When Is It Time to Place a Loved One with Dementia in a Long-Term Care Community?

When Is It Time to Place a Loved One with Dementia in a Long-Term Care Community?

As the pool of seniors in American becomes increasingly greater with each passing year, a frequent question more and more families are faced with is: “How do I know when it’s time to place my loved one with dementia in a long-term care community?”

Most long-term care experts will agree that every scenario can be unique and different. The general rule of thumb however is that there is really no downside to placing a loved one in community too soon. However, there are many drawbacks in waiting too long.

If your loved one requires a higher level of care, and for whatever reason(s) you decide to wait, the number of things than can potentially go wrong are endless.

Medication Management
In a facility like a memory care unit, all medications are carefully regulated. They are administered on a strict schedule, the nursing and care staff look for any indications that a resident’s regimen should be changed, and they can usually implement these changes quickly once the doctor has approved them.

When your loved one is living at home, all of the medication oversight falls to you. While many family caregivers learn a great deal while caring for their loved ones with dementia, there are certain signs and issues that only medical professionals can pick up on and address. Even if you do notice a problem, getting them to the doctor for an evaluation to change their meds can be a struggle.

Mobility Issues
Toward the end stages of dementia and Alzheimer’s disease, patients have extremely limited mobility. This is a serious hazard for both the patient and their caregiver. For example, a petite 70-year old woman could easily get hurt trying to get her 180-pound husband to the bathroom two or three times each night. Continuing to care for him at home puts them both in danger of falling.

Bathing, toileting, dressing, and other activities of daily living all come with risks, but a facility is far better equipped to safely handle any of these concerns. They have the proper equipment, training, and manpower to assist residents and prevent accidents.

Wandering
A loved one can easily get out of the house without their caregiver realizing, and this can be a life-threatening situation. Wandering can (and does) happen in facilities, but the residents are limited to spaces within the building and, in some cases, a secure area outside. This is why supervised memory care is so valuable for dementia patients and their family members. The residents are able to move about, but the premises are heavily monitored and often feature special security measures to prevent them from wandering away from the facility and getting lost or injured. The response time when someone does wander is greatly increased as well, due to the number of employees available to look for them.

Caregiver Stress
It doesn’t matter if you are in your thirties or in your seventies, the stress that dementia puts on a caregiver is the same. If you are in your thirties, chances are you are in reasonably good health, but older caregivers are more likely to have medical conditions of their own to contend with. Stress can quickly manifest itself in people of any age, and is known to exacerbate even minor ailments. Be honest with yourself about your emotional and physical limits while caregiving. Sometimes placement in a facility is best for both the caregiver and the loved one’s overall health and well-being.

Long-Distance Caregiving
Caregiving from afar rarely works, especially for loved ones with progressive illnesses like dementia. How could it? Some local family members can provide intermittent support, but they still struggle to stay on top of the level of care and assistance that their loved one requires. Adequate supervision and care can’t be provided from afar. The patient’s needs will continue to increase, and it will only put more strain on the caregiver and leave the person with dementia more vulnerable.

In a long-term care facility, yes, there are more residents, but there are also more caregivers. Unlike family member who lives across town or across the country, nurses and aides are on duty around the clock to ensure residents are safe and their needs are met.

Rely on a Plan, Not a Promise
The most important reason to have a plan way before it is time to even think about placement is because you probably make a promise years ago that you would handle a loved one’s care yourself. It is common for people to promise to take care of their parents, spouse, siblings, whomever and pledge to never place a loved one in a nursing home for any reason.

There is the fact however that as a patient, a person deserves and should demand to be taken care of to the best of one’s ability. A dementia patient’s daily care should not be substandard simply because of a promise their family member made some 20 or 30 years ago. We all have made promises we haven’t kept for one reason or another. This thing about, “I promised my mom I would never put her in a facility,” is noble, but that’s about it.

Sometimes it can simply be a matter of pride for caregivers. A caregiver doesn’t want their family to know that he/she is struggling with Dad, so they do the best they can, not even realizing that the care they are trying to provide is substandard. Every person deserves to be taken care of. A loved one may not be able to communicate or have any idea what is going on around them, but they deserve to have their dignity intact.

Placing your loved one in a long-term care community doesn’t have to be as dramatic as it is often portrayed to be. Communities that offer Memory Care are nothing like the nursing home setting of 30 years ago. It’s highly likely that neither the potential resident nor the caregiver has ever been in a specialized facility that cares for individuals with dementia, because most people don’t have a plan in place for that scenario.

There is research involved, a medical assessment of your loved one must be conducted, and there needs to be a financial plan in place to cover the costs of professional care. When you take your time to prepare, there is less drama and fewer surprises.

Do yourself and your loved one a favor and be prepared. Placing a loved one is one of the most loving things you will ever do for them. You are doing something your heart tells you not to, but you are doing something that your mind knows is the right thing to do. At the end of the day, this is exactly what you said you would do all those years ago….take care of them. When you can no longer manage, you seek out placement. This is, in fact, taking care of them.

My Parents Need Assisted Living. Where Do I Start?

My Parents Need Assisted Living. Where Do I Start?

It can be difficult to realize that dad or mom need more care in a setting like assisted living. Just as your parents kept us safe and secure when we needed it, there comes a time when we’re called upon to return this same caring concern with our parents.

Steps to Take When Your Parents Need Assisted Living

Some of us will provide care to our parents or senior loved ones in our own home for a period of time, but this scenario is not always possible for all families, or…always desired by the children or parents themselves. Many families will in turn, find themselves searching for an assisted living community. These communities provide an intermediate level of residential care for seniors who aren’t safe living by themselves.

Ideally, your parents can be full participants in the search, but if your loved one is impaired by Alzheimer’s disease or dementia, you may to proactively take more control of the decision making.

If you see that your parent(s) need assisted living, here are some steps that can help you find them the right care:

1. Determine what you can afford.
Like it or not, money is going to be a factor in many families’ searches. Look at what your family can afford on a monthly basis. You may be need to look into creative ways to pay for care, like social security, veterans benefits, or long-term care insurance if your parents have that available to them. Some families may have to consider difficult options such as pooling resources from the adult children, selling a family home, or even cashing in a life insurance policy.

2. Research assisted living communities in the area you are planning to have your parents live.
Make a list of needs and preferences and research which communities can meet those criteria while being in your price range. For those families who ultimately cannot afford private-pay senior care and will require state assistance in the form of Medicaid, an appropriate resource is your county’s Aging & Disability Resource Center (ADRC).

3. Visit a number of assisted living communities.
No amount of time viewing brochures, floor plans, photos, or reviews can substitute for an in-person visit to an assisted living community. Schedule visits for you and your parent at a minimum of three communities on your short list. If you and your parent have the time and stamina, it may be helpful to visit more communities as you narrow the search. A good time to tour is during a meal, such as lunch, so potential residents can try the food and get a good sense of the community’s culture; as many residents will be out and about during a mealtime. Based on these initial tours, narrow down your search to two or three favorites. Perform follow-up tours…perhaps even unannounced…to get a good sense for the community you and your parent are considering.

4. Include your parent or senior loved one.
The more involved your parents are in the search, the better. Of course, you can do much of the legwork for them, but have discussions with your parents about their desires and preferences and, ideally, present them with a range of options.

5. Prepare to move.
If you’ve come this far in the process, there’s no sense in delaying the move. It’s risky to procrastinate when a parent needs care, as the delay can lead to avoidable accidents and medical problems.

6. Work together towards a decision.
Whether your parent is choosing the community themselves or you need to make that decision for parents impaired by Alzheimer’s or dementia, try to make sure that everyone in your family feels good about the choice. When possible, have conversations with your parents discussing the pros and cons of each option and try to find consensus about the right option.