Care Special: It’s ok to share the care

Finding support for older relatives and loved ones can seem like a daunting task, but help is at hand
Care is a four-letter word, and is often viewed as such by those who most need it. Older people tend to be stoic, adamant that they can cope, and often display huge resistance to any suggestion of them needing help – until something happens which leaves no alternative.
Many think that having a carer will take away their independence, but in many cases it does the opposite, and enhances their lives.
The delicate broaching of the subject and the decision to explore what would be best to put in place can take months. Sometimes this process is brought to a swift conclusion simply because the need has become a necessity rather than a precaution.
Seeking care for older relatives is not something many of us have done before. Somehow it doesn’t feel right – when we were children it was our parents who cared for us. As a result, we lack the basic knowledge about how to organise a care package.
So where do you start? Here are some pointers about the different levels of care that are available to help you make the right choice.

Basic care
This is for people who don’t need any help with personal care, just someone in the house for reassurance because they may get a bit wobbly and need someone to keep a watchful eye.
This level of care is appropriate for those who might need help with hearing aids, monitoring their fluid intake, cooking, driving to medical appointments, shopping, dog walking and general companionship.

Intermediate care
This is for people who need more support. The carer’s duties might include: helping with personal care and hygiene; administering medication;
rehabilitation; operating stair lifts, bath lifts, transfer boards, wheelchairs, zimmer frames and hospital beds; cooking; shopping; light housekeeping; going to medical appointments, and social events; pet care; walks and companionship.

Complex care
This level of care is needed for people who have a debilitating illness such as dementia or are suffering the after-effects of a stroke or heart attack. The carer’s duties may include: help with administering medication; end-of-life care; personal care; night calls; waking or sleeping night care and bed baths. They will be experienced with operating standing or ceiling hoists; catheter care; stoma care; commodes; hospital beds; rehabilitation; taking blood tests and slide sheets. They will also be able to cook from scratch, provide administrative support and help with shopping.

Carer companions
  • Provide physical care and support to a client
  • Assist with bathing, grooming and dressing
  • Handle household tasks such as grocery shopping and laundry
  • Prepare and serve meals and snacks
  • Administer oral and topical medication, monitor fluids
  • Assist with prescribed physiotherapy exercises or an exercise regime
  • Provide mental and emotional support
  • Make recommendations to family members and healthcare personnel
  • Organise suitable recreational activities
  • Collaborate with other healthcare professionals to provide the best possible care
  • Drive to appointments, visits out to garden centres etc or for lunch
  • Provide companionship
  • Help with pet care

Once the decision has been taken for care to be put in place, you will need to decide how best to achieve this. Will you seek care through an agency who employs the carer on your behalf? Will the carer provide their services on a self-employed basis or will you employ them?
Taking on a carer who is employed through an agency can be costly, particularly if their services are likely to be required over a long period. There may also not be the level of choice of individuals available, but, on the plus side, the process is quite straightforward and works well for many.
If there is more than one carer working on a rota (very often two weeks on/ two weeks off), both carers can be self-employed. On this basis you would simply settle their invoice when it is presented, generally at the end of each two-week rota period.
If the carer is notself-employed or paid through an agency you must act as their employer. In this instance you must:

  • Check if the person can work in the UK
  • Have employer’s liability insurance
  • Register as an employer
  • Set up and run payroll, or pay someone else to do it on your behalf*
  • Pay statutory benefits, for example maternity pay and sick pay
  • Deduct and pay the employee’s income tax and National Insurance contributions
*If you do not have an accountant a domestic payroll agency will set up your carer’s payment scheme and will prepare a contract for your employee. They can also advise about pension contributions.
Finding the right carer is key. Through the pages of The Lady and our jobsboard,, you will find agencies and individuals offering their services, or you can run your own advertisement, detailing precisely what you require. It can feel like a minefield, but The Lady and our advertisers are here to support you in any way we can.
The important thing to remember when seeking care is that you are not alone. We are here to help.