Most of us just think of homes under one umbrella, old peoples homes, how wrong we can be. I did not realise there were two types until I got involved in choosing a suitable home for my Mum. Care homes, also called rest homes, are what the title says, a home for the elderly to rest and be cared for in their latter years. The staff will probably have NVQ’s or similar and be sufficiently trained in caring for the elderly, helping them to wash and dress, put shoes on, taking them to the toilet, showering them, helping them to eat and drink if necessary, but they are not nurses and not qualified to do anything medical, apart from giving out medication.
The staff in care homes help residents to walk, either on their own or with a walker, or push them in a wheelchair. They will play games with them, give them manicures, take them on trips to places, serve them drinks and snacks, perhaps read to them if possible. These homes are probably, for want of a better word, more easy going and happier than nursing homes, as most residents are just old or have slight dementia, are hard of hearing and just have limited mobility.
Usually once in a care home if it is a caring environment and the staff get to know and get fond of the residents (which they do), they will not be moved to a nursing home as long as the staff can cope with any deterioration in their condition or health. Old people are usually slight and do not weigh a great amount so if two carers can lift them and do not need any equipment to do this then the home will be happy to accommodate them.
The same with dementia, a great deal of old people in care homes will have vascular dementia, which is different from Alzheimers, easier to cope with as they are really just “pleasantly confused”. If they are no danger to others or themselves, and not violent or disruptive, again they will be allowed to stay. Sometimes of course you will get some poor souls who do not realise what they are doing, being abusive to staff and other residents, causing mayhem, wandering outside which would be unsafe for them. Doors in care homes are not allowed to be locked as the State feel they are not prisoners.
Nursing homes are needed if a person needs regular nursing care, either during the day or 24 hour care. This care is proved by the NHS and provides registered nursing care, so the staff need to be highly qualified and perhaps specialise in geriatric nursing. They must be able to administer injections, give enemas, treat bedsores, cuts and bruises, in fact almost anything an A & E department would deal with and beyond. Very few have a resident doctor, but one would always be on immediate call.
Many of the residents will be bedridden, equipment such as hoists, bath seats and shower seats and various other lifting and moving equipment will be used. If there is a question about whether an old person needs a care home or nursing home, an assessment will be made to discuss the individual’s health, social, mental and therapeutic needs, this is called Eligibility Criteria.
If they have a rapidly deteriorating or unstable condition requiring regular supervision they will certainly need a nursing home, or even a hospital, maybe even Palliative care. You hear the term “bed blocking” this refers to beds occupied in hospitals by older people who cannot be discharged as they can’t look after themselves at home, have no one to look after them, waiting for a vacant room in a care or nursing home or maybe too ill to be moved or dying. This problem will of course worsen with an increasing elderly population.
Nursing homes are quite serious places, more reminiscent of hospitals than anything else, but with a more one to one nursing approach. Of course some people will be in great pain and this must be controlled as far as possible, breathing difficulties may arise so oxygen must be on hand, the knowledge and need to monitor or change dosage at short notice is required.
There is another type of nursing home which takes care of anyone with mental problems, which will have staff proficient in dealing with patients suffering in this way e.g. psychiatrists and mental health nurses.
Both types of senior care homes cater for different needs and the final decision will usually be made for you by an assessment team. If Alzheimers is the problem the person will not be aware of what is really happening to them, which is probably a good thing for them, only the relatives tend to feel the person they knew is no longer there, which is a very sad feeling. If your elderly parent or relative is suffering medical and physical problems and in constant pain, you will be glad he or she is having proper nursing care. If he or she is just old and failing as the years go by, then a care home is the better option to provide a caring, but home-like, environment.
