Overnight care so the family carer can sleep

The cost is the part most people are surprised by, and usually in the right direction. Families who have been carrying the nights alone for a year tend to have a number in their head that came from a care home brochure or from a friend who used an agency, and it is often twice what covering two nights costs. Nothing here is a minimum contract. You agree the nights directly with the carer, so a week that turns out to be wrong can be sorted out with a message, and plenty of families move their nights around the calendar as work, family visits and hospital appointments come and go.

One thing the planner cannot show you is what the nights are worth to the person you care for. Families almost always book night cover for their own sake and then find that the person receiving it sleeps better too, because somebody who is not exhausted and not on edge settles a house differently at ten o'clock at night. That is the part nobody puts in the budget, and it is the part people mention first when they tell us how the first month went.

If you recognise most of this, read the signs of carer burnout and how long carer burnout lasts. The second one matters, because the answer is longer than people expect and it is the reason to act before you are at the bottom rather than after. Our whole caring for a parent section is written for the person doing the caring rather than the person receiving it, and looking after yourself as a carer is the plainest place to start.

It is hardest on spouses. A husband or wife in their eighties caring for a partner at night is doing a job that would be given to two people in shifts anywhere else. Nobody expects a night nurse to do seven nights a week for two years. It is not a lack of devotion to say that a person cannot do it alone, and it is not a step towards a care home. In practice it is usually the thing that puts a care home off for years.

Two practical points. First, book the same carer for the same nights rather than taking whoever is free. The person receiving care settles far better for a face they know, and you sleep better when you know who is downstairs. On PrimeCarers you choose the carer yourself and agree the nights directly with them, so Tuesday and Wednesday is the same person every week.

Second, decide early whether you need a sleeping night or a waking night, because the difference is about twenty pounds a night and a lot of unnecessary worry. A sleeping night carer sleeps in a spare room and gets up when they are needed, which covers most situations including somebody up once or twice for the bathroom. A waking night carer stays awake all night, and is for somebody up most of the night, needing turning, or seriously ill. Do night carers sleep? answers the question families often feel awkward asking, and waking night or sleeping night walks through the choice. If it turns out you need all seven, read seven nights a week before you book, because a single carer cannot do seven nights indefinitely and there is a better way to arrange it.

1. 1

   Ask for a carer’s assessment

   Free, and it is yours

   Under the Care Act, councils in England must assess any carer who appears to need support, whatever the level of care they give and whatever their savings. It looks at your health, your sleep, your work and what you need to keep going, and it is separate from the assessment of the person you care for. Ask adult social services for one by name. Our guide to what a carer’s assessment is explains what happens and what to say.
2. 2

   Ask what the respite budget covers

   Varies by council

   If the assessment finds you need a break, the council may offer a respite budget. Ask specifically whether it can be spent on overnight care at home rather than a stay in a care home, because families often assume respite means the person going away and it does not have to.
3. 3

   Ask for it as a direct payment

   Choose your own carer

   Where a council agrees to fund support, it can usually be paid to you as a direct payment so you arrange the care yourself. That is what lets you choose a specific carer and specific nights rather than accepting an agency rota. Ask the social worker how direct payments work in your area.
4. 4

   Check the benefits that are not means tested

   Worth an hour

   Attendance Allowance for the person you care for is not means tested and is not affected by savings, and Carer’s Allowance may apply to you. Neither pays for a night on its own, and both are money that people who qualify often never claim. Age UK and Citizens Advice will help you fill the forms in for free.

Do not wait for the funding to start the care if you can avoid it. Assessments take weeks and sometimes months, and the point at which most families ring us is the point at which waiting another six weeks is not realistic. Book the nights you need now, keep the receipts, and keep the assessment moving in the background. When to consider respite care and the respite care pillar cover the wider options, including day cover and longer breaks.

The second one is worth taking seriously rather than dismissing, because it is sometimes true at first and almost never true after a fortnight. People do accept help at night, and they often accept it more easily from a carer than from a husband or a daughter, because it is not personal and nobody is embarrassed. The way through it is a daytime introduction: the carer comes for an hour in the afternoon, has a cup of tea, is introduced as someone who is going to help, and then arrives at nine that night as a face rather than a stranger.

The third one, the slippery slope, is the opposite of what usually happens. The families who end up in a care home fastest are the ones where the family carer could not carry on. Night cover is often what keeps somebody at home, and overnight care or a care home sets the two side by side.

There are two practical things to have ready before the carer arrives, and neither takes long. The first is a single page: the medication and when it is due, the GP's number, your number, what usually happens in the night and what has worked before, and where the spare bedding is. The second is the bed, if it is a sleeping night. A carer needs a proper bed in a room with a door, not a sofa, and it is worth making it up the day before rather than at half past eight while somebody stands in the hall.

Give it a fortnight, and change the carer rather than the plan if it is not right. The most common mistake families make is deciding after one bad first night that overnight care does not work for them, when what happened is that they lay awake supervising. The second most common is booking the wrong kind of night: a sleeping carer for somebody who is up every hour will not work, and that is a problem with the booking rather than with the carer.