Most people with dementia live at home, often with help from their partner or children. For a long time that works well. But at some point you notice it is getting harder. When is it time for professional care, and what can you expect? Here is an overview.
Signs that more help is needed
Every situation is different, but these signs are common:
- Your loved one forgets to eat, drink or take medication.
- Personal hygiene declines: washing less, wearing the same clothes.
- Dangerous situations arise, such as a gas cooker left on or going out at night.
- Your loved one becomes more restless, especially in the late afternoon or evening.
- You, as a family carer, sleep badly, feel irritable or no longer have time for yourself.
That last sign is often underestimated. Looking after yourself is not a luxury: it is what allows you to keep caring for your loved one.
Who does what? The main roles
The GP
The GP is often the first point of contact. They can arrange tests, discuss the diagnosis and refer you on.
The dementia case manager
After the diagnosis you can be assigned a dementia case manager. This is a regular contact person who thinks ahead with you, guides you to the right help and supports you as a family carer. Dementia case management is part of district nursing under basic health insurance.
The home care organisation
Home care helps with daily life: personal care, the daily routine, medication and noticing changes. The better the carer knows your loved one, the better they can respond to what is needed.
What does a carer do for someone with dementia at home?
- Providing structure. Fixed times for getting up, personal care, meals and rest give something to hold on to and reduce restlessness.
- Personal care. Help with washing, dressing, eating and drinking, with attention to what the person can still do.
- Dealing with behaviour. Responding patiently to restlessness, suspicion or repeated questions. Not correcting, but responding to the feeling.
- Safety. Watching for fall risks and helping to keep the home clear and safe.
- Noticing changes. Discussing changes in behaviour, appetite or health with you and the GP in good time.
- Relieving family carers. So you have time for yourself, your work or your family.
Why familiar faces matter so much
For someone with dementia, an unfamiliar face at home can be unsettling, especially when that person comes to help with washing or dressing. A small, permanent team that knows your loved one’s life story, habits and preferences makes a big difference. It brings calm, and it saves you from having to explain everything again and again.
How is dementia care at home paid for?
- Health Insurance Act (Zvw). Personal care and case management fall under district nursing. You do not pay a deductible for this.
- Social Support Act (Wmo). Through the municipality you can apply for support and for help for family carers, such as respite care.
- Long-term Care Act (Wlz). If supervision is permanently needed throughout the day, the CIZ can issue a Wlz indication. Care can often still take place at home.
- Personal budget (pgb). This lets you choose who provides the care.
Tips for a good start
- Write a short life story of your loved one: work, family, hobbies, habits and what brings calm.
- Keep a notebook where family and carers leave short messages.
- Agree who the main contact person in the family is.
- Start care a little too early rather than too late. Getting used to it goes better before there is a crisis.
Dementia care from RytelZorg
RytelZorg provides dementia care at home in Voorburg, Leidschendam, Wassenaar and The Hague. Our carers are trained in dealing with changing behaviour and work closely with you, the case manager and the GP. We start with a free introductory meeting at your home.
Also read our tips for family carers and the page on dementia care. Questions? Contact us or call 06 14 97 58 70.