Low Expectations - Attitudes on choice, care and community for people with dementia in care homes

12 July 2013

Jane Buswell is Chair of the BGS Specialist Nurse and Senior Practitioners GroupCapture2

A report by the Alzheimer’s Society, with foreword provided by the actor, Kevin Whately, indicates that along with the usual examples of both good and bad care being delivered around the country, expectations are worryingly low among people in care homes and their relatives, as well as the staff working in the care homes.

With 80 per cent of residents living in care homes having either dementia or significant memory problems, says the Alzheimer’ Society, providing good care for these people should be the primary focus of the care home sector. More needs to be done to raise expectations about the quality of life for people with dementia in care homes because lower expectations will always be self-fulfilling.

Care versus Quality of Life

Some of the results reported in the survey are quite encouraging. Seventy-four per cent of the people surveyed (comprising family members of people with dementia, staff working in care homes and people with dementia themselves) said that they would recommend the care home that the person with dementia was in, to others, and 68 per cent thought the quality of care received by the person with dementia in the care home was good.

Care however, does not necessarily equate to quality of life and by quality of life, people probably think of elements which boost morale and provide a sense of purpose and wellbeing.

Only 41 per cent of respondents thought the quality of life of the person with dementia living in the care home was good.

Only 44 per cent of the family members of people with dementia felt that the opportunities for activities in the care home were good. Only 26 per cent felt that the care homes provided good opportunities for trips out of the care home. Clearly, while people with experience (either as a care home resident or as a family member of a care home resident) are grateful that they or their relative is not being starved, neglected or otherwise abused in the care home, but there is a sense that the home’s service is not structured to provide good quality of life to those residents with dementia.

Public Perceptions

The views of people with exposure (vicarious or direct) magnify the perceptions of the wider public. Only 30 per cent of UK adults agreed that people with dementia in care homes for older people were generally treated well. Here we have the doubled edged sword of the media in action. While bringing examples of bad care to the attention of the public, it fails to highlight the many examples of good care.


While staff felt that the care home in which they worked provided a good level of care, as might be expected, they generally reported that they had not had sufficient training.

The Alzheimer’s Society concludes in the report that the government and care sector must work together to improve public understanding that people with dementia in care homes can enjoy a good quality of life. Meaningful choices in care should be promoted. The Society’s YouGov survey found that 70 per cent of UK adults would be “scared of going into a care home in the future”, and 24 per cent of family members of people in care homes with dementia, had found it difficult to find information on care homes.

While more could be done to address the gaps identified in the survey (public perception) the Alzheimer’s Society promotes promotes a tool, “Your handy guide to selecting a care home,” as a resource for making informed decisions about care homes.

The full report may be downloaded here.


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