I arranged live in carers for my relative. The reason for this was my relative was proudly independent and insistent that no-one was going to make her go into a home. At this stage I already had carers coming in a couple of times a day, and social services (bless em) had decided that this wasn't enough, and said she should have carers coming in four or six times a day. (They could suggest this because she was self-funding, so no expense for SS). I found the option of carers 'popping in' several times a day was useless for my relative, who wouldn't cooperate and the carers that came never had the time to persuade her to do anything eg wash, eat, use the toilet, etc.
So the only remaining options was a care home, or live in carers. Everyone, it seemed to me, was keen to get her into a care home. I felt sorry for her.
I thought at first that a live in carer wouldn't work with someone with dementia, but then I decided to give it a try. I contacted some agencies and eventually set it all up, and she lived with this arrangement for 15 months. My experience was that this is quite a lot of work for the person (me!) arranging it, but if put in the time to keep an eye on everything then it did work well for my relative. The problems are: resistance from the person about having someone in the house; physically setting up a living arrangement for someone in the house; finding a good agency (I hit a few bad ones, and did have to change agencies after 9 months); agreeing arrangements for petty cash and the carer's meals; managing the changeover every three weeks or whatever when a new carer comes; making sure the carer has a good relationship with the health service (I ended up doing most of the liaison with the NHS). Still, I would say it was a good arrangement for my relative for most of that time. I did speak to the carer every day during this period (I lived far away) and visited every two weeks. I also relied a lot on neighbours to keep an eye on things. A few carers were unsuitable, but agencies seem willing to change them if they are. I didn't want the responsibility of employing a carer directly, and then having to find replacements for them, so I chose to use agencies.
It became less appropriate as my relative became more physically disabled. When she had to be hoisted, the agency insisted on there being two carers, and then it became complicated when the second carer came, and it meant using a second agency. I did do this, but then if my relative needed moving at an unpredicted time, it was difficult. I know some people hoist single handed, but most agencies insist you have two people to do it. I felt her health was threatened by having only one carer available. Also at this time her world had shrunk to such a small space, and I didn't feel she was getting enough stimulation from just one live in carer. You never know how much time the carers spend with your relative - they deal with the physical things, but they may not spend time interacting with them. I became worried about her isolation. Also at this point I didn't think she necessarily knew that she was still in her own home. So I took the decision to move her to a nursing home. This move was successful, and I am glad I did it when I did - not earlier, and not later.
Hope this helps.
