As individuals age, they often require in-home assistance to continue to live independently. This holds true for seniors who do not have health issues, as well as those who are suffering from Alzheimer’s disease or another related dementia. Fortunately, there is home care that is geared towards both individuals and situations. Home care for those with dementia is different than other types of home care in some important ways.
Please note, we have written a companion article about how residential memory care differs from regular assisted living here. Those seeking information about paying for memory care should begin here.
When considering in-home care for a loved one with dementia, it is important for caregivers to understand the difference between regular home care and dementia home care. Awareness of the differentiation between the two types of care allows caregivers to choose the option that is most suitable for the loved one at the current time.
Regular home care, which is often referred to as in-home care, is non-medical in nature. (There is also the option of in-home health care, which offers similar care as regular home care. The main difference is that with home health care, individuals are able to receive medical assistance, such as diabetes injections and monitoring of vital signs.) Personal care aides provide companionship, supervision, and one-on-one assistance with activities of daily living (ADLs), such as helping an individual bathe, get dressed, get to and from the bathroom, and eat. They also assist with light housecleaning and other household chores, such as shopping for groceries, running errands, and preparing meals, and also might provide medication management and transportation to appointments and social outings.
This type of care is a great option for individuals who are able to maintain some independence, but do require assistance with certain tasks. While regular home care might be appropriate for an individual in the early stage of Alzheimer’s disease, as the disease progresses, more advanced care is needed. This is where dementia home care becomes an important and appropriate option.
Dementia home care is geared specifically towards those with Alzheimer’s disease and related dementias. While caregivers offer the same assistance as regular home care, dementia caregivers are familiar with the stages of the disease, how it manifests, common problematic behaviors, strategies to adequately deal with them, and safety issues related to dementia. Commonly, care plans are established to focus on the likes, dislikes, and personality of the individual with dementia, and activities are planned accordingly to stimulate one’s memory. This may include looking at photo albums, listening to music, doing art projects, or reading. Surprisingly, dementia home care typically costs the same as regular home health care.
Persons with Alzheimer’s disease and other dementias have different needs, with these needs changing and evolving as one progresses through the stages of the disease. With Alzheimer’s, there are three stages: early-stage, middle-stage, and late-stage.
In early-stage Alzheimer’s (typically lasts 2-4 years), one is generally still very independent and requires minimal supervision or outside care beyond what a family can offer. Often, an individual can still drive, attend social events, and is still able to perform all daily living activities, from dressing oneself to cleaning the home to cooking. In this stage, one may forget common words and need simple reminders to assist with memory. One may also need assistance with medication management, organization, money management, remembering and keeping appointments, and developing coping strategies to maintain independence. During this stage of Alzheimer’s, it’s important to make care plans for the future.
During middle-stage Alzheimer’s (typically lasts 2-10 years), one requires more care than does someone in the early-stage of the disease. One’s memory is greatly affected and one may not recognize familiar faces or he/she may become lost in an area in which they know. Behavior and mood may be erratic, displays of aggression and uninhibitedness might be seen, and one’s ability to reason is not normal. Also, individuals often demonstrate difficulty with physical movements and coordination. During this stage, Alzheimer’s patients may require assistance with activities of daily living, such as dressing and feeding oneself. They may also need reminders, such as what is appropriate clothing for the season. It is important that an individual with dementia follow a structured schedule during this stage, which can aid in diminishing feelings of stress and anxiety, which is commonly associated with dementia. For instance, one may get up the same time each morning, eat breakfast at the same time each day, and so forth. Consistency with caregivers will likely be very beneficial.
During late-stage Alzheimer’s (typically lasts 1-3 or more years), an individual will require intensive care 24-hours/day. One will exhibit extreme confusion, both in regards to past events and present circumstances. The ability to process information ceases to exist and the individual will have a very difficult time communicating verbally, if they are able to do so at all. Behavior and mood is extremely unpredictable and one may even experience hallucinations and delusions. Commonly, an individual with Alzheimer’s will need to move to a facility, such as a Memory Care Unit (if they haven’t already done so), in order to receive the extensive care that is needed.
As mentioned previously, paid dementia caregivers have training and experience in caring for someone with Alzheimer’s and other dementias. They understand the disease, the progression of it, how to handle the erratic moods and behavior. They also understand how to help maintain low levels of stress for the individual instead of escalating the stress level which some untrained caregivers may unwittingly do. They cater to the specific needs of an individual with dementia, often incorporating activities and experiences that are meant to stimulate one’s memory. In addition, they provide assistance with activities of daily living, prepare meals, and help to provide family support, as do regular paid home caregivers.
Adult day care is a great alternative to paid home care, for both full-time family caregivers and for individuals with Alzheimer’s or related dementias. Adult day care is ideal for family caregivers who are employed full time or simply as a means to give a caregiver a break from their caregiving duties. It is also more affordable than hiring a home caregiver. Adult day care provides supervision, structured activities, meals, assistance with daily living activities, and sometimes transportation. Many adult day care facilities employ staff that are knowledgeable to the needs of those with dementia and structure their activities and programs around these needs. In fact, some adult day care centers are intended specifically, and only for, those with dementia.
The cost of dementia home care and adult day care varies based on the state in which one lives, as well as the geographic regions within each state. Nationwide, on average, the cost of dementia home care should be comparable to that of a home health aide, which is approximately $21.50 / hour (as of May 2019). Regular in-home care costs slightly less than dementia home care. As mentioned previously, adult day care offers the more affordable option, which runs on average, $75 / day nationwide.
Please note, for low-income individuals and families, Medicaid, local non-profit organizations, and local Area Agencies on Aging (AAA) offices may be able to provide financial assistance for in-home care and / or adult day care. Read more about paying for home care and adult day care.