Two people with dementia may need very different support. One may need reminders and help finding the bathroom; another may need assistance throughout the night. Before visiting homes, write down the person’s usual routines, communication, sleep, food preferences, mobility and situations that cause distress. Ask the treating team what the next placement must be able to provide.
Ask staff to work through a real situation
| Situation | What to ask |
|---|---|
| Wakes and walks around at night | Who is on that unit at 3am? How do staff supervise movement, offer help and record changes? |
| Becomes distressed during bathing | How would staff learn the person’s preferences, change the approach and involve family or clinicians if distress continues? |
| Has eating or swallowing instructions | Who follows the professional meal plan, assists at meals and reports difficulties? |
| Has difficulty explaining pain or discomfort | What observations are recorded, who reviews them and when is medical advice sought? |
Look at the environment and an ordinary shift
The Department of Health’s environment guidance highlights clear cues, suitable lighting and an environment that supports daily activity. During the visit, look for a recognisable route to the toilet, places to sit away from noise and opportunities for safe movement. Ask how the home adapts the setting to the individual, rather than treating a locked door as the whole care plan.
Ask to meet someone who normally works on the unit, not only the person conducting tours. How are the person’s preferred name, language and routines passed to relief staff? What happens on weekends? A polished activities calendar says little about support when a resident is confused outside an organised session.
Do not sign away the discussion about restraint
Ask what alternatives are tried, who authorises restraint, how consent is obtained and how use is reviewed and recorded. The SWD Code of Practice, section 12.7 addresses these procedures. A blanket admission form is not a satisfactory explanation of why a particular measure would be used for your relative. Any proposed sedating medicine belongs in a discussion with the treating clinician, including its reason and review plan.
Agree how the family will hear about changes
Name a main and backup family contact. Agree when staff will report changes in eating, sleep, mobility or behaviour, and set the first care-plan review date. Include the resident in decisions in a way they can understand; ask the care team for help when consent or decision-making is uncertain.