After two years, the church set up a monthly group in the lounge using the ‘Brain and Soul Boosting’ resource from Pilgrims’ Friend Society. Jenny, although shy at first, began overtime to share her faith with others and publicly praise God in the times of prayer. For the others in the group, the resource was a great springboard to communicate the gospel and was a safe place to be vulnerable, built on the strong foundation of friendships built over time.

Church members moving into a care home may feel isolated and cut-off from the fellowship of the church; it is common for members to feel forgotten and abandoned when they move into a care home. Arranging for regular visitors, including members in church activities and involving them in meetings and decisions about church life, are all ways in which the church can help those living in care homes to remain active in the fellowship and maintain a valued contribution to church life.

Ministry and pastoral care to people living in care homes can be undertaken by many members of a Christian faith organisation – it does not have to be only the remit of the leadership team or pastoral care team. Indeed, this ministry can be intergenerational – involving a wide range of age groups from the church; it can involve single visitor support or small team ministries. Care home residents can be encouraged and enabled to attend church services, events, and regular activities; church groups can be facilitated to provide outreach and teaching to those living in care homes – e.g. small services held in the home, bible study, or prayer groups, children and young people visiting to sing, perform small plays or simply read or talk to residents.

National Schemes to Support Those Living in Care Homes

There are several national schemes to promote the pastoral & spiritual support of people living in care homes:

Care Home Friends

Care Home Friends is a Christian organisation that exists to support churches in making links with local care homes. They work to facilitate churches to ‘adopt’ local care homes, with trained volunteers spending time and building friendships with residents and developing good community and neighbourhood relationships between church and care homes (www. carehomefriends.org.uk)

The Methodist Homes Association

The Methodist Homes Association employ Care Home Chaplains who regularly visit residents in care homes, building up relationships and getting to know the life experiences and interests of the residents, in order to better meet their spiritual and pastoral needs. (www.mha.org.uk).

Anna Chaplaincy

Anna Chaplaincy promotes the support of local churches with regular visits to residents in care homes and the provision of small religious services to offer spiritual and pastoral support to those living in care homes (www.annachaplaincy.org.uk).

Pastoral Action in Residential Care Homes for the Elderly

PARCHE (Pastoral Action in Residential Care Homes for the Elderly) is a church-based ministry of Christian teams who visit care homes to bring fellowship, comfort, bible-teaching, communion, and friendship to the elderly living in care homes (www.parche.org.uk).

How Church Can Provide Pastoral Support

Here are some ideas for churches to provide pastoral support to those living in care homes:

• Identify and understand the services of local care homes in the neighbourhood.
• Meet with the managers and staff of local care homes, to hear how the church can help
  them in meeting the spiritual and pastoral needs of residents.
• Break down the barriers and dispel the myths and fear of care homes through fostering good relationships between church and local care homes.
• Ensure that every church member living in a care home is visited regularly and kept informed and involved in church activities and decisions.
• Invite and include care home residents to church services and regular activities.
• Offer practical support to residents who may wish to attend church, e.g. care, transport.
• Identify opportunities for church members to engage with local care homes – visiting,
  befriending, holding small services.
• Involve church groups in ministering to residents in care homes – e.g. bible study, prayer
  groups, youth and children groups visiting, nativity play performance, singing.
• Identify a pastoral lead for ministry to local care homes – to liaise with care homes, co-ordinate pastoral support and links with the church.

© Professor Keith Brown from ‘Guidance for Christian Faith Organisations in the Support and Value of Older People’.

With a lack of experience of how care homes work, knowledge about the type of care different registrations provide and an understanding of how to reach out and engage with residents and staff, there can be a fear and reluctance to visit and get involved with local care homes. By spending time getting to know the different care homes in the neighbourhood of the church, understanding the sort of care provided and needs of residents, and making introductions to the care home management and staff teams, local churches can help bridge the gap towards care homes, establish regular contact and relationships with staff and residents and thus reduce the fear of moving into care home settings.

The Care Quality Commission (2015) define a care home as “a place where personal care and accommodation are provided together”. People may live in the service for short or long periods. For many people, it is their sole place of residence and so it becomes their home, although they do not legally own or rent it. Both the care that people receive and the premises are regulated by the CQC. The care and activities which care homes provide are defined as ‘regulated activities’, which include personal care, accommodation, nursing care, treatment of disease or injury, management of long-term conditions.

Care homes for adults will be registered specifically for people who are:

• Over 65
• Living with Dementia
• Have long-term mental health conditions
• Require treatment for substance misuse
• Living with Learning Disabilities
• Living with Physical Disabilities.

The majority of care homes are registered as ‘Residential’ homes – providing long-term care, convalescence, crisis support or respite care on a 24-hour basis. Where the care and support for individuals require the ongoing input of registered/qualified nurses, the care home will have to be registered as a ‘Nursing Home’.

There are also other forms of registration, where people live independently, receiving regular personal care and support with long-term conditions on a daily or regular basis (but not 24 hours) – these include ‘Supported Living’ and ‘Extra-care Housing’. Details of registration and the scope of regulated activities can be found on the CQC website: www.cqc.org.uk/

Funding for Care Home Placements

Funding for care home placements can be complex; the arrangements for funding will often change, as the needs of the individual change. For example, funding of a specialist placement for someone with Dementia may be higher for the first few weeks, as the person needs more care to settle into the home; someone whose condition rapidly deteriorates may require more care and the funding may need to be increased. Care home fees are set by the provider organisation – but the local authority and NHS will agree and set parameters for public funding of placements; this will include resource for the provision of care according to the regulated activity of the care home – it will not include additional costs for extra services, activities or specific aspects of the accommodation such as a view, garden access, etc.

A now chronic funding situation in Adult Social Care means that year on year there have been fewer local authority funded placements. Some care homes struggle to maintain financial viability and the Care Home sector represents one of the lower paid, with high vacancy rates and turnover of staff. The lack of public funding for care home placements means that many people have to use their own income and savings to fund their care home. In these cases, the individual agrees the fee and services direct with the care home manager. The local authority could pay for some or most of the care home fees, following a care needs assessment which is undertaken by an Adult Social Care department. Any care home funding which is met by the local authority is ‘means-tested’, so that the individual makes a contribution to the costs of their care, according to their ability to pay.

The Funding of Care Homes by Local Authorities

The following applies to the funding of care homes by local authority:

• The ‘care needs assessment’ identifies the individual’s needs for care home placement and the associated costs for this.
• The ‘care needs assessment’ will identify the cost of actual care and support required from a care home. Costs of additional services or extra aspects of care home fees, will not be included in the cost of care, e.g. hairdressing, social outings/activities, rooms with a view or garden.
• For the local authority to contribute to costs of a care home placement, a financial assessment of the individual will be undertaken. This includes the ‘means-test’ of the individual’s financial assets.
• The ‘means-test’ includes consideration of the individual’s income, savings and value of their property, to calculate how much they need to contribute towards the cost of care home placement.
• Where placement in a care home is a permanent arrangement, the value of property is included in the ‘means-test’.
• A person’s property will be included in the means test at its present market value, but less any mortgage or loan remaining and less 10% of its value where there would be expenses to sell it.
• Where a property or savings is jointly owned, the values will be considered equally and only a proportion of the value of assets will be included in the ‘means-test’.
• The local authority sets a national range of value of financial assets, above which an individual must pay for their own care home placement (this is classed as self-funding).
• If a person’s financial assets fall between the lower and higher value set nationally, the local authority will fund some of the care home fees, but the individual will have to pay the rest.
• Once an individual’s assets fall below the lower value – the local authority will fund the cost of care home placement, identified through the ‘care needs assessment’.
• Anyone paying for their own care home placement should not be left with less than the Personal Expenses Allowance per week. This is set nationally and reviewed annually.
• Where the value of a property is included in the financial assessment and results in the individual contributing to or paying in full for their care home placements, payments may be deferred until the property is sold and funding available. (further information from www.ageuk.org.uk)

When the care of the individual is to meet a primary healthcare need, and the individual needs ongoing, specialist nursing, therapy or medical input, the funding may be met by the NHS. In this case, the individual is not required to contribute to any costs of the care home placement.

NHS Funding for Care Home Placement

Individuals should be considered for NHS funding of care home placement when:

• Plans are being made for a care home placement on discharge from hospital.
• It is believed by health and social care staff that the person’s significant health needs are unlikely to improve after a period of rehabilitation – in hospital or the community.
• Prior to moving to a Nursing registered care home.
• There is a significant deterioration in the individual’s physical or mental state and the current level of care seems inadequate.
• On an annual basis, when an individual is living in a Nursing registered care home.
• If the person’s health and condition rapidly deteriorate and they may be approaching the end of life.

There are a wide range of advice for individuals and families regarding choosing a care home – from statutory, voluntary and private organisations. As with any accommodation or housing, the choice of care home is very personal – with the added requirement that the care provider must be able to meet the personal needs for care and support, nursing and long-term management of their condition. Older people may turn to the church for support and advice about moving into a care home – whether for short or long-term care. If the individual has no local family, has become unwell and frail or needs to make a decision when being discharged from hospital or to avoid a hospital admission, they may look to the church fellowship for support, guidance and advice.

Whilst church members or leaders have no legal or formal input to decisions about care homes – unless someone has been appointed Lasting Power of Attorney for health & wellbeing for an individual – older people may need and appreciate the pastoral support in helping them choose a care home and make the necessary arrangements for this.

How to Help Someone Choose an Appropriate Care Home

The following may be helpful in supporting someone to choose an appropriate care home:

• Be clear what needs the individual has, in terms of care and support.
• Where does the individual want to live – at home? locally? near to family?
• Understand all the options – can the care be provided at home? could the placement be short-term? what type of care is needed?
• Make a short-list of suitable care homes.
• Read the inspection reports – www.cqc.org.uk.
• Contact the care homes – to discuss the type of care they provide, fees and vacancies.
• Visit the care homes, with the individual to get a feel for the place, residents, staff.
• Look at the layout of the care home, the garden, communal spaces, corridors.
• Ask about social and spiritual care – mealtimes, social activities, pastoral support, religious activities, links with local churches and the community.
• Ask family, friends, neighbours for recommendations.
• Offer prayer and pastoral support to the individual – as with any big decision of life, moving into a care home is better undertaken in a planned and prayerful way, if this is possible and time allows.

Sources to Help Choose the Right Care Home

• Age UK (2019) – Choosing the right care home – www.ageuk.org.uk Care Quality Commission (2019)
• Help Choosing Care – www.cqc.org.uk Healthwatch (2017)
• Five Steps to follow when choosing a care home – www.healthwatch.co.uk Healthwatch (2017
• Choosing a Care Home, The Mum’s test – www.healthwatchlancashire.co.uk Independent Age (2020)
• How to Find the Right Care Home – www.independentage.org.uk Which? (2020)
• Later Life Care; Tips for choosing a Care Home – www.which.co.uk

© Professor Keith Brown from ‘Guidance for Christian Faith Organisations in the Support and Value of Older People’

Wendy Dodson, one of our Church Champions, recently sent an email to us sharing an interview she did for BBC Three Counties Radio. During the interview, Wendy shared about her ministry with older people in her church and we were so inspired that we just had to share it. So, with Wendy’s permission, we have written the interview up into a blog format. 

Wendy Dodson is part of St Luke’s Church in Watford. She led a thriving over 60’s group called ‘Being Educated’ that meets every Tuesday for coffee, Bible study, expression, and prayer at St Luke’s Church. The group grew out of a social coffee morning that was held on Tuesdays. However, the members of this group said they wanted something more spiritual, as Wendy Dodson explains, 

“There was already a flourishing Friday lunch club for older people, and they started coming on the Tuesday morning. They were asking to have either an Alpha course or a Lent course. And that’s how it began.” 

During her interview with the BBC, Wendy shared lovely stories of spiritual renewal, reconciliation, and healing that God had worked in the group. This is what she had to say,  

“We like the idea of blessing people by giving them a nice cup of coffee and a welcome, then they feel they belong. One lady said that the turning point for her was when somebody said, ‘I have saved you a seat’. That is when she really felt like she belonged.

Having blessed people and helping them feel that they belong, we want to help them come to faith and believe because this changes their behaviour in the challenges of life.” 

Romans 14:7-9 says, “For none of us lives to himself, and none of us dies to himself. For if we live, we live to the Lord, and if we die, we die to the Lord. So then, whether we live or whether we die, we are the Lord’s. For to this end Christ died and lived again, that He might be Lord both of the dead and the living.” 

We all want to feel that sense of belonging, of being part of a family, of experiencing unconditional love. But we all come from very different walks of life, and not everyone has a positive view of family. So, simple things like saving a seat for someone or greeting people at the door and welcoming them inside can let people know they are loved. 

I am often reminded of the words of Jackie Pullinger, a straight-talking missionary, who worked in The Walled City. She shared in an eye-opening interview that Christianity isn’t all about preaching, it’s also about acting. People come from very different backgrounds and they interpret words and expressions very differently. During her time spent in the Walled City, Jackie was asked whether it was a problem that she did not speak the language. Her response changed the way I thought about Christian ministry. 

“If I had known Chinese I would have said too much. I thought that preaching the gospel was explaining how Jesus came to die for your sins and, of course, that’s not preaching the gospel at all. Because that’s not necessarily good news to anyone who doesn’t know love, who doesn’t understand your language, who doesn’t follow your logic. So, it was a good thing because I found out that the people were not listening anyway, they were watching to see how I acted, whether I really did love them. And if I really did love them, maybe God really did love them.” 

Isn’t that beautiful? Sometimes it’s the simple things that make all the difference; taking the time to listen, making someone a cup of tea, phoning once a week to check-in, praying for someone when they come to mind. Be encouraged that God can work through the normal everyday situations to reveal His love to the lost. 

Wendy certainly discovered this for herself, with her over 60’s group, as she explains, “We have seen lots of answers to prayer. We have seen people who have not been reconciled in their families become reconciled to them. 

For instance, one lady had a son that she didn’t like but she loved her daughters, and she gave the daughters money regularly. She was very challenged by what we had been discussing and she came one Tuesday and said, ‘I just want you to know that I’ve actually written a cheque to my son’. That was a very moving occasion.

Another time, we were reading a passage from Isaiah 49:15-17 that says, ‘can a woman forget her nursing child, that she should have no compassion on the son of her womb? Even these may forget, but I will not forget you. Behold, I have engraved you on the palms of my hands; your walls are continually before me. Your builders make haste, your destroyers and those who laid you waste go out from you.” 

One of the women in the group became a little tearful and asked if I could visit her. So, I went round in the afternoon to see her. She told me that she’d been adopted and had never ever told anybody, not even her husband of her children, and she’d carried the burden of not being loved by her mother with her all these years. We were able to talk about it and she really found some healing from that which was wonderful.” 

Wendy Dodson and her team have been faithfully serving the over 60’s at St Luke’s Church every Tuesday for a long time and they are still so encouraged and overwhelmed by the many ways God restores, heals, and brings joy to people over and over again. 

If you have a passion for serving older people but you don’t know where to start, would you join our community of Church Champions? We encourage and walk alongside hundreds of church champions who care about reaching, serving and empowering older people. Maybe you can start supporting those in your community today by praying for people you know of, making phone calls to the lonely, writing letters, or carrying out doorstop visits. We also have a variety of free resources on our website to help give you some ideas.  

To listen to the full interview with Wendy Dodson, click here. I know it will be a great encouragement to many of you faithfully serving in this season.

During our chat with Mavis, she shared about her time working in residential care homes and hospital wards for older people. In the care home, there was one particular man whose door she used to pass by every day on her rounds. One day, he called her inside. They got talking and the man shared about how he used to teach Greek and Hebrew back in the fifties. Mavis thought his intelligence and knowledge around complex topics was simply incredible. While he was talking, she couldn’t help thinking ‘what do I know about that?’

She shared with us, “he was very much into deep conversations and questioning you on things. I said that I don’t know much about what he does but I could tell him about Jesus.”

After a few conversations, he started opening up. He shared about how he was once engaged to a lady who became hospitalised in Canada in a coma. He shared how his fiancé woke up one day and said to him, “I don’t know why you’re interested in heaven because there is nothing there. I have been in a coma and there is nothing there. It’s nonsense.”

Mavis told the man that his fiancé was right in one respect, but not the other. When you are in a coma, there is nothing there. The Bible says that when you die, there is judgement, but she wasn’t dead, she was in a coma. Now that she has died, she will be somewhere. Either in heaven or not in heaven. “So,” Mavis said to the man, “she told you the truth in one respect. There is no judgement when you are in a coma because there is no heaven or hell there.” After sharing this, Mavis left him to think about what she had said until the following week.

When she returned to see him the next week, he said that he understood what she had shared but that he could not make a decision. For four months, week after week, his response was the same. The whole time, Mavis was praying to God, asking Him to give her something to say to this man.

One day, while she was visiting with him, she said, “when you were working in the Middle East, it was hot wasn’t it?” He replied that it was. Mavis asked him, “did you wear shirts?” He replied that he did. He had two shirts: one white and the other blue. Mavis asked how he decided which shirt to wear each day and he told her he would open up his wardrobe in the morning and decide.

Mavis told the man, “if you want to accept Jesus as your Lord and Saviour, I want you to pick a white shirt. If you don’t want to accept Jesus as your Lord and Saviour, I want you to pick a blue shirt. I am going away for a week now, but when I come back, I want you to have made your decision.” And then she went away.

When Mavis returned a week later, she came back to see the man and he said, “I have picked a white shirt and now you need to pray for me.” Mavis was overwhelmed and thanked God. She prayed for the man and then she went away for a fortnight’s holiday with her husband.

On the third Monday, she returned and went to the office to sign-in before paying her visit. The lady at the reception said there was no point coming to visit because the man had been sent to hospital on the Monday before and on the Saturday he had passed away.

From her first conversation with the man, to the day he passed away, six months had passed. Six months went by but God would not give up. God kept him alive until he was saved.

Mavis told us, “it is such a humbling experience because it has got nothing to do with you. We are just the mouthpiece for God and I just think of the day when we get to heaven and I say to that man, ‘no shirts up here then!’”

During our time together, Mavis shared another story of a woman on the ward who she visited with. This lady had dementia and did not speak at all. When Mavis went to see her, she was very distressed. Mavis told us, “I said to the lady, ‘you weren’t very well last night’, and she looked at me straight in the face and said, ‘He wouldn’t let me go up the ladder’. ‘Who wouldn’t let you go up the ladder?’ I asked her. She said, ‘you know Him, and He wouldn’t let me go up’. So, I said, ‘Okay, I understand. Do you want to go up?’ She said that she did but that He wouldn’t let her.”

So, Mavis said, “I will hold your hand and I will pray and if you accept this prayer with your heart, then we will know.” They prayed together and Mavis told the lady she would see her next week. As she was turning to leave, the lady said, “I can’t go up the ladder yet because I haven’t spoken to my son in two years and I need to put it right.”

The next week, Mavis went to visit the lady and was met by one of the staff members in the hall. He said that something funny had happened during the week. He shared that the lady’s son had turned up, there were lots of tears, and then he went away.

Mavis went in to visit with the lady and she said her son had come to visit and it was good. Mavis prayed for her again and said, “I will see you next week.” But the lady replied, “I won’t see you next week because my daughter-in-law is coming and then I am going up the ladder.”

The following week, Mavis visited the ward and was greeted by another one of the carers who told her that the daughter-in-law had come, there had been lots of tears, and then she had left. The carer said, “I went in to make her a cup of tea, but she was lying in her bed with her hands on her chest and she was gone.”

“It blows my mind, the mercy of God,” Mavis told us, “these people that nobody talks to or makes time for, because they don’t think they understand, I see God break-in. You see the tenderness in the heart of God in those situations.”

Before you had even thought about God, He was pursuing you. The stories Mavis has shared are a wonderful reminder that God is always pursuing us, even when we are far from Him or we can’t make up our minds whether to follow Him, or we have unresolved problems, He is always pursuing. He loves us so much that He never gives up – not even when our lives are drawing to a close. Praise God for His mercy!

Psalm 139:16-17 says, “Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there were none of them. How precious to me are your thoughts, O God! How vast is the sum of them!”

To find out more about joining our free Faith in Later Life Church Champion community, visit our Church Champion website page.

1. Treat the person with respect and dignity

Be positive and encouraging; make the individual feel included and valued.

2. Be a Good Listener

It is important to be a good listener to the person and their family. Often, people just need a chance to share what they are experiencing, their fears, and their feelings. Someone with Dementia may need more time to answer questions or say what they mean to say.

3. Communicate Well

Do your best to be clear and calm. Ask questions clearly and simply to convey warmth and understanding. Even if you don’t understand what is being said, try not to get irritated or stressed.

4. Remember the Little Things

Show that you care and they count. Don’t avoid or exclude the person with Dementia, but reassure, encourage, and include them.

5. Stay in Touch

Hearing from someone briefly, even if it’s just a five minute phonecall, helps a person with Dementia and their family to feel less isolated or less like they have been forgotten. So, do your best to stay in touch because it can make all the difference!

6. Offer Practical Help

Sometimes, it’s the little things that make all the difference for someone living with Dementia. Supporting the person with independence by offering practical help in the form of transport, housework, shopping, gardening, or chores is often greatly appreciated. Try to offer help with practical tasks but in a sensitive way (maybe asking to undertake a task jointly with them so they aren’t made to feel incapable).

7. Organise a Treat

We are all different and so organising a treat is something very person-specific. Some treats do not need to cost a lot or even take up a lot of your time; for example: bringing around afternoon tea, flowers, or a nice meal. Try to think of some way you could brighten up their day with something special.

8. Help Family Members

Supporting those living with and caring for the person with Dementia is just as important as caring for the individual themselves. Often, family members need practical help, emotional support, and regular breaks from being a carer. So, do what you can to offer support to family members in ways that bless them.

9. Find Out More About Dementia

Much of the fear around this condition is due to a lack of understanding of it, how it affects people, and how it might alter behaviours. So, the most helpful thing you can do is educate yourself by finding out more about Dementia. Equipping yourself with all the information is a great way to get rid of the fear that surrounds this condition and take control of your response to it.

10. Help People Get Help and Support

There are many different services, helplines, and support groups to help people with Dementia and their families. Whilst health services may be able to help with diagnosis and medication, the majority of support and ongoing help comes from community groups, services, and voluntary organisations.

We hope you have found this advice helpful and we pray it equips you with the support and guidance you need to support another person with dementia in the best way possible.

(Based on Alzheimer’s society 2014)

© Professor Keith Brown excerpt from ‘Guidance for Christian Faith Organisations in the Support and Value of Older People’ – become a church champion to receive a free copy of the full guidance booklet over email