The Types of Care

• Washing: this includes bathing, showering and transferring into the bath and shower.
  
  
• Dressing: this includes undressing and may include braces, artificial limbs and surgical appliances.
  
  
• Mobility: moving from room to room, and into gardens, etc..
  
  
• Transferring: this includes moving from a bed to a chair, wheelchair or commode, etc., and vice versa.
  
  
• Feeding: partaking of prepared foods.
  
  
• Toileting: this can include replacing protective undergarments or surgical appliances.
  
  
• Limited Medical Assistance: such as following prepared prescriptions for medicines and assistance with basic dressings.

2. Nursing Care

Nursing care provides medical care via a registered nurse, as well as personal care. There is financial help towards the cost of nursing care for those medically eligible, even if via an otherwise privately funded home. Nursing care can vary enormously; however, utilising the prior Registered Nursing Care
Contribution (RNCC) bandings may be useful for personal assessment. There were four levels of
assessed nursing need for NHS funding purposes, the first three of which received RNCC (which is now one contribution across all first three levels), and the last one still applicable to fully funded nursing care.

The nursing bands are as follows:-

• Low Need
  
  
• Medium Need
  
  
• High Need
  
  
• Primary Need
  

A. Low Need

Low need care is deemed to be needed by people who require minimal medical care and attention by a registered nurse.

B. Medium Need

Medium need care is deemed to be required by people with multiple medical needs who need at least daily attention from a registered nurse. The person's physical and/or mental state is likely to be stable.

C. High Need

High need care involves complex and/or frequent attention from a registered nurse throughout a 24 hour period. The person's physical and/or mental state is likely to be unstable or unpredictable.

D. Primary Need

Primary need care involves 'continuous and intense' medical attention by a registered nurse. It can be a small step from limited medical assistance under personal care, to low level nursing care, and from High Need Nursing Care to Primary Need, with major potential financial consequences, as we will see.

EMI Care

EMI (Elderly Mental Ill) Care, is a specialised form of care which deals with dementia and other mental illnesses. The care given is tailored to the person's mental condition, needs specialised training and has added security and safety measures. EMI care can be with or without nursing.

II. The Location of Care

1. Care at Home

This is known as ‘domiciliary care.’ Care at home is often the first choice, as it has familiar
surroundings, the spouse or partner may be at hand and it is often easier for the family to visit.
Both personal carers and registered nurses can visit. However, when dependency is high for
personal and/or nursing care, residential care is usually necessary. Care at home can cost the same, less or more than residential care - dependent on how much care is needed. Full-time care at home can cost at least as much as residential care, as it involves at least one professional carer - whose salary is solely paid by the care fees of the recipient, as well as the operating costs and profits of the care provider (company).

2. Retirement Accommodation

Retirement accommodation comes in many forms, but its common denominator is (or should be) accommodation with a warden or other officer close at hand in case of an emergency. This includes sheltered accommodation, extra care housing, assisted living, very sheltered housing, close and continuing care environments, and care villages. These terms are often fluid and used differently by various organisations and authorities. Care is not usually provided with basic retirement accommodation, and if needed will have to be arranged separately – whether personal and/or nursing. However, care is provided to various levels with more intense retirement accommodation facilities. www.extracarehousing.org.uk is a useful site for retirement accommodation information and links.

3. Residential Care

Residential care is usually the final destination for those who survive through domiciliary care and/or
retirement accommodation, as a point is reached in which the appropriate level of care cannot be
provided within the domestic home or the various forms of retirement accommodation, and is often
the first location of professional care. Both personal and nursing care can be provided within the ‘safe’ environment of a purpose built or adapted accommodation, and with carers close at hand at all times. Residential care homes are typically known as ‘care homes,’‘ residential homes’ or ‘nursing homes,’ but are officially titled ‘care homes without nursing care’ and ‘care homes registered to provide nursing care’ respectively.

III. Temporary Care

There are three common types of temporary care, which we will touch on briefly:-

1. Intermediate Care
2. Respite Care
3. Trial Care

1. Intermediate Care

Intermediate care is temporary residential care, which is usually in place of an ‘unnecessary’ stay in a hospital. It may be to stop someone going into hospital, or to send them to after hospital treatment. It should be part of a comprehensive plan designed to assist recovery and independence, and be no longer than six weeks.

2. Respite Care

3. Trial Care

Trial care is temporary care to see if the person will want or be able to live in a care home.

IV. The Costs of Residential Care

Care costs, as most of us are aware, are not cheap. Average weekly prices for private care homes (which are much less than this adviser has experienced) are reported as follows:-

Source: A-Z Care Home Guide 2008