Expert advice, guidance and support
‘What I needed in those initial few weeks was a mentor to steer me through, someone who had been through it all before and knew the daily trivial problems that would build up into big issues.’
Despite there being a network of advice and support available carers often report of not knowing who to turn to for the right information at a time when they are facing a number of challenges caring for their loved one and the impact on their own life.
Arranging social care can be a challenge. From knowing where to start, what type of care and support you or loved one needs and who pays for it. The care system can be complicated and difficult to find your way through, but you are not on your own we are here to help you through the process
Ambiance Advice, drawing upon its wealth of expertise offers professional impartial advice to help families travelling the dementia journey to become more informed, connect with services that best meets their needs and through the process experience HOPE.
Knowledge brings Power. Power brings Hope. Hope brings Smiles.
– Carol Howell
Ambiance Advice is led by an independent social worker registered with Social Work England, with over 15 years’ experience of working in local authority settings and direct experience of working with people living with dementia.
We offer expert impartial advice, guidance, and support in:
- Navigating some of the experience’s dementia may present, that you may find difficult and challenging, possible reasons and practical solutions.
- Provide practical advice in a range of topics including financial support you or the person may be entitled to, equipment and assistive technology. We can signpost you on to the relevant to services who separately can help or if preferable co-ordinate this on your behalf completing required paperwork and making any relevant referrals.
- Simplify local authorities (social services) and Health’s legislative frameworks, the Care Act 2014 and Continuing Health Care. We can assist in understanding the process involved and the threshold for meeting each criteria in order to access funding to purchase services and charges that you may incur.
- Help you Plan ahead, so you can feel confident that the care and support you receive in the future will be right for you, and your affairs will be managed in the way you wish. This may include consideration of making a Will, Advance decisions about your future care and treatment or Lasting Power of Attorney.
- Act as a Certificate provider for your Lasting Power of Attorney, section 10 requires the signature of at least one certificate provider. The role of the certificate provider is to certify that the person fully understands the purpose of the Lasting Power of Attorney and the scope of the authority conferred under it when they signed it.
- Assessing a person’s Mental Capacity. The Mental Capacity Act 2005 provides a framework for assessing whether people can make their own decisions and what to do if they can’t. We have a thorough knowledge of the Mental Capacity Act and how to apply it in practice and when assessing mental capacity and making best interest decisions.
The topics below is not exhaustive of list of the areas we can support or advise you in but give you an idea of the scope of our expertise and experience.
Please don’t hesitate to contact us for further information on any of the topics list or if the information your looking for isn’t there, we here to help, remember we have travelled the same journey.
It may seem overwhelming at first. You may feel shock, you may be worried about the impact it will have on you and those close to you and you might feel scared. But getting a diagnosis of early-stage dementia can help you make changes to live as well as possible and make plans.
A diagnosis may be life-changing, but it is certainly not life-ending. Despite the challenges it brings, many people with dementia live fulfilling lives for many years.
The memory clinic or another health specialist in charge of your care should tell you the type of dementia they think you have. They may suggest medication to slow the progression of your symptoms. They should also arrange to see you regularly to check how you are getting on.
Understanding changes in behaviour
As the dementia progresses, many people develop behaviours that can be challenging. This includes restlessness and aggression. Aggression is not just about physical acts but can be shown in other ways, including verbal aggression. These behaviours can be distressing, both for the person and the carer. If a person with dementia becomes aggressive, it is important to remember that they are not ‘behaving badly’ and are not to blame. Their behaviour may be a direct result of changes in their brain, or be caused by a general health problem, such as pain from an infection. These behaviours can also reflect problems related to the care the person is receiving, or their general environment or social interactions. In this case, the behaviour is best viewed as an attempt to communicate an unmet need, rather than as a direct symptom of dementia. If a person is being aggressive, they should be assessed by their GP in the first instance to identify any possible underlying causes.
Understanding changes in communication
Dementia affects people’s communication in different ways. Some people, particularly early on in their dementia, may have very few difficulties communicating. It may be enough to summarise regularly and provide assistance to keep people on track. Some people may have virtually no language at all. In these situations, the person will need a lot more help to communicate and you may need to use other forms of communication when interacting with them, for example gestures , facial expression and the tone of your voice. If someone is shouting and distressed, try to use a low soothing tone in our voice. If you match their energy you will likely escalate how they are feeling.
The term ‘sundowning’ refers to a state of confusion occurring in the late afternoon and spanning into the night. Sundowning can causes a range of behaviour, confusion, anxiety, aggression or ignoring direction. Sundowning can lead to pacing and wandering. The cause of this behaviour is unknown and may continue for several months often happening in the middle and later stages of dementia.
Maintaining good Health - Eating and Drinking
Poor appetite, cognitive impairment (problems with mental abilities), physical disabilities and sensory impairments (hearing and sight loss) can all cause the person with dementia to have problems eating and drinking.
Although eating and drinking difficulties are fairly common in people with dementia, each person’s difficulties will be unique to them and their situation. Because of this you should take into account the person’s preferences, beliefs, culture and life history. For example, their religious beliefs may mean they do not eat certain foods such as pork or shellfish, or they may be affected by the environment around them. You should tailor solutions to the person’s individual needs and preferences.
As dementia progresses, the person is likely to need more support to meet their needs.
Making the home a safer and more comfortable environment
The design and layout of a person’s home can have a big impact on their daily life. There are lots of ways you can make the person’s home ‘dementia friendly’. This means that it is set up to help them stay independent, physically active and safe.
Assistive technology has potential benefits for people with dementia providing it is introduced early on in the care of an individual with dementia and is tailored to each individual’s needs. For example, it can enable people to live independently for longer, reduce stress on people with dementia and carers and can potentially enhance the quality of life for people with dementia and give them greater choices about their care.
For carers, there is evidence to suggest that since the introduction of telecare in to their caring situation, they have benefited from more peace of mind, a better night’s sleep, improved the relationship with the person(s) they cared for,
Some people with dementia may feel stigmatised by assistive technology, it is important that they are consulted as to whether they are happy to use it.
When you can no longer live alone
There may come a time when you need more support and are no longer able to manage at home on your own. It can be hard to know when this point has come. You won’t necessarily have to move into a nursing or care home if you can no longer live alone. There are a range of housing options that you could consider such a sheltered housing, extra care scheme or shared lives scheme. Some of these will give you more independence than others, depending on the amount of support you need.
As a person’s dementia progresses, there may come a time where full-time residential or nursing care is needed. If the person cannot make this decision for themselves, it is often left to the carer or family to make the decision about moving them into a care home. Being prepared for this eventuality early on, and having discussions as early as possible, can help to make the decision slightly easier when the time comes.
Advance decisions (living wills)
An advance decision allows you to express your wishes to refuse medical treatment in future. It is sometimes referred to as a living will.
An advance statement enables you to write down your general wishes and preferences for your future care. This can include anything from your preferences on food, drink, and hobbies to where you would like to live. Advance statements are not legally binding but must be taken into account if decisions are ever made for you.
Lasting Power of Attorney
A power of attorney is a legal document that allows someone to make decisions for you, or act on your behalf, if you are no longer able to or if you no longer want to make your own decisions. You can have an LPA for health and welfare (which covers decisions about care and treatment, including where you live) or for property and affairs (which covers decisions about finances and selling a house on your behalf) or both.
Making a will
A will is the only way to make sure your money, property, possessions, and investments (known as your estate) go to the people and causes you care about.
Care in the Community
Care Assessment (Care Act 2014)
The local authority (also known as local council) has a duty to assess the care needs of a person with dementia. The assessment will determine what care needs they have, and whether the local authority will contribute towards meeting them. Any person has a right to this assessment, even if they will end up paying for their own care.
The process is called a ‘care needs assessment’. The aim is to work out exactly what the person’s needs are, and the level and type of care and support required to meet these needs. It will also help the local authority to decide whether or not someone is eligible for care and support funded by the council. Social workers usually undertake the role of the assessor.
Carers Assessment (Care Act 2014)
The Carer’s Assessment is a process where your Local Authority or Local Council Social Services assess your individual needs as a carer.
The Assessment will look at the impact that caring for a person with dementia is having upon you, and will then identify the type and level of support that you need to be able to carry out your role as a carer. This could include some respite care for the person with dementia, so that you have some time to yourself; or some training in safe ways to help a person with dementia move around, or some help coming to your home.
The Carer’s Assessment was established as part of the Care Act 2014, which sets out the legal rights of people with caring responsibilities to receive an assessment, and then receive support dependent upon their needs.
Paying for Care and Support
There are national rules about who has to pay for care and support, although these can vary locally. It mainly depends on the type of care and support that you need, where you live and what is available.
If you are living at home, you will usually pay for the costs of your own care and support. The local authority (council) may also contribute, but this depends on your income and your assets (such as savings or shares). You may be assessed by your local authority as having to pay for all your own care and support at home. This is sometimes called being a ‘self-funder’.
If you are receiving care and support in your own home, you are entitled to keep a basic level of income (money you receive regularly), however much your care costs. The Care Act states that charges for care must be ‘reasonable
Home care and residential care home charges
Upper savings threshold in England (above which the person has to pay all their costs) is £23,250
Lower savings threshold in England (below which a person’s savings are no longer taken into account, although all other income including benefits and pensions is still counted) is £14,250..
Personal expenses allowance for people in residential care is £24.50 a week
Continuing Health Care
In some cases, a person may be entitled to receive NHS Continuing Health Care Funding This funding from the NHS will cover the full cost of their care, if the person is deemed to have a healthcare need, whether in your own home, or in a care home. It is difficult for people with dementia to meet the criteria for eligibility because they are often assessed as having social care needs rather than healthcare needs.
This is assessed by a multi-disciplinary team (at least 2 professionals from different healthcare professions) who will look at different areas of need and use a tool to identify the level of need you have. The process should be transparent, and you should be informed who will be coordinating the process.
This is a complex area, often particularly so for people with dementia, where distinguishing between these two types of care can be very difficult.
Nursing Funded Care
If you do not qualify for NHS continuing healthcare, you might still be able to receive NHS-funded nursing care contribution because you do have some level of nursing care need. This is only paid if you are assessed as needing nursing care in a care home registered to provide nursing care. The standard rate in England is £165.56 per week for 2020.
You can claim Carer’s Allowance if you look after someone for 35 hours per week or more and they receive certain benefits. You do not have to live with them or be related. Your claim can also be backdated by 3 months from the date you apply.
You can apply for Carer’s Allowance if the person you are caring for receives any of the following:
- Daily living component of Personal Independence Payment (PIP)
- The middle or highest care rate of Disability Living Allowance (DLA)
Attendance Allowance (AA) is a benefit for disabled people who are over state pension age with care needs. You do not have to receive help providing you can show you need it. You must usually have had care needs for at least 6 months before you can get AA and expect to have care needs for at least 6 months after making the claim.
Higher rate £87.65 weekly
Lower rate £58.70 weekly
Personal independence payment
Personal independence payment (PIP) has replaced Disability living allowance for all new claims after June 2013. Personal Independence Payment (PIP) is not a means-tested benefit. This means it is not affected by earnings, other income, or savings. You must be over 16 and have not yet reached state pension age to claim.
Daily living component
Enhanced rate £87.65 weekly
Standard rate £58.70 weekly
Enhanced rate £61.20 weekly
Standard rate £23.20 week
Planning for your end of life care can be emotionally very difficult for both you and your loved ones. Having a plan for your end of life care can also provide comfort and support to your family and carers in the last months and years of your life by relieving them from having to make certain difficult decisions on your behalf. The exception to this is where medical decisions are required, and these will always be made by a senior healthcare professional.
End of life care includes palliative care, which is specialist care that is provided to help you feel as comfortable as possible by managing your pain and other distressing symptoms. Palliative care is provided by a range of professionals including doctors, nurses, social workers and other specialists like physiotherapists, occupational therapists, or complimentary therapists. Counsellors, clergy, and social care staff will also be available to you.
These professionals and the services they provide can be available to you in your own home, hospital, care home or hospice in order to meet your physical, psychological, social and spiritual needs and those of your family. Your family and friends may also be closely involved in caring for you.
Ambiance Advice Costs
We believe in being open and transparent in everything we do and have set out our hourly cost for Ambiance Advice including our confirmation and cancellation terms below to enable you to make an informed decision.
Ambiance Advice operates within a 25-mile radius of Cheadle, Stockport.
Our introductory rate for this service is £65 per hour plus travelling costs.
The length of time required will be dependent on what advice is needed as each persons circumstances will be unique to them.
We will discuss with you our anticipated costs prior to any booking. To secure a booking we require a £40 deposit followed by full payment of agreed cost the day prior our planned visit.
If you wish or need to change the date or time of your appointment up to 24 hours before your appointment, we will be more than happy to accommodate and rearrange.
Should you cancel your appointment within 48 hours of an agreed visit your deposit will be non-refundable to compensate us for subsequent loss of work and administrative fees.
We really look forward to working with you in finding solutions to any problems you may be experiencing and connecting you with services and products that may be right for you.
We would love to hear from you
If you or a loved one would like to know more about dementia advice or support, please don't hesitate to contact us. You don't have to travel this journey alone.