Your loved one has been living at home, but the dementia advanced beyond its early stages and daily activities like cooking, dressing, and washing have become difficult, even aggravating. As instances of wandering and confusion increase, safety is more of a concern.
Long-term residential care, some form of assisted living, is the answer. Of the millions of Americans over 65 in assisted living—a combination of housing, support, and healthcare—the Alzheimer’s Association says more than half have some form of dementia. The elder-care industry is brimming with specialized options, which can make the important task of choosing where to live next overwhelming.
These are anxious times, but change can be positive if you enter the process with the right information and, especially, questions.
Not all options for residential long-term care are suitable for persons with Alzheimer’s disease (AD) or another type of dementia. In the disease’s early stages, when functioning independently is still possible, retirement housing or independent living may be appropriate.
Around-the-clock supervision provided by nursing homes is best for persons with moderate to late-stage dementia, but there are also options specifically for persons afflicted with dementia. Dementia care facilities, which may be stand-alone facilities or a wing of an assisted living facility or nursing home, are sometimes called Alzheimer’s special care units or memory care units. Learn more about the differences between assisted living and memory care units here.
Another (more expensive) consideration is Continuing Care Retirement Communities (CCRCs), which offer services on a continuum from independent living to assisted living to full-time nursing home care. CCRCs let residents stay in a single location throughout the progression of their condition.
Did You Know? Free assistance is available to help families find an appropriate memory care home for their loved ones. Get started here.
What follows is advice for finding the best assisted-living options, and key questions to ask, but keep in mind that experts are available to help. Free assistance can be invaluable, alleviating the emotional stress that comes with taking these difficult steps toward moving into a facility that offers housing and full-time specialized care.
Assisted living referral services or placement agencies, such as A Place for Mom, Seniorly and Caring.com provide helpful services in helping families find the right home for their loved one, doing much of the legwork on the family’s behalf. These organizations work by providing free, local advisors who are familiar with the nuances of all the residences in a certain geographic area. The advisors are compensated by the assisted living residence when someone moves in. This is how these organizations are able to provide their services for free. A good advisor will carefully consider the individual’s care needs and preferences and attempt to match that individual with a home that has strengths in those areas. An advisor will narrow down options and arrange tours for the potential resident or their family members. A family has no commitment to an advisor and if the advisor is not providing value, a family should not hesitate to find a different person.
The downside of assisted living referral services is that when matching families to multiple communities, the admission offices at those communities can be aggressive in contacting the family. The phone will ring. That said, this is a small price to pay for what can be an invaluable service.
Choosing a dementia care facility for your loved one requires time and effort. Research several facilities before making a decision, and visit your top options armed with knowledge and good questions. Preparation ensures the decision ultimately benefits your loved one.
Some assisted living communities may have specialized dementia care units, and entire facilities exist whose specific purpose is to care for individuals with AD/dementia. When scouting a dementia care facility, get a sense of how knowledgeable the staff is about the needs and care of persons with Alzheimer’s disease or other types of dementia, and consider if the facility is designed to handle the requisite challenges.
Anxiety can come with wondering how high-quality the care is at the facility. When you visit, make sure to talk not only to the administration and staff, but also to some of the residents and their family members. Visit the residence multiple days, at different times each day, to get a feel for the overall experience. Eat meals there, and participate in activities with residents. Try to understand how things operate when you are not around. Check for cleanliness, especially in shared common areas. Get a feel for whether the residence is warm and tranquil. Keep notes on likes, dislikes, and features or characteristics that distinguish one residence from others.
Remember to ask the practical questions.
Be crystal clear on exactly how much a residence will cost, including placement fees and what kinds of payment they take.
Finally, when talking to residents and their families, ask whether they are satisfied with the level of involvement and interaction in the facility. As a caregiver, you have a lot of knowledge and experience that is valuable to the continued care of your loved one, even in a long-term care facility.
Tip: Sharing a resident’s life history with staff (perhaps even writing highlights to post in the room) can provide a greater appreciation of your loved one as an individual. This will improve care, because if the staff understands someone better, they can set more personalized and effective goals.