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Dementia & Alzheimer's Care
Alzheimer's and Dementia Care in Assisted Living

Care Services for Dementia

Are you frustrated and confused in finding quality care for a loved one living with Alzheimer's or a form of dementia? You've learned that Alzheimer's and dementia carries conflicting expert opinions, dense education, and a whole slew of medical care options.

Now, you're forced to make decisions on your own, without the loved one's feedback. That's hard.

How do you know you're making the best choice for someone who cannot voice their preferences? It's guess-work, a painful one too. Decisions like these are not easy, even unbearable, and they can leave you doubting yourself, your choices, and your sanity.

When facing tough decisions like this, get the facts and learn everything possible about the disease. Find research and learn the facts to give you guidance.

Getting to the rare place of peace and acceptance takes time and carefulness. The first step is planning and doing it well before the disease consumes the person.

What type of care facility is appropriate?

Find Alzheimer's Care
Find Alzheimer's Care

Only you can decide what's best for a loved one. In the process, there are relevant factors to help you determine if a placement is appropriate. The Alzheimer's Association recommends paying close attention to conditions that give strong indications that alternative living is best for everyone involved.

Are your loved ones displaying any one of more of the behaviors, incident(s), and conditions:

  • Increasingly withdrawn and isolated
  • Consistently worsened health
  • Weight loss due to swallowing problems related to the disease progression
  • Unable to feed, bathe, and dress self
  • Prone to falling
  • Requires assistance with ambulating
  • Bedridden
  • Wanders and confused during the days and nights
  • Unaware of surroundings
  • "Acts out"; has a minor upset resulted in violent behavior
  • Increased incontinence or avoids protection or voids receptacles other than the toilet
  • Evaluate how the loved one's care affects you, the caregiver:
  • Unable to socialize or take time for themselves
  • Unable to lift or transfer the person with dementia
  • Have difficulty sleeping and getting enough rest
  • Neglects other familial roles and friendships
  • Feels stressed, exhausted, hopeless or helpless
  • Abuses alcohol or medications to cope
  • Frequent bouts of crying
  • Has a serious health problem such as pneumonia
  • Verbally, physically or emotionally out of control in response to a person with dementia who doesn't listen, asks the same question excessively, and wanders

Selecting the Location of a Facility

Because of its care intensity, it's difficult for a family to give 24/7 care. It's simply too demanding. When researching a service, how convenient is it to you and other family members? Convenience is important because it allows you to visit often, to stay in close touch and to monitor the care.

In a survey conducted by The Center for Disease Control in 2010, found that 42% of Residential Care Facilities offer memory care and 58% of facilities do not include or provide dementia or Alzheimer's care.

Alzheimer's Disease or Other Dementia
Responses of refusal (< 1%), and don't know (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Resident Responses)

Other Factors in Memory Care

Alzheimer's or Memory care means the facility and staff require training in dementia care.

Memory care is sometimes part of a larger, assisted living facility like care continuum but not always. In other cases, it's a stand-alone service. Since Alzheimer's and dementia affects many, the stand alone model is on the rise.

All Memory Care facilities remain locked so that the residents have a freedom to wander in the building, to engage with other residents without the danger of going outside and getting lost. So when visiting one, make sure it's safe and secure.

Look for signs of respect, dignity, and compassion. Are they treated like grown-ups? Are they up and around, dressed and well-groomed, or are they restrained, medicated and out of it? Your first impressions are accurate in the look and feel of the facility.

Safety Matters

Facility Safety
Facility Safety

The safety of a facility lies in the staff's knowledge of dementia. Some centers have little experience in dementia while other facilities have staff with extensive experience and training in Alzheimer's and other forms of dementia care.

Nursing homes are better equipped to deal with the unique challenges of residents suffering from dementia, but many assisted living centers do too. They have a continuum of care model that gives care to residents with failing health or memory. At memory care facilities like these, you'll find the unique and needed security measures in place.

The important ones are:

  • Door alarms that correspond to patient-worn receivers
  • Window security (thick screens, etc.)
  • Lowered beds
  • Remote monitoring
  • Personal alarms that sound when a resident tries to walk when they are physically unable
  • Nurse call systems for unexpected emergencies

Needed Security Designs

Alzheimer's or Memory care facilities address needed security designs. They have added safety features like video surveillance--to monitor residents who wander. Since nursing homes face a shortage of beds, assisted living facilities step up to solve the problem and provide a home-like atmosphere.

Home-like does not mean safe, so check the home and its track record before choosing to move your aging parent or grandparent into the facility. Also, consider talking with people who have family members in assisted living facilities if you know them, they can give you a better gauge of the care available than a simple background check.

Services Special Needs

As mentioned, some memory care facilities hire well-trained staff members who meet the unique needs of the cognitive-impaired residents. Most care homes and facilities self-define their dementia unit and the services offered.

What kind of activities does it have for residents? How many hours a day do they have planned activities? How many days a week do they have activities? For those who offer structured activities, look for the ones that provide them throughout the day, at least five days per week. Notice if the classes or undertakings follow these parameters and strategies.

  • Keep the person's skills and abilities in mind.
  • Play simple songs on the piano or other musical instruments.
  • Attention is given to what the person enjoys.
  • Notice if the resident is happy, anxious, distracted or irritable.
  • Notice if clear direction is given in activities.
  • Do residents have daily routines in place, like setting the dinner table or sweeping the kitchen?
  • Is attention given to residents who have difficulty seeing, hearing or performing simple movements?
  • Is the focus on enjoyment, not achievement?
  • Does the staff encourage movement?
  • Are activities adjusted to disease stages?
  • What makes the dementia unit specialized? What precautions do the facilities take to eliminate wandering? Can someone easily leave?
  • Is the staff trained for dealing with difficult behaviors?

Alzheimer's Licensed Facilities

Most states require a special license for the facilities that advertise as Alzheimer's care centers. Look for senior housing that meets the special needs of those with cognitive impairment. Currently most homes self-define their dementia unit and what's offered.

The family needs to spend time in the care facility to observe the staff and how they interact with residents, what happens at mealtime, and whether the residents seem engaged in activities. Get a sense if the residents eagerly participate in an activity and if they're engaged and enjoying them.

Speak with the other family members of residents. They have insight into the facility that gives you the inside scoop. Find out if the facility sponsors groups or classes for the families to learn how to better manage and give care.

The more you observe the easier it is to decide whether it's the best place for a loved one.

Long-Term needs

As Alzheimer's and dementia progress, find out how the facility meets the needs of residents. Determine whether it fits the projected needs in 6 months or a year? At what point will a change be necessary? Does the facility have a relationship with other facilities that can better care for the later stages of dementia? If so, learn about them.

Check with your loved one's doctor to gain a better understanding how the disease progresses and alters the behavior, and the body and mind. Knowing this equips you to make better decisions for the person you love.

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.