So far in this Care Combine series, I’ve been talking mostly about the difference we want to make to the lives of dementia patients who continue to live in their own homes. Around 700,000 of them in the UK and 5 million in the US according to the sources we quoted in my previous article.

But The Care Combine is not just about the patients, because dementia is not a 1-person illness. Let’s make a full list of those we aim to help. You could call this The Care Combine Manifesto:-  

1. Dementia Patients

… should not feel cut off from their communities, lonely and isolated. They need daily contact with others in a safe environment, enjoying their company, having fun, and above all, doing things that make them still feel useful despite their new disabilities.

2. Family Carers of Dementia Patients

 … should not have to give up jobs or interests to provide 24 x 7 care for a loved-one. Just like everyone else, they’ll get tired, stressed and ultimately sick unless they get proper time off, on a regular basis, from one of the world’s toughest jobs. Proper training would help too.

3. The Families of Dementia Patients

… should not feel forced into the agonising and often very expensive decision to place their loved-one into full-time residential care only because no-one is at home during the day to provide the supervision required.

4. The Nation

… should no longer have shortages of

1. domiciliary care workers.
2. hospital beds — those currently occupied by dementia patients who no longer need treatment but cannot be discharged because there’s nobody to help them at home.
3. tax revenues from family carers forced to give up their jobs.

+ + + + +

So those are our objectives. How do we achieve them? This is my Care Combine Vision. It all starts with a physical place, which I’m calling The Bine.

What is The Bine?

It’s a community centre, ideally situated in the heart of the community, where 20-30 people with dementia — let’s call them members — come together every day of the week during working-hours. There are care professionals on site, aided by a number of volunteers — and we’ll call them helpers. In this safe environment and with as much help as they need, the members will be engaged in real, purposeful projects and activities.

What do you mean by ‘purposeful projects and activities’?

They do things for their community, for their family and friends, for one another. Like growing vegetables and donating them to a food charity. Or recording stories for the grandchildren. Or performing as a choir. Or going to visit people in the area who are housebound, perhaps doing their shopping for them or dog-walking. With the number of people at The Bine, members and helpers together numbering around 50, there’ll be scope for people to work in smaller groups, to choose the activity they enjoy best.

How will dementia family carers benefit from the Bine?

While their loved-ones are at The Bine, they’ll have the whole working-day free to resume their old careers or interests. Or take up new ones (perhaps with help from The Bine). Or if they enjoy the Bine activities, they can join in as helpers – and by volunteering 2 days a week, the person they care for will get free Bine membership.

How will you cope with different levels of member ability?

Some people with dementia continue to function at a high level, and will be encouraged to do so, taking leadership roles. Others need a lot more help. But even if they can only manage to stir the ingredients on a baking project with someone holding their hand, they’re still helping – it’s still their cake. The key is making sure we have enough hands to help, when they’re needed. Our aim? Never more than 2 members for each helper. 

What will you do if someone doesn’t want to join in?

There will be no compulsion. If a member wants to opt out, The Bine will have a quiet corner for them, with a helper to make sure they’re OK. But we’d also think about why, usually talking with their carer. Is it because they’re sick or tired? Is the task too difficult? Or are we asking them to do something they don’t enjoy? When we understand the reason, we can take the right action to fix it.

We also have to accept that The Bine will not be the right solution for everyone. If we found that a member was regularly refusing to participate, we would notify the family and suggest alternative arrangements.

How will the staff be trained?

We aim to set the gold standard in dementia care. Senior Bine staff in each location will be trained directly by the central Care Combine team, which will also provide support materials. Training will then be ongoing for all staff and helpers, with a different training topic set online each week. One huge benefit of this is that for the first time, family carers will receive formal training — because most of them will be volunteering at The Bine for at least 2 days a week.

How much will membership cost?

In every country where Bine Centres are set up, the central Care Combine team will set a standard weekly membership fee — typically this will be similar to the average fees that parents in that country might pay to put a child into a private pre-school full-time. But provided the carer volunteers for 2 days a week at The Bine, the fee is waived entirely – membership is FREE. Or for 1 day volunteering, it’s halved. The choice is made by the carer and the family. We believe that nobody should be denied good care because they can’t afford it.

Will anyone with dementia be able to join?

In principle, anyone living at home in the community, yes – although The Bine would not be suitable for those whose physical frailty required specialist equipment. We would also reserve the right to exclude anyone who posed a physical threat or was abusive to staff and members of The Bine community. But otherwise, anyone – no matter what their age or capability.

I’m not a carer. Will I still be able to volunteer to help?

Absolutely! The more helping hands we have, the better. Helping can mean just dropping in for a few minutes for a coffee and a chat, or getting fully involved in one of our big projects. And if you’re interested in a career in care (it’s a job that won’t be robotised), we’ll be able to set you out on the right path.

Will you be able to help us open a Bine Centre in our community?

We were hoping you’d ask. That’s The Care Combine’s intention – to help communities everywhere to set up their own Bine Centres. It’s the way we believe charities and social enterprises should work — at community level, where people can see at first-hand the impact of their own hard work and donations.

I’ve mentioned the central Care Combine team a couple of times. Our role will be to provide the materials, the training and the support that will make each independent Bine Centre a success — in return for an annual licence fee. For example, we’ll have experts in our team to advise on such matters as fundraising, legal issues, finding and equipping premises. We’ll supply manuals and videos for Bine activities and staff training. We’ll negotiate on behalf of the Bine network to win grants and sponsorship for local operations. And we’ll set up feedback and reporting systems to ensure that our standards are maintained.

When will it all start?

It already has. That’s why I’m writing this article now — to set out ideas that will open a discussion. If we can turn this Vision into reality, will it achieve the objectives laid out in the Mission Statement. What needs further discussion? What are the flaws in the plan? Where does it need further thought? Over to you.