A woman is enquiring about care for her father. He has dementia, he has started accusing her of stealing from him, and last week he left the house at four in the morning.
She has not told anybody this. She is ashamed of it on his behalf, she is exhausted, and she does not know whether it is the kind of thing that makes somebody refuse to take him on.
She asks a general question about services. The provider answers with a general answer about person centred dementia care, and the conversation she actually needed does not happen.
1. Name the difficult behaviours explicitly
Aggression, accusations, wandering, refusal of care and incontinence, so a family recognises their situation described without having to say it first.
2. Say plainly that these are common
Which is true, and which is the single most relieving thing anybody can tell a family who believe their situation is unusual or shameful.
3. Explain what happens when care is refused
The commonest practical problem, and the one families most need answered before committing to anything.
4. Explain the approach to distress and agitation
Concretely, in terms of what a carer actually does, rather than in terms of a philosophy.
5. Explain the experience the staff have
Specifically with dementia, including training and how long people have done this, which is what a family is assessing.
6. Explain the continuity arrangements
Which matter enormously here, since unfamiliar faces are frequently the trigger for the difficulty, and a family needs to know how small the team will actually be rather than being told that continuity is a priority.
7. Explain the safety measures
Wandering, kitchen risks, medication and what can be put in place, which is what keeps families awake.
8. Explain what happens as things progress
Honestly, including when a level of care will no longer be enough, which families need to plan for rather than discover.
9. Explain the position on capacity and consent
Who decides, what happens where somebody refuses care they need, and what the legal framework is, in plain words.
10. Explain the respite options
Since the person making the enquiry is frequently exhausted and does not know that any relief exists.
11. Address the carer directly
The daughter making the enquiry needs support of her own, and almost nothing is addressed to her.
12. Explain the costs and funding plainly
Which is the ground in care fees and funding questions families ask.
13. Never assess anybody's needs automatically
Information, recognition and an immediate route to a person, with the assessment made by somebody qualified.
Explain what happens if he does not want care at all
Which is extremely common and which families feel responsible for. Explaining how providers actually approach a reluctant person is frequently the most useful thing in the whole conversation.
14. Let her describe it in writing at eleven at night
An assistant that names the difficult behaviours first, says plainly that they are common, explains what happens when care is refused and what respite exists reaches a daughter who has not been able to say any of it out loud. The late night pattern is described in families researching care homes late at night, and the sector questions in dementia care enquiries from families. Start at try, see features, and the sector view sits under senior care.