Care Homes

Overview

A care home is a place where people live and receive support with daily tasks such as dressing, washing, eating, and taking medicines. Some care homes also provide nursing care from registered nurses for people with more complex health needs. Moving to a care home is a big step, but it can offer safety, comfort, and social contact.

Yes, many older people and people with disabilities live in care homes. It is also common for people to move into a care home after a hospital stay or when conditions like dementia become harder to manage at home.

Care homes mainly support older adults, but they can also support younger adults and children with severe disabilities or complex health conditions. Anyone with a care need that cannot be safely met at home may be eligible.

Symptoms

Common symptoms

• Needing help with everyday tasks such as bathing, dressing, or using the toilet
• Frequent falls or difficulty walking and getting around the home
• Forgetting to eat, drink, or take medicines
• Feeling very lonely or isolated
• Having a chronic illness that requires more monitoring than can be provided at home
• Confusion or memory problems that make being alone unsafe

Symptoms in children

• For children with severe physical or intellectual disabilities, the need for a residential setting may appear as difficulty breathing, feeding, or managing seizures despite home support.
• Children may need care outside the home if they require 24-hour nursing that parents and community services cannot provide safely.

Symptoms in older adults

• Sudden or gradual weight loss due to forgetting to eat
• Bruises, cuts, or fractures from falls at home
• Soiled clothing or unwashed appearance due to difficulty managing personal hygiene
• Getting lost in familiar places or leaving the stove on
• Worsening confusion, restlessness, or agitation at night

Causes

Main causes

• Physical decline from ageing, chronic illness, or disability
• Memory problems or dementia that make it unsafe to live alone
• Lack of family or community support
• After a serious illness, surgery, or hospital stay where a person can no longer manage at home
• An unsafe home environment, such as stairs or poor heating

Risk factors

• Living alone
• Having multiple chronic conditions such as heart disease, diabetes, or chronic lung disease
• Recent hospitalisation
• Progressive conditions such as Parkinson’s disease or Alzheimer’s disease
• Limited mobility or difficulty with daily activities
• Caregiver burnout — when family carers can no longer cope with the level of care needed

When to see a doctor

See a doctor urgently if:

• If the person has had a fall and cannot get up without help
• If they are suddenly confused, drowsy, or less responsive than usual
• If they have a high fever, severe pain, or signs of an infection
• If they are not able to eat or drink enough and show signs of dehydration

Book a routine appointment if:

• If you are noticing a decline in memory, mobility, or ability to care for themselves
• If the person is losing weight, not eating well, or skipping medicines
• If they are having frequent minor accidents at home
• If you are a carer and feeling overwhelmed or unable to keep up with the level of care needed

Diagnosis

There is no single test to say a person needs a care home. Instead, a care needs assessment is arranged by your local social services. A social worker or occupational therapist will talk to the person, their family, and their GP to understand their daily needs, safety, and social circumstances.

Tests that may be done

• A care needs assessment to check what help is needed with daily activities
• A mental capacity assessment if there are concerns about decision-making
• A home safety assessment to see if the current home environment is suitable
• Memory and cognitive tests if dementia or confusion is suspected
• Blood tests and physical examinations may be arranged by the GP to identify any treatable conditions that are making things worse

What to expect at your appointment

The assessment usually happens in the person’s home. A professional will ask questions about how the person manages washing, dressing, cooking, going to the toilet, moving around, and taking medicines. They may also ask about memory and mood. After the assessment, you will receive a recommendation of what type of support would help, which may include home care, day care, or a care home placement.

Treatment

Moving to a care home is not a medical treatment, but it is a care plan. The right setting provides a safe environment, personal care, medication management, and social activities. For people with medical needs, nursing homes provide regular involvement from registered nurses and visiting GPs.

Self-care at home

• Visit a care home several times before deciding, if possible, to see if it feels welcoming and safe.
• Talk to the home’s staff about the person’s routines, preferences, and history to help the transition.
• Keep a list of current medicines and health conditions to share with the care home staff.
• Ensure the person’s personal items, photos, and familiar belongings are brought along to make the room feel like home.
• Stay involved: visit regularly, call, and attend care review meetings.

Medical treatments

Medical care in a care home is provided by the person’s GP, who can visit if needed. Care home staff manage medication, dressings, and daily care under a medical professional’s guidance. Physiotherapy and occupational therapy may also be available to support mobility and independence. If a person has dementia, their care plan will focus on comfort and quality of life, not on any specific medication.

When is surgery considered?

Surgery is not a treatment for needing a care home. However, some people may need an operation for a condition such as a hip fracture, and afterward they may move into a care home while they recover. Always speak to the surgical team about the recovery plan and whether a care home can be arranged.

Living with this condition

Life in a care home can become the new normal. Most homes have set routines for meals, medication, and activities, but residents are encouraged to keep personal hobbies and interests. It may take a few weeks or months to adjust to a new environment, and it is okay to feel a mix of relief, sadness, or gratitude during this transition.

Lifestyle tips

• Encourage participation in on-site activities such as exercise classes, craft sessions, and games.
• Keep up with social connections: invite family and friends to visit, or arrange video calls.
• Spend time outdoors in the garden or on walks if mobility allows.
• Respect the person’s need for quiet time as well as social time.
• Discuss any concerns about care quality with the home’s manager — a good home listens.

Diet and exercise

Care homes offer regular meals and snacks. If the person has a special diet, such as diabetic or soft food, tell the staff. Light exercise, such as chair exercises or short walks, helps maintain strength and mood. Staying active also reduces the risk of blood clots and pressure sores. If a person has trouble eating or drinking, staff can offer fortified drinks and feeding support.

Mental health and emotional wellbeing

Moving to a care home can feel like a loss of independence, and this may lead to sadness, anxiety, or low mood. It is important to talk about these feelings. Many care homes have visiting healthcare professionals, or you can ask your GP about mental health support. Reminding the person of positive aspects, like safety and company, can also help.

Prevention

Sometimes a care home move can be delayed or avoided. Regular GP check-ups, home safety adaptations, home care visits, and good support for carers can help people stay at home longer. However, when needs become complex, a care home is the safest option. Seeking support early can help you plan and avoid a crisis.

Vaccines

It is important for people living in care homes to stay up to date with recommended vaccinations, such as flu and COVID-19, because infections can be more serious in older adults. Ask your GP or pharmacist about which vaccines are recommended.

Screening programmes

Your local social services will carry out a care needs assessment to decide what support is needed. There is no routine medical screening for care home admission, but your GP may offer memory tests, fall risk reviews, and medication reviews to help plan care.

Complications

If left untreated

• If a person who needs more care remains at home without support, they may suffer falls, fractures, and bruises.
• They may become dehydrated or malnourished, which can lead to urinary tract infections and worsening mobility.
• Medication errors may occur, such as missing doses or taking too much.
• Unmanaged dementia can lead to wandering, getting lost, or unsafe use of appliances.
• Carers may experience exhaustion and burnout, affecting their own physical and mental health.

Long-term outlook

With the right care home, many people experience improved safety, nutrition, comfort, and social contact. Families often feel reassurance knowing that their loved one is supported day and night. It can take time to settle, but with involvement and compassionate care, a care home can become a genuinely good place to live.

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