Living with a serious condition like dementia doesn’t have to mean moving into residential care. For many families across Camden, Islington, Haringey, Hackney and greater London, professional home care makes it possible to stay in the place that matters most — home.
At Visiting Angels North London, we support people living with a wide range of conditions — from dementia and Parkinson’s disease to complex care needs and the complications that come with ageing. This guide explains how home care helps, condition by condition, and what families in North London need to know.
Dementia and Alzheimer’s Disease
Dementia is one of the most common reasons families come to us. Around 944,000 people in the UK are currently living with dementia, and that number is projected to rise to over one million by 2030.
For someone living with dementia — whether Alzheimer’s disease, vascular dementia, or another type — familiarity is everything. The Alzheimer’s Society notes that remaining at home “allows them to stay in a place that feels familiar and safe to them.” The smells, the layout, the routine — all of these provide an anchor when memory begins to fade. Moving into a care home, however well-staffed, removes that anchor entirely.
Home care in the early and middle stages of dementia typically involves:
- Support with personal care, washing, and dressing
- Medication prompting and management
- Meal preparation and nutrition monitoring
- Companionship and cognitive engagement
- Assistance with mobility and fall prevention
- Support for family carers, including regular check-ins and respite
As the condition progresses through its later stages, the level of support can be increased — right up to 24-hour live-in care where needed.
The 7 Stages of Dementia
Dementia is broadly described as progressing through seven stages: from no cognitive impairment in the earliest phase, through mild forgetfulness, noticeable memory loss, moderate decline requiring help with daily tasks, moderately severe dementia requiring hands-on personal care, severe dementia, and finally very severe dementia where the person needs full-time support with all aspects of daily living. Not everyone progresses at the same rate, and some conditions — like Lewy body dementia — can involve sudden changes rather than gradual decline.
What Is Sundowning?
One of the most challenging aspects of living with dementia — both for the person affected and for their family — is sundowning. Sundown syndrome, or sundowning, describes a pattern of increased confusion, agitation, restlessness, or distress that occurs in the late afternoon and evening.
The Alzheimer’s Society describes sundowning as a recognised behavioural symptom that can affect people at various stages of dementia, particularly as the condition becomes more established. Possible triggers include fatigue, low lighting, disruption to routine, and changes in the body’s internal clock.
Strategies that can help with sundowning include:
- Keeping the home well-lit as daylight fades
- Maintaining a consistent daily structure
- Reducing stimulation in the late afternoon
- Gentle physical activity earlier in the day
- Calm, reassuring conversation in the early evening
- Dementia care at home
A live-in carer who is present through the evening can make an enormous difference here. Managing sundowning requires patience, knowledge, and presence — things that aren’t possible without someone in the home at that time.
Dementia with Lewy Bodies (DLB)
Dementia with Lewy bodies (DLB) is the second most common form of progressive dementia after Alzheimer’s disease. It is caused by abnormal clumps of protein — called Lewy bodies — forming in the brain, affecting both cognitive function and physical movement.
DLB is often harder to manage than other forms of dementia because of its distinctive and unpredictable symptom profile. In addition to the memory and thinking difficulties common to all dementias, DLB typically causes:
- Visual hallucinations — often vivid, detailed, and distressing
- Fluctuating cognitive ability — the person may seem almost completely lucid one moment and severely confused the next
- Parkinsonism — tremors, stiffness, and slowness of movement
- REM sleep behaviour disorder — physically acting out dreams, often involving movement or shouting
- Extreme sensitivity to certain antipsychotic medications
That last point is particularly important. Some medications commonly used to manage agitation in dementia are potentially dangerous for people with Lewy body dementia and can cause a severe adverse reaction. A carer experienced in DLB will know to flag any medication changes immediately to the GP or specialist team.
Sleep is also a major concern. According to the Lewy Body Society, sleep problems affect approximately 40% of people with Alzheimer’s disease — but up to 90% of people with Lewy body dementia. This is one of the strongest arguments for having overnight support in place.
The average life expectancy following a Lewy body dementia diagnosis is around six years, according to the Alzheimer’s Society — though this varies significantly. Given the rapid and unpredictable nature of the condition, early care planning is strongly recommended.
Living With Parkinson’s Disease
Around 153,000 people in the UK are currently living with Parkinson’s disease. It is a progressive neurological condition affecting the brain’s ability to produce dopamine, which in turn affects movement, balance, and — over time — cognition.
As Visiting Angels’ own national guidance notes: “Living with Parkinson’s means facing change, but it shouldn’t mean giving up your independence.” Home care is central to making that possible.
How Home Care Supports People With Parkinson’s
The physical demands of Parkinson’s often increase gradually. A person who manages well independently in the early stages may need increasing support as the condition progresses. Home care can be scaled precisely to that need — from a few hours of support per week to full-time live-in care at more advanced stages.
Our carers support people living with Parkinson’s with:
- Medication management — timing is critical in Parkinson’s care; missed or delayed doses can cause significant symptom fluctuation
- Fall prevention — Parkinson’s significantly increases fall risk; experienced carers understand safe transfer techniques and home hazard awareness
- Mobility support — including help with walking aids, exercises recommended by a physiotherapist, and getting in and out of bed
- Personal care — dressing, bathing, and toileting with full respect for dignity and independence
- Nutrition and hydration — swallowing difficulties (dysphagia) are common in later-stage Parkinson’s and require careful attention at mealtimes
- Communication support — Parkinson’s can affect speech, and a carer who takes time to listen and communicate patiently makes a real difference
Parkinson’s UK recommends that people with the condition have their care needs assessed regularly, as needs evolve. Contact our team to discuss a care assessment for your loved one.
Urinary Tract Infections in Older People: What Every Family Needs to Know
Urinary tract infections (UTIs) are one of the most common health concerns in older adults — and one of the most frequently misunderstood. In younger people, a UTI tends to produce classic symptoms: a burning sensation when urinating, frequent urge to use the toilet, and cloudy or foul-smelling urine. In older people, these physical symptoms are often absent — or masked.
UTIs and Dementia: A Dangerous Combination
For people living with dementia, a UTI can look like something much more alarming. According to the Alzheimer’s Society: “UTIs can cause sudden confusion (also known as delirium) in older people and people with dementia. If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI.”
Age UK similarly advises that a UTI in someone with dementia “may quickly [cause them to] become more confused or agitated, or you might notice a sudden change in their behaviour” — and crucially, notes that “infections can speed up the progression of dementia, so it’s important to get help quickly.”
Research published in Alzheimer’s & Dementia by Cedars-Sinai describes the relationship between infection and cognitive decline starkly. As principal investigator Dr Shouri Lahiri explains: “It’s a vicious cycle where dementia increases the risk of infection, and infection-related delirium accelerates cognitive decline.”
This is why rapid recognition matters — and why a consistent, attentive carer is so valuable. A family member who visits once a week may not catch the early warning signs. A carer who is present daily almost certainly will.
How to Prevent UTIs in Elderly People
Prevention is far better than treatment. Key strategies include:
- Good hydration — dehydration is the single biggest risk factor. Many older people don’t feel thirst adequately and need prompting to drink throughout the day
- Consistent personal hygiene — particularly important during all personal care and toileting routines
- Regular prompted toileting — avoiding long periods without passing urine
- Monitoring for early warning signs — any change in urine colour, odour, or frequency, alongside any shift in mental state or behaviour, should prompt early medical review
A live-in or visiting carer is ideally placed to monitor all of these — and to escalate quickly when something doesn’t seem right.
Read more about how our carers support complex health conditions →
Complex Care Needs
The term “complex care” refers to support for people whose needs go beyond standard personal care — typically because of a serious medical condition, multiple co-existing diagnoses, or the need for clinical-level interventions at home.
Complex care at home can include:
- Catheter care and stoma care
- PEG feeding and nutritional support
- Medication administration, including insulin or subcutaneous injections
- Epilepsy monitoring and seizure management
- Post-stroke rehabilitation support
- End-of-life and palliative care
- Two-carer support for people who require assistance from more than one person
At Visiting Angels North London, we work alongside district nurses, GPs, and specialist community teams to ensure that people with complex care needs receive the full clinical oversight they require — while living in their own homes.
Find out more about complex care support in North London →
Coming Home from Hospital
For many families, the need for home care becomes urgent following a hospital stay. Older people are particularly vulnerable to what’s known as deconditioning in hospital — a rapid decline in physical and cognitive function caused by bed rest, disruption to routine, and reduced activity.
The risk of a fall, infection, or readmission is highest in the days and weeks immediately following discharge. Home from hospital care provides the intensive support needed to bridge that gap safely — and to prevent an avoidable return to hospital.
We work with discharge teams across North London and can often arrange care quickly when a hospital discharge is planned.
Talk to us about home from hospital support →
Choosing the Right Home Care Provider in North London
If your loved one is living with any of the conditions described above — dementia, Lewy body dementia, Parkinson’s disease, or complex care needs — the quality and consistency of their carer matters enormously.
At Visiting Angels North London, we:
- Are registered with and regulated by the Care Quality Commission (CQC)
- Operate across Camden, Islington, Haringey, Hackney, Newham, Brent and Tower Hamlets
- Draw on over 30 years of global Visiting Angels expertise, combined with a team deeply embedded in the North London community
- Offer live-in care, 24-hour care, hourly visiting care, and specialist dementia care
- Carefully match carers to clients based on personality, needs, and experience — not just availability
If you’d like to talk through your options, we’re here to help — with no obligation.
📞 Call us today | 🌐 Request a free care consultation
Sources: Alzheimer’s Society (alzheimers.org.uk) | Age UK (ageuk.org.uk) | Lewy Body Society (lewybody.org) | Parkinson’s UK (parkinsons.org.uk) | Cedars-Sinai Medical Center | Visiting Angels UK (visiting-angels.co.uk)
