Many families describe a version of the same morning. A stranger arrives at the door. The person they love, who used to hold a room, looks up from the kitchen table and does not know who this is or why they are here. There is fear in that look, and sometimes there is anger. By the time the situation is calmed down, the carer has forty minutes left on the clock. This happens on Monday. A different stranger arrives on Thursday. And then again on the following Monday. Families watch this loop and cannot understand why it is considered normal.

If you are living with this, the feeling underneath it is probably not just frustration. It is grief. You know your parent or partner well enough to read their face, and what you are reading is distress that did not have to happen. That matters. It is not you being difficult. It is you being right.

Why a rotating rota is not a neutral choice for someone living with dementia

The Alzheimer's Society is clear on this. People living with dementia rely on familiarity to feel safe. When short-term memory is fragmenting, the face of a known person becomes one of the few anchors left in a day. A carer who has been coming to the house for three weeks carries an enormous amount of unspoken knowledge: they know that the light in the hallway needs to be on before the door opens, that breakfast has to come before washing, that a certain song on the radio will shift the mood in a room. None of that is written on a handover sheet.

NICE guidelines on dementia, published as NG97, are direct about personalised care and consistent relationships. They state that care should be tailored to the individual and that continuity of carer is part of delivering that. It is not a luxury preference. It is what good dementia care looks like.

And yet most care arrangements in this country are built on rotas. Rotas exist because they solve a staffing problem on the provider side, not because they serve the person being cared for. When a carer calls in sick, someone else is sent. When someone goes on annual leave, there is a cover arrangement. This is operationally convenient and clinically questionable when the person at the other end of the door has dementia.

What you can actually do about it

The first thing is to name it. Put it in writing to whoever is currently arranging the care. Ask, specifically, for a named primary carer and for any substitutes to be introduced in person before they ever arrive alone. Keep a record of every unfamiliar face and the distress that followed. If the care is funded through the council, this record becomes the basis of a formal complaint. The Local Government and Social Care Ombudsman handles complaints about adult social care, and the fact that care does not meet NICE guidance on continuity is a legitimate grounds for escalation.

If the care is being paid for privately, you have more leverage than you might think. You are the client. You can request a named carer in writing. If the arrangement cannot offer that, you are within your rights to end it.

The second route is direct payments. If your local council has assessed your parent or loved one as needing care, they may be entitled to receive the funding as a direct payment rather than having care arranged on their behalf. Gov.uk explains this in plain terms. Direct payments let you, as the family or as the person themselves, choose and employ the carer directly. You keep control of who comes through the door. For families dealing with dementia, this can be the single most important change they make. It is not easy paperwork, but Carers UK on 0808 808 7777 can walk you through how it works in your area.

The third route is choosing an arrangement built around one person from the start. Most of the way care has been arranged in this country puts a coordinating layer between the family and the carer. What good care actually looks like, for someone with dementia, is: one carer, chosen by the family, who meets the person before any commitment is made, and who keeps coming back. The family knows their name. The person they care for learns their face. The carer builds the kind of knowledge that cannot be handed over in a note.

We at Hibant hear from families who have been through a year or more of rotating strangers before they find an arrangement that actually holds. What they tell us, almost every time, is that they wish they had pushed harder for continuity earlier. The distress is cumulative. Every unfamiliar face is a small reset.

If you want to talk through what a more stable arrangement could look like, the Alzheimer's Society Dementia Support Line on 0333 150 3456 is free and staffed by people who understand the specific dynamics of dementia care. They have no commercial stake in what you decide. Call them first if you are not sure where to start.

Tonight

The one thing worth doing before you sleep is writing down, in a sentence or two, the specific distress you have seen. Not a general complaint but one moment: what happened, when, and how long it took for things to settle. That record is the beginning of every conversation you will need to have, whether it is with the current provider, the council, or anyone else. You do not need to have a solution tonight. You just need to start making it visible.

If you would rather not fight this battle alone, this is exactly the situation Hibant was built for. We are a London introductory care agency, and we work specifically with families who need one consistent person, not a rota. Every carer we introduce has been DBS-checked and insurance-verified before they ever meet your family. You choose the carer yourself, you meet them in person before any arrangement begins, and the relationship is directly between you and them. For families managing dementia, that directness is not just a preference. It is what keeps the door familiar. You can reach us at hello@hibantcare.com or read more at hibantcare.com.

Hibant

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Useful links to keep handy

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