It’s difficult to know when your loved one needs to change living situations, because the disease progresses so slowly. Alzheimer’s takes years to transition from early to mid and late stages, so even if your gut says it’s getting worse, your mind and heart might argue otherwise. Add the guilt and emotion that can come with putting a loved one in memory care and the decision becomes even more difficult.
1. When you can’t keep them safe at home
A decline in overall health for someone with dementia can be a major sign of trouble. Watch for unexplained weight loss, hunched posture, and bruises. Difficulty standing and walking without assistance is something that can lead to falls and broken bones, which are very common for people with Alzheimer’s disease. On the opposite end of that spectrum, sitting for too long is another dementia-related behavior that has been shown to be unhealthy. Wandering and becoming lost can be mediated with technology but are also incredibly serious and dangerous behaviors.
An active and well-trained memory care community is equipped to assist at both ends of the behavioral spectrum. The physical layout and scheduled activities can calm active patients, prevent wandering (or allow for structured wandering) and establish routine. Inactive individuals can be encouraged to become more active or may do so by witnessing others and may benefit from social interaction. Staff is trained to motivate dementia sufferers to interact with others, participate, move around and even go outside. If this isn’t happening at home, your loved one may get worse faster.
2. When caregiver stress becomes overwhelming
Taking care of someone with dementia is difficult, especially with your own life to manage as well. The tasks can be endless. Stress is inevitable, especially as the disease’s symptoms worsen to include loss of communication and uncontrolled behavior. Even if you think you’re hiding your stress from your loved one, you express it subtly in ways that they’ll perceive, and this leads to difficulties including acting out. If caregiving has become so stressful that it’s affecting your own happiness (watch for difficulty sleeping), it’s time to think about memory care.
3. When you or your family can’t sustain a healthy living environment
If one parent has dementia, maybe your other parent is being a devoted spouse and handling caregiving. Family members feel tremendous pressure to keep someone home, thinking I can handle this. I love this person. No one, however, is immune to caregiver fatigue. Watch for the signs like bills going unpaid, an unusually messy house, hoarding, food having gone bad, and general messiness (like dishes piling up in the sink, or trash not going out). Also note the personal hygiene of the individual with dementia. Much of the tasks like assisting with bathing, brushing teeth and clipping nails fall on the caregiver and a caregiver having difficulty coping will start letting things slip. These are signs that another living situation is necessary.
4. When social life shrinks to isolation
Someone with dementia will become less social as their world becomes more confusing. The mental impacts of Alzheimer’s cause a person to retreat inwards and living at home makes it so much easier to be alone even if someone else is in the house. As the disease progresses, more confusion, less stimulation and inward retreat can become a self-reinforcing circle.
Interacting with a diversity of people is important because studies have shown that social isolation worsens symptoms. Memory care communities, by design, encourage social interaction.
5. When the primary caregiver may not be a good caregiver
This one is difficult. A loving and caring husband or wife just may not be equipped to be a good caregiver to a loved one with dementia. Caregiving for dementia is like caregiving for a young child, it can be frustrating and tedious. One significant difference is the child will grow past their challenging behavior while someone with dementia’s behavior will likely become more challenging. It is usually the adult child who recognizes their mom or dad is unable to provide the care their spouse requires, and it can be a challenge to have the conversation with their parent and siblings. However, one should not avoid or deny this difficult situation and in the vast majority of these cases, memory care is a better option.
6. Your gut knows something’s wrong
Again, it can be emotional to decide it’s time to move your loved one out of a home they’ve possibly been living in for years or decades. But we can tell when something’s wrong, and that nagging intuition as the signs rack up is not to be ignored. If you feel like it’s time, listen to your instincts. There’s no blame, and no fault, in making tough life changes. Alzheimer’s disease and related dementias are manageable if caregivers make smart choices including transitioning at the right time to memory care.
From finding and touring memory care residences to finalizing legal documents to managing the memory care move, it will take at least 2 months to sort out the logistics of moving your loved one into memory care. For most families, 3-4 months is more normal. Financial hurdles, like getting covered by Medicaid, obtaining VA pension benefits or finding other payment support will take even longer. Even with professional financial planning assistance, it can take 6 months to arrange payment.
It is highly advantageous to be prepared when the times comes for memory care rather than to be scrambling. The onset of the need for memory care is just as like to be sudden as it is to be gradual. Patient behavior can change dramatically accelerating the need for memory care. However, unexpected changes with primary caregivers is just as likely to initiative the need. Since many caregivers are spouses and elderly themselves and they often push themselves beyond their own limits, caregiver injuries are more common than thought.
Another benefit of starting early is that it can let your loved one actually have a say in the decision. Making the decision in later stages of the disease, when the largest stakeholder can’t communicate well because of symptoms, will only exacerbate emotions including the guilty feelings that often come with this change.
The sooner the preparation begins, the more likely it is to be a positive transition.
Memory care is not the same as assisted living or a nursing home. The difference between memory care and assisted living is that memory care is specifically for people with Alzheimer’s disease, or related dementia, because they require a higher level of skilled care and supervision. Also called Special Care Units or Alzheimer’s Care Units, memory care communities usually offer shared and private spaces. Sometimes memory care exists as a wing within assisted living communities or nursing homes.
When compared to memory care, nursing homes are more expensive, more restrictive to the individual and provide a higher level of care. Nursing home candidates are typically accessed and found to require a “nursing home level of care”, which is a formal designation. Not all, not even close to all, persons with Alzheimer’s disease require nursing home level of care at the early or middles stages of the disease.
Memory care has more frequent safety checks than assisted living (patients are monitored 24 hours per day), and staff is specially trained to meet the needs and demands of residents who have difficulty with basic tasks because of dementia symptoms, from early to mid and late stages. Memory care units, therefore, offer most of the same services as assisted living, but with increased supervision and more routine, including structured activities to stimulate memory and hopefully slow the disease’s progression. These activities might involve music or pet therapy, games, arts and crafts, etc.
Memory care residences are also constructed differently, with enhanced security to prevent behavior like wandering. The hallways often run circular because patients with dementia will become upset when they encounter a wall. There aren’t individual kitchens in memory care, to cut down on stress and accidents. The colors, lighting, and even accouterments like fish tanks create an atmosphere that is more soothing for people with dementia.
Memory care typically costs more than assisted living, on average $1,000 more per month because of the need for specialized care. However, memory care costs significantly less than nursing home care, perhaps several thousand less per month depending on the state in which one resides.