How To Tell If Someone With Signs Of Dementia Needs Assisted Living
In the popular understanding of dementia, people with dementia cant safely live alone. They dont recognize their loved ones and might barely even know themselves. This portrayal is a simplistic picture of a complex collection of diseases. Dementia is a slow and unpredictable illness. It doesnt always manifest as cognitive issues. For example, the key symptom of a dementia called primary progressive aphasia is a loss of the ability to speak, frontotemporal dementia might manifest as behavioral changes, and Alzheimers may progress slowly for many years.
Further complicating the picture is the reality that people with dementia may seem fine one moment and lost the next. Many people with dementia may not be diagnosed for yearsor even at all. Sometimes, family members confuse normal aging for dementia. And occasionally, loved ones think an elder with dementia is faking or exaggerating their symptoms.
So how can you tell when an elder with dementia needs assisted living? Theres no definitive test, but the following five signs suggest that a struggling senior needs additional help.
What Is Assisted Living
Assisted living is a type of housing for people who need help with some medical and personal care but can still handle some parts of daily living on their own.
Most facilities are designed to feel like home and encourage residents to be as independent as they can be. You and your loved one can choose the services you want the staff to take on and those your loved one can handle. Living spaces can be individual rooms, apartments, or shared quarters.
Assisted living services vary from place to place, but they usually include:
- One to three meals a day
- Social and recreational activities
Your Loved One Wanders
If your loved one wakes in the middle of the night or becomes confused and disoriented he or she may wander. Wandering can be extremely dangerous as your loved one will walk and not realize where they are, or how to get back home. It can put seniors in dangerous situations and leave them exposed to harsh elements in the winter and summer. Memory care communities are secured and often have enclosed outdoor spaces to keep your loved one from wandering off without a caregiver.
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Schedule The Move For Their Best Time Of The Day
Typically, late mornings and early afternoons are a dementia patients best time of the day. Early mornings and evenings may be more difficult.
The transition from one home to the next will be less stressful when your parent is most likely to be calm, allowing more time to settle in before s/he becomes fatigued or agitated.
Does My Loved One Have A Healthy Structured Routine At Home
People with Alzheimers benefit from a consistent, structured daily routine. They also benefit from a healthy diet, regular physical activity, and mental and social stimulation. Circumstances may make it impossible for you to offer your loved one a daily routine that supports their well-being: for instance, if you work long hours, or depend on support from family members who cannot commit to regular hours, meaning that the patients routine is frequently disrupted.
If you feel that while you would prefer to keep your loved one at home, you are not able to give them a good quality of life, it would be a good time to consider a nursing home. Nursing homes can offer a customized treatment program, a healthy diet, 24-hour support and supervision, and social activities. If you would like further advice on Alzheimers nursing homes, please contact us here.
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How To Know When Its Time For Assisted Living: 10 Questions To Ask Yourself
Determining the right kind of care for your senior family member and knowing when to reach out for help can be difficult. According to Levison, both senior well-being and caregiver mental health may be strained by the time many families take these essential steps.
In my experience, families and caregivers often wait until things are progressing to a breaking point before looking for assisted living options, says Levison.
Be proactive about recognizing common signs its time for assisted living with this checklist.
Communicate With The New Caregiving Staff
First and foremost, the staff want to get to know new residents. The more they know about your parent, the easier it is to spark conversations and connect with him/her as s/he settles in.
Additionally, its helpful to lean on the staff and allow them to explain the new transition and to support your parent during the move. Again, choosing a memory care-specific community means the administration and staff are well-versed experts and will know exactly what to say without causing further confusion or upset for your parent.
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Who Makes The Decision
In some cases the person with dementia will be able to decide for themselves whether or not they need to move into a care home. If this is the case, then they should make their own decision and be offered any help they need to do so. However, often by the time the person with dementia needs the level of care that a care home provides, they have lost the ability to make this decision for themselves.
If the person is not able to make this decision, someone else will need to make this decision for them. This would usually be the persons attorney under a health and welfare Lasting power of attorney, or their personal welfare deputy, if they have one. Any attorney or deputy must make decisions in the best interests of the person. An attorney or deputy for property and financial affairs is often able to make this decision for the person with dementia. This is because they have the legal power to arrange the finances to pay for this care. However, professionals or members of the persons family can challenge this decision.
For more about mental capacity in England and Wales, and how to know if someone is able to make decisions for themselves, see our page on the Mental Capacity Act. For more information on attorneys and deputies see Lasting power of attorney and Becoming a deputy for a person with dementia.
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Concerns About The Care That My Loved One Is Receiving In A Care Home
If you have any concerns about the care of a person in the care home or the ability of staff to meet their needs, please speak to the manager in the first instance. State what the concerns are and what you would suggest could address these. If this does not resolve the issue or you are dissatisfied with the response, ask the manager for details of their line manager so you can express your concerns to them. In cases where there are still concerns or the situation is a safety risk, indicates neglect or poor standards of care you could then raise this with the Care Quality Commission , Care Social Services Inspectorate Wales, Care Inspectorate or Regulation Quality Improvement Authority .
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What To Do If They Refuse To Let Go Of The Idea
Sometimes, your older adult will refuse to let go of the idea of going home, no matter how much you try to soothe or redirect.
If that happens, you might need to agree to take them home and then go for a brief car ride.
Experiment with how long it takes before you can take them home without protest. Or, suggest a stop at the ice cream shop, drugstore, or grocery store to distract and redirect.
If its not possible to actually take them out or get into the car, even going through the actions of getting ready to leave can still be soothing. This will shows that you agree with them and are helping to achieve their goal.
Meanwhile, the activities of getting ready give you more chances to distract and redirect to something else.
Keep in mind that not everything you try will work the first time. And even if something works once, it might not work the next time.
Do your best to stay calm, flexible, and creative this technique gets easier with practice.
How Memory Care Differs From Assisted Living
Cost of Memory Care vs. Assisted Living
For both assisted living and memory care, several variables affect cost. These include the geographic area where one lives, whether one has a private room or a shared living space, and the amount of care service required. However, due to the specialized dementia care that is offered at memory care units, costs are higher than assisted living. On average, one can expect to pay approximately $4,000 per month for assisted living and $5,200 per month to reside in a memory care unit.
Another crucial new consideration in paying for assisted living and memory care is the updates in 2019 and 2020 to Medicare laws. Medicare Advantage, a Medicare option that partners with private insurers to provide customized care, is expanding its definition of supplemental benefits, and will allow assisted living and memory care communities to be officially designated as a beneficiarys home. While the program wont cover the entire cost of living in these residences, it can potentially save a good deal of money by paying for various aspects of living in assisted living or memory care. About one-third of Medicare recipients are enrolled in Advantage, and that number is likely to rise. More on the new Medicare Advantage. More about paying for memory care.
Physical Differences Between Memory Care and Assisted Living
Medication Management in Memory Care and Assisted Living
Staffing Differences in Memory Care and Assisted Living
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Safe And Happy At Home
Of the 5.2 million people in the United States who have Alzheimersdisease and other types ofdementia, 70 percent remain at home, an option thats been shown to keep peoplehealthier and happier and help them live longer. And with the averagenursing home running $50,000 a year or more, home care can be much moreaffordable than rehab facilities, nursing homes andassisted livingresidences.
But cheaper certainly doesnt mean easiercaregivingoften falls on the shoulders of family members and friends. And thosewell-meaning folks can burn out without the proper support, warnexperts.
The care of dementia is actually the care of two people: the person withthe illness and the person taking care of him, says Johns Hopkins expertDeirdre Johnston, M.B., B.Ch., B.A.O., M.R.C.Psych. But when Johnston and a team of researchers studied more than 250Baltimore residents with dementia as well as their caregivers, they found astaggering 97 percent to 99 percent of both groups had unmet needs.
Keeping your loved one safe and happy at home can seem overwhelming. Butdont lose heart: Plenty of help is out there, for your loved one and you. Here are some tips that may help:
What Is The Mental Capacity Act
As their condition progresses, people with dementia may become unable to make some decisions for themselves. When this happens, the person is said to lack the mental capacity to make the specific decision at that time.
The Mental Capacity Act is the law in England and Wales that protects and supports people who lack capacity to make a decision. It also outlines who can and should make decisions for them.
The Mental Capacity Act covers important decision-making about a persons property, financial affairs, and health and social care. It also covers everyday decision-making, such as decisions about what a person wears, what they eat and their personal care.
It does not cover decisions such as voting, making a will, marriage or divorce. For advice on these decisions, talk to a relevant professional or visit the government website .
The Act can help people with dementia, their carers and professionals to make specific decisions and to plan for the future.
Mental capacity laws in Northern Ireland
Northern Ireland has different laws around mental capacity and offers different legal tools to manage loss of capacity. These include Enduring power of attorney and controllership.
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A Senior Is Hurting Emotionally
Caregivers sometimes worry that seniors who transition to assisted living will feel locked away or isolated. For most seniors, assisted living offers significantly more companionship and freedom than they previously had. Your loved one will have access to caregivers and friends, to classes and chances to learn and socialize.
Ethics Approval And Consent To Participate
The study was approved by the Regional Committee for Medical and Health Research Ethics in Southeast Norway using the following procedure: Participants were informed in writing as well as verbally. Competency was evaluated by the nurse in charge in the nursing home, and when competent, the PWD was asked to give his or her informed consent. If not competent, the next of kin was asked to approve or reject participation . In addition, the PWD was informed about the study and asked whether she or he wanted to participate before and/or during each interview . Furthermore, the interview with the PWD was terminated if he or she physically indicated that he or she did not wish to continue, for instance, if the PWD appeared to be nervous or agitated, or walked away. Pseudonyms have been used to preserve anonymity of the participants.
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Tips On Transitioning A Loved One To Memory Dementia Or Alzheimer’s Care
As your loved ones memory declines, or as the effects of dementia or Alzheimers disease become too much for the family or caregivers to handle, you will have to make the decision to place her in memory, dementia, or Alzheimers care. After you have consulted your family and her healthcare professionals, made financial arrangements, and chosen your loved ones new home, you have to prepare for transitioning her to a new level of care. You understand the need for the move, but it still is difficult for you to accept the decision, and your emotions run even higher when you think about telling your loved one and anticipate moving day.
To help ease the transition for your loved one , we have rounded up 50 tips from caregivers, memory care facility administrators, dementia and Alzheimers experts, and others who have experience in working with seniors who require special care. Keep in mind that everyone handles the transition differently, and you will need to use the tips that best fit your loved ones personality and needs and your situation. Please note, our 50 tips for easing the transition to memory, dementia, or Alzheimers care are not listed in order of importance or value in any way rather, we have categorized them to help you find the tips that will be most useful to you.
Connect With A Dementia
In Johns Hopkins Maximizing Independence at Home trial,researchers found that patients who were in contact with a care coordinatorat least once a month for 18 months were 50 percent less likely to move toan institution or pass away than those in the control group. Carecoordinators can help with safety concerns, medical attention, medicationmanagement, legal andadvance-care-planningadvice, nutrition support and more. They can be especially helpful when aloved one is dealing with other medical conditions for which she needstreatmentand research has shown that about 60 percent are.
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First Steps: Getting An Assessment
The first step towards choosing a care home is to get a new needs assessment from social services.
If the assessment suggests a care home would be the best option, the next step is a financial assessment .
The financial assessment will show if the council will pay towards the cost of a care home.
In most cases, the person with dementia will be expected to pay towards the cost.
Social services can also provide a list of care homes that should meet the needs identified during the assessment.
Do Not Ambush Your Parents With The Decision
Never go home one day and tell an aging parent that their time at home is up and it is time they move to an assisted living community. They may receive this with plenty of resistance and strong resentment.
Take a different approach and start a friendly conversation with the retirees. Casually mention that there is a great option out there they can explore to make their lives more fulfilling and fun. Drop the subject if they are not on the same page today and wait for another opportunity to bring it up.
Some retirees may resist the idea vehemently because they have the wrong idea of what assisted living homes are. Many aging parents may think that assisted living facilities are institutions where they will not have any freedom and end up feeling like they are prisoners. It can help to have some pamphlets of some top-notch communities so that your dementia-afflicted parent can have an idea of what they will be getting into.
When dealing with a close-knit family, everyone should voice their opinions on the matter. Do not forget to talk finances with everyone to know how your parent will afford their new lifestyle. People with low-income can seek out various financial aid opportunities to help cover some of assisted living costs. Talking to your parents can reveal information about their retirement savings to make plans accordingly.
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Staying In A Familiar Atmosphere To Retain Memories
For those with dementia, staying in a familiar environment unearths several benefits for home care. This reduces anxiety and confusion as the client remains in a familiar routine. Additionally, being familiar with the layout and surroundings of the close environment increases safety, comfort and awareness.
Living around household memories also helps improve the cognitive function in dementia patients and helps reduce memory loss and confusion. You can live with your close family and partners, pets, family, photos and so on and in the early stages of dementia, this can have many positive effects.