It is a dilemma almost every family in the country will have to face one day, as more and more people live longer.
But the choice between finding a care home for relatives increasingly unable to manage on their own and leaving them to struggle on in their home could become a thing of the past amid surging demand for live-in “companion carers”.
Once a virtually unheard-of option, a small network of companies providing full-time live-in carers, say they are experiencing a rise in demand in the wake of waves of scandals about standards in care homes and traditional homecare agencies as well as headlines over soaring fees.
Although still only catering for a tiny proportion of the older population, they are now hoping to become an increasingly mainstream choice, with some providers holding talks with NHS and social care bodies about future plans.
They are also hoping to recruit an army of new carers, targeting recent divorcees and those considering a mid-life change of career and lifestyle.
It follows research suggesting that older people who remain in the familiar surroundings of own home, with appropriate adaptations and live-in care, suffer a third fewer falls and a quarter fewer hip fractures than their counterparts in care homes.
With fees ranging from £750 to £1,400 per month, depending on the level of care needed, the cost is comparable to moving into a higher-end care home, and significantly cheaper for couples.
Carers are carefully matched to ensure they have similar interests as their clients and are likely to become friends. They then move into a spare room in their clients’ home, sometimes on rotation with others.
According to the Live-in Care Hub, a network of 14 small and medium sized companies offering live-in care set up two years ago to promote the sector at present only around 10,000 families currently make use of it although all have reported growing interest. By comparison, around 290,000 older people in England and Wales live in care homes, according to the last census.
“There does seem to be an increased awareness,” said Peter Seldon, chief executive, Consultus Care, a founding member of the group.
“There is also a general receptivity to the whole notion of keeping mum and dad in their own home with family around them – and their pets, pets are particularly difficult in a residential home. "
He added: “The element of companionship is very important and a crucial part of the selection process is [asking] are they going up have similar interests, are they going to be able to have a conversation, is a relationship possible; it's not just about primary care.”
But he said the challenge now is not attracting people to considering live-in care but in finding the carers to meet the demand.
“The big push we’ve got on right now is getting the message to people who haven’t thought of being carer of considering it as a career. We want to get people to look at it. In the UK he sector has taken a lot of people from South Africa with ancestral British passports, as well as Australia and New Zealand and increasingly from Eastern Europe, but we are really keen to more British people to look at this.”
The growing demand is illustrated by the approach of Pete Dowds and Tom Brooks, two young web entrepreneurs who set up a service called Elder.org last year to help families find carers for older loved-onesquickly using similar technology to online dating and consumer review websites.
Originally, they planned to offer a service arranging full-time live-in carers as a niche offering on the side. But such was the demand that, only a year later, they have now switched the company entirely to that direction.
“Care is not just about providing safety, but helping to maintain a sustained quality of life for the recipient,” said Mr Dowds.
“Our technology makes it easier to discover the service, undertake care appraisals, be matched with a tailored carer, and the delivery and management of care itself.
“We want to ensure that when we match care professionals with recipients, they aren’t only matched based on skill and requirement, but also on common interests.
“This way, once the carer moves into the recipient’s home, they have a mutual interest which can help them build strong and lasting relationships, developing into genuine companionship.”