Companionship for someone who is housebound

Companionship care is regular time with somebody your relative gets to know: conversation, meals, hobbies and light jobs, rather than washing and dressing. It suits a person who is housebound well, because what they are missing is company and contact with the world outside. The reasons somebody stops going out vary. It may be a fall and the fear of another, frailty after a spell in hospital, breathlessness that makes the front step feel like a hill, or a fear of being somewhere they cannot easily get home from. The week below works for any of them.

Three things make a week like this work. The first is that the visits happen on the same days at the same time, so your relative knows on Sunday night that somebody is coming on Monday at twelve. A visit that moves around is harder to look forward to. The second is that each visit leaves a thread for the next one: a card to post, a jigsaw half done, a recipe to try on Friday. The third is that the days without a visit still have one fixed point in them, a phone call, a volunteer or a delivery, so no day is left empty.

The companion visits in the example are two hours long. That is the usual length for a companionship visit on PrimeCarers, and the shortest booking is one hour. What a companion visit looks like, hour by hour walks through one visit from arriving to leaving. If family, friends and free services already fill most of the week, how to help a lonely elderly person covers building a week out of those first, with a paid companion for the days nobody else can do.

The NHS advises older adults to be physically active every day, even if it is only light activity, and to break up long periods of sitting. Getting up to make the tea together or to walk to the window counts. The NHS also publishes gentle sitting exercises that can be done in a chair at home, and says to check with a GP or a health professional involved in their care if you are unsure they are suitable. A companion can do them alongside your relative as company. They do not replace exercises set by a physiotherapist.

What carers do with clients on a companionship visit has more ideas, matched to how your relative feels on the day. A companion will also do the light jobs that keep a house going while they are there, such as the washing up, a load of laundry or changing a bed, and companionship with light housekeeping sets out where that stops. Washing, dressing and help in the bathroom are personal care, which is a different kind of visit.

Most of these start with a phone call, and a companion can make it with your relative during a visit. You can find your local library service on GOV.UK by postcode. The NHS page on free NHS eye tests says that somebody eligible for a free NHS sight test may also be entitled to a mobile sight test at home if they cannot leave home unaccompanied because of a physical or mental illness or disability. If your relative's sight is failing as well, sight loss and care at home covers what helps.

The free routes to company are set out in befriender, volunteer or paid companion, with who to ring for each. A volunteer and a paid companion can work alongside each other: the volunteer's call on a Tuesday, the companion on Monday, Wednesday and Friday.

One reason somebody stops going out is fear of falling, and that fear can feed itself. Doing less weakens the legs and the balance, which makes a fall more likely, which makes going out more frightening. Fear of falling explains that cycle and what the NHS and NICE say breaks it. The NHS says exercises to improve strength, balance and flexibility can help somebody who has fallen or is worried about falling feel stronger and more confident on their feet, and that a GP is the person to see if you are worried about balance or mobility. For the strength and balance work itself, how to get physiotherapy at home and keep the exercises going covers the NHS and private routes.

1. 1

   Talk to the GP or a physiotherapist first

   Before anything else

   Ask whether your relative could be referred for strength and balance work, and whether they need a walking aid. The steps below go better with a professional's advice behind them.
2. 2

   The doorstep and the garden

   A few visits

   Opening the door, standing on the step, sitting outside with a drink. The companion is alongside, and the visit ends before your relative is tired.
3. 3

   To the gate, then the end of the road

   When the step feels ordinary

   A short walk with a known turning point and a chair to come back to. If a walking aid has been fitted, it goes every time.
4. 4

   A short trip with a known place to sit

   When the walk feels ordinary

   A café, the corner shop or a neighbour's house, somewhere close with a seat and a toilet, and a plan for coming home early if it is not going well.
5. 5

   A regular outing

   Once it feels possible

   The hairdresser, a lunch club or a friend's house on the same day each week, so going out becomes part of the rhythm rather than an event.

A step back is part of this, not a failure. A chest infection or a bad week can mean a few visits at the doorstep again before the next walk. If a walking aid is part of the plan, walking aids and how to choose one explains why it should be fitted by a physiotherapist or occupational therapist rather than bought from a photograph.

If fear of going out is the main thing keeping your relative in, rather than their legs or their breathing, that is worth raising with the GP in its own right. The NHS page on agoraphobia says it should be possible to arrange a telephone consultation for somebody who does not feel ready to visit the surgery, and that people can refer themselves to NHS talking therapies without seeing a GP. A companion can help with the phone call. Treatment is for the GP or a therapist to decide.

The NHS pages behind that list are on low mood and loneliness in older people, malnutrition and pressure ulcers. Mental health in later life covers telling a bad week from something the GP should see, and what to do if you are worried about their safety today. Agree with the carer at the start how they will tell you, whether that is a message after each visit or a call if something changes, so nothing waits for the next time you happen to speak.

The example week at the top of the page is 6 hours, usually about £108. How much does a companion carer cost? sets out other patterns. When you are ready to look for somebody to visit your relative regularly, you can search for carers near you and compare their rates before you sign up to anything.

PrimeCarers is an introductory service, not a care agency. Carers are self-employed, set their own rates, and you choose who visits. Before a carer's profile appears, they have had an identity check, a right to work check and an enhanced DBS check on the Update Service, and have been interviewed online. We do not check qualifications, training or references, so what a carer says about their experience is their own account, for you to ask them about. Separately from those checks, every visit booked through PrimeCarers is insured, by the carer's own policy or by cover PrimeCarers arranges where they do not hold one.

Some of the cost may not have to come from savings. Attendance Allowance is a benefit for people over State Pension age whose illness or disability means they need help caring for themselves or somebody to supervise them, and GOV.UK says it is not means tested. A council care needs assessment is free to ask for and can lead to help with the cost. PrimeCarers does not give financial advice, so for anything beyond these, talk to a regulated adviser. If your relative is reluctant to let anybody in at all, how do you get someone to accept care covers how to raise it and what to try.