‘The time has come’: reflections on the ‘tipping point’ in deciding on a care home move

Abstract

Objectives

Often perceived as a last resort, a care home move for a person living with dementia is often undertaken when all other options have been exhausted. Deciding the right or optimal time is to move remains an important question for many families.

To investigate factors that are weighed up in deciding to make a care home move.

Method

Qualitative in-depth interviews with 21 family carers and 5 care home residents living with dementia in England. Thematic analysis was applied to all transcripts to extract key themes and sub-themes; a summation is provided here.

Results

Participants emotionally recollected an accumulation of stressors, exhausting other options of care, a risk/benefit analysis, wishes of person living with dementia, and a readiness to move as indicators of when a ‘tipping point’ was reached. They also felt strongly that early planning, prior experience of care homes, understanding funding arrangements and having support with decision-making would help.

Conclusion

Deciding to move to a care home is complex, contextual and deeply personal. Early planning in the form of joining waiting lists, using day centres and respite services may help in creating relationships with intended care homes for the future. There is growing need for support with financial advice and funding arrangements, for both self- and publicly funded individuals.

Keywords:

• Dementia
• care home move
• optimal timing
• qualitative

Acknowledgements and disclaimer

We thank participants in this study, members of the Study Advisory Group for their time and contributions, and Professor Steve Iliffe for commenting on a previous draft of the paper. This paper reports independent research funded by the National Institute for Health Research (NIHR) School for Social Care Research (SSCR). The views expressed in this publication are those of the authors and not necessarily those of the NIHR SSCR, the NHS, the NIHR or the Department of Health and Social Care.

Disclosure of interest

The authors report no conflict of interest.

Additional information

Funding

This study was funded by the National Institute for Health Research School for Social Care Research.