The dementia diaries.
Top tips for choosing a residential home

We all dread the day – the day you have to admit to yourself and everybody that you cannot cope. Despite all those promises to yourself and to your parent that they would never go into a home, you have to face the reality that they are safer and would be better cared for by the professionals.

For me, it was like a physical punch and I felt my heart break when the doctor leaned forward and said ‘you cannot cope with this anymore’. He was right. I was beyond exhausted, trying to keep a business going, look after a house, keep a relationship going, be awake 24 hours a day looking after Mum in the day and up all night as she was wandering and wanting the toilet. I felt like the mother with a wakeful baby – but babies can’t get up and fall down the stairs. On top of that was the emotional strain of the belligerence and anger which dementia so often brings. Like the thousands of carers out there, I lived in a twilight world of fear and concern. And still I cried and felt a failure, a deceiver, a betrayer.

Add to this the fear of putting mum or dad in a home. We are bombarded with media tales of elderly abuse, over medication, poor nutrition, cruelty and neglect. But there are wonderful places out there – the places which do not get a mention because they are not hot news. They quietly, carefully give care, dignity and safety to our parents and see high quality as normal, expected service.

So how do you find these havens?

  1. Define your needs. There is a big difference between residential and nursing homes. Your doctor will advise on which is required, but in simple terms if your parent needs 24 hour care, lifting and administration of medication it is nursing. If they can mobilise, dress, walk around and take medication which is offered to them, it is residential.

  2. Research. A day of internet research will yield you a list of places to visit. First get a list of local providers and then check each one (if you are in the UK) through the Care Quality Commission website and the NHS website. You are looking for consistently high ratings and reviews.

  3. Research again. Ask around and listen to advice. When I ignored the advice of a provider of in-house care, I put Mum in a very expensive ‘very nice’ home. 48 hours later they decided she was ‘too much’ and threw her out into the care of two people they had not ID’d, in wet clothes, medications lost and no breakfast. I was in a business meeting and was not even given time to get back to take her home myself.

  4. Visit. You need to spend time going around to see the homes. The key is to do spot visits – just arrive and ask to look around. If you have called ahead and they ask you to specify a time, don’t go. A good residential home will be happy to walk you round, give the services, the entertainment, the cost, the staff/resident ratio and a good look at all the rooms. Say you will call back and go at a meal time.

  5. Use your senses. There are a few things which will tell you that a home is well managed and gives dignity – sight and smell. Ask the following questions:

    • Does the place smell fresh and with no hint of urine?

    • Does the food smell of home cooking rather than cabbage and school dinners?

    • As you walk round, do the residents look calm?

    • Is it warm? (Old people get cold quickly)

    • Do the staff smile at you?

    • Do you hear staff talking to residents with kindness?

    • Are residents seated in groups and not sitting alone in dark rooms?

    • Are the bedrooms clean and airy?

    • Are the floors flat? (many residential homes are set up in old houses with uneven floors – lethal to the unstable elderly)

    • Are the toilets spotless?


      If you can say yes to all these, then you are probably in a good place. The next step is getting them there, but that is a whole article of its own. Next time we will look at breaking the news.

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