needed, care was arranged that enabled her to leave the care home and return home with Caregivers supporting her on a daily basis.

Stacey describes a significant improvement in her wellbeing once she was back among her own belongings, photographs and familiar surroundings. Importantly, the arrangement also supported her daughter. Rather than every visit being centred around providing care, she could spend time with her mum as her daughter again.

Is residential care sometimes the right choice?

Yes. The message of the podcast is not that residential care is wrong or that everyone should remain at home.

For some people, a care home may be the most appropriate setting and provide the level of support, security and community they need. The important point is that it should not automatically be viewed as the only option.

Every person's circumstances are different. Their health, mobility, home environment, family support, finances, preferences and safety all need to be considered. Before deciding, it can help to ask a simple question:

What support would this person need to live safely and happily at home?

Once you understand that, you can begin comparing it with the other options available.

Could loneliness be influencing the decision?

One of the most important points Stacey raises in the episode is loneliness. Someone living alone may begin to believe that moving into a care home will automatically solve the problem because they will be surrounded by other people.

But being around people and feeling connected are not necessarily the same thing. Stacey explains that sometimes what a person really needs is regular companionship and someone who can help them continue doing the things they enjoy.

That could mean having someone to:

• Share a cup of tea and conversation with
• Go for a walk
• Visit the shops
• Attend appointments
• Continue hobbies and interests
• Visit friends or community groups
• Prepare and enjoy meals together
• Simply provide regular company

For someone who is otherwise managing well, companionship care may provide the social contact they are missing without requiring them to leave their home.

Loneliness should be taken seriously, but it is worth understanding what is causing it before deciding that moving home is the only solution.

What alternatives to a care home are available?

Home care does not describe one single type of support. It can range from occasional visits through to somebody living in the person's home and providing ongoing support.

The right arrangement depends on what the individual needs.

Visiting care

Visiting care involves a Caregiver visiting at agreed times to provide support. For one person, that might mean a little help in the morning. Someone else may benefit from several visits throughout the day.

Care can include support with:

• Getting washed and dressed
• Preparing meals
• Medication
• Shopping
• Household tasks
• Getting out and about
• Personal care
• Companionship

Visiting care can be particularly useful when someone can still spend periods of time safely on their own but needs support with particular parts of their day.

Live-in care

When someone needs more regular support, live-in care may be another option. A Caregiver lives in the person's home and provides support around their routines and needs.

For some families, live-in care provides an alternative to residential care because the person can remain in familiar surroundings while having somebody nearby for much of the day.

This can be particularly important to someone who values their routines, neighbourhood, belongings or pets. It can also provide reassurance for family members who are worried about their loved one spending long periods alone.

Respite care

Sometimes a family does not need a permanent change but does need additional support for a period of time. Respite care can give a family carer a break or provide additional support following an illness, hospital stay or change in circumstances.

It may also provide an opportunity to see how additional care works before making longer-term decisions.

Think about what your loved one would be leaving behind

Choosing care is not only about the number of hours of support somebody needs. Home has an emotional importance too. It may contain decades of memories, familiar furniture, photographs, neighbours, routines and belongings. There may also be a much-loved pet.

In the podcast, Stacey encourages families to think about these everyday parts of life when considering different care arrangements.

Ask your loved one what matters most to them.

It might be:

• Sleeping in their own bed
• Keeping their usual morning routine
• Living with their dog or cat
• Seeing familiar neighbours
• Remaining close to friends
• Continuing to visit a local club or community group
• Spending time in their garden
• Having their own possessions around them

These things may appear small when compared with practical care needs, but they can have a significant effect on someone's quality of life.

Care at home can support the whole family

Care decisions often focus understandably on the person who needs support. But their family may need support too.

When a son, daughter or partner becomes the main carer, the relationship can gradually change. Visits that were once spent talking, having lunch or enjoying time together can become dominated by practical tasks. There may always be shopping to do, medication to organise, meals to prepare or another appointment to arrange.

Over time, family members can become exhausted. Introducing professional care does not mean that the family is stepping away. In some situations, it allows them to return to being a husband, wife, son or daughter rather than feeling responsible for every aspect of care.

You may find our guidance on respite care useful if caring responsibilities are becoming difficult to manage.

How do you know how much home care is needed?

This is not always something a family can determine alone. You may know that your parent needs some support but have no idea whether that means one visit each day, several visits or more continuous care.

That is where an assessment or home care consultation can help. A Care Manager can look at the person's circumstances, understand what they can manage independently and discuss where support may be needed.

The aim should not be to provide as much care as possible. It should be to identify the right amount of support for that individual. Sometimes that may mean starting with fewer hours and increasing care later if needs change. In other circumstances, the family may be underestimating how much support is needed.

What happens if the care a family asks for is not enough?

Stacey gives an example in the podcast of someone returning home from hospital after a fall and fracture. The family might initially request a Caregiver in the morning to help the person get up and another visit in the evening to help them get into bed.

On paper, that may sound reasonable. However, if the person is very unsteady and at high risk of another fall, it would leave them alone for many hours during the day. If a Care Manager believed that arrangement was unsafe, Stacey explains that they would be honest with the family. They might recommend additional care or a period of live-in respite care while the person recovers.

This is an important part of choosing the right support. A good care provider should listen carefully to what you and your loved one want, but they should also be prepared to explain when they believe a proposed arrangement may create unnecessary risks.

What if the recommended care is unaffordable?

Cost inevitably plays a role in care decisions. A family may recognise that their loved one would benefit from more support but simply not have the budget to provide professional care throughout the entire day.

That does not necessarily mean the conversation ends there. Stacey explains that families can look at the wider picture and consider what other support might be available.

For example:

• Could another family member visit at certain times?
• Could professional care be focused on the highest-risk parts of the day?
• Would a falls alarm or pendant provide additional reassurance?
• Could neighbours or friends provide some social contact?
• Could the care arrangement change as the person's needs change?

Our home care cost calculator can give you an indication of what different levels of support may cost.

The important thing is to be open about your circumstances. A care provider cannot promise that every arrangement will be safe or appropriate, but they should be willing to discuss the options available.

Questions to ask before deciding on a care home

If you or a loved one are beginning to consider residential care, it can help to explore the decision from several angles before deciding what happens next.

You might ask:

• Why are we considering a care home?
• What is becoming difficult at home?
• Is loneliness part of the problem?
• How much support does my loved one actually need?
• Could visiting care provide enough help?
• Would live-in care be appropriate?
• Could respite care help in the short term?
• What does my loved one want?
• What routines, relationships or belongings are important to them?
• What would make staying at home unsafe?
• What can the family realistically continue to provide?
• What would the different options cost?

You do not need to answer all of these questions yourself. Speaking to a care professional can help you understand what is realistic and identify options you may not have considered.

Our guide to home care in the UK is also a useful starting point if you are unfamiliar with how care at home works.

Keep your loved one at the centre of the decision

Family members often begin looking at care because they are worried about someone they love. However, wherever possible, the person receiving care should remain involved in deciding what happens next.

Ask them:

• Where would you prefer to live?
• What are you finding difficult at the moment?
• What would you accept help with?
• What would you prefer to continue doing yourself?
• What worries you about receiving care at home?
• What worries you about moving into a care home?
• What matters most to you about your everyday life?

Their answers may be different from what the family expects.

Our guidance on having care conversations with elderly parents may help if you are unsure how to begin the discussion.

Be realistic about safety

Supporting someone to remain at home should never mean ignoring genuine risks. There may be circumstances where the person's needs have become too complex for the arrangement being considered.

Falls, mobility, medication, cognitive changes and the person's ability to call for help all need to be taken seriously. The goal is not to keep someone at home at any cost. It is to understand whether their needs can be met safely at home and, if they can, what support needs to be in place.

This is why professional assessment can be valuable. It can provide an outside perspective when family members are understandably emotionally involved in the decision.

Do your research before making a final decision

Stacey's final advice in the episode is simple: keep an open mind, research the options and speak to people who can help. Making an enquiry about home care does not commit you to anything.

You may discover that a small amount of visiting care would provide enough support. You might decide that live-in care is worth considering. Or, after exploring the alternatives, you may conclude that a care home genuinely is the right choice.

What matters is that the decision is informed. If possible, begin exploring care before circumstances reach crisis point. This gives your loved one more opportunity to be involved and gives the family time to understand the choices available.

A care home is one option, not the only option

There is no single care arrangement that is right for everyone. For some people, residential care provides exactly the environment and support they need. For others, the right combination of visiting care, companionship, live-in care, family involvement and other support may allow them to continue living safely and independently at home.

The important thing is not to assume that needing more help automatically means leaving home. Understand what has changed. Talk openly with your loved one. Consider the risks as well as the things that matter to them. Then explore what support could realistically be put in place.

Sometimes the answer will be residential care. Sometimes, as Stacey's story shows, there may be a way home.

Continuing the conversation

If you're navigating the care journey, you may find it helpful to explore more episodes of The Care Podcast, where families and care professionals speak honestly about the realities of care.

If you are thinking about support for yourself or someone you love, our team is here to talk things through. Helping families make sense of care is what we do.

You may also find our Care Advice Hub useful, where we share practical guidance for families at every stage of their care journey.