There’s a lot to consider when it comes time to get help in caring for a loved one with Alzheimer’s or dementia. Equip yourself with the information you need to find the best memory care services —download our eBook today.
Living with Alzheimer’s or dementia is challenging, and caring for a loved one struggling with these conditions can be stressful. Professional care can help relieve the burden on caregivers and improve the quality of life for patients. Assisted living and memory care (also called Alzheimer’s special care units or dementia care) is designed for patients who prefer a communal living environment or require more care than can be provided at home.
Memory care is specialized treatment for people living with Alzheimer’s or another type of dementia or a brain injury. As Alzheimer’s disease symptoms progress, a patient will eventually need more care than a caregiver can provide at home.
Memory care involves long-term, intensive residential care that’s provided in a skilled nursing facility with memory care, an assisted living facility, a continuing care retirement community, and a nursing home. Memory care services should be explored when an individual demonstrates confusion in their daily life; neglects their personal care; shows signs of agitation, aggression, or violence; suffers from social isolation; or faces safety risks, such as falls, injuries in their home environment, or potential to wander and become lost.
Memory care communities provide a secure environment where residents can strengthen their cognitive abilities through specially designed programs. Memory-enhancing activities and therapies can help delay further cognitive decline while addressing patients’ emotional and behavioral needs. The staff in these communities have expertise in handling the many challenges associated with Alzheimer’s disease or dementia and are trained to work with patients who often struggle with Alzheimer’s behavioral symptoms, mood swings, disorientation, and even delirium.
A memory care community is uniquely designed to support the needs of patients with Alzheimer’s disease or other forms of dementia. The creation of a special community within assisted living memory care facilities provides intensive care for people with memory loss issues in these three ways:
The confusion many people have between Alzheimer’s and dementia care is understandable, as Alzheimer’s is both the most common cause of dementia and one (but not the only) form of dementia. Dementia is the name for a group of brain disorders that make it hard to remember, think clearly, make decisions, or control one’s emotions. Dementia is not a normal part of aging. It is caused by damage to brain cells that affects thinking, behavior, and feelings.
Although Alzheimer’s makes up an estimated 60 to 80 percent of overall dementia cases, it’s not the only form of dementia. Alzheimer’s is a specific disease, while dementia is not. Common signs of Alzheimer’s Disease are similar to signs of dementia in the elderly and include:
There are many other forms of dementia with different causes and different stages of dementia. The symptoms for those forms of dementia may or may not overlap with the symptoms of Alzheimer’s. For example, a vascular dementia diagnosis typically indicates someone has suffered a stroke. Although later symptoms often include memory problems, initial symptoms are more likely to include things such as poor judgment and trouble planning.
Dementia With Lewy bodies (DWB) occurs when Lewy bodies— microscopic protein deposits in the brain—form and impair cognitive function. In addition to the memory loss and decisionmaking challenges found in Alzheimer’s and vascular dementia, a Lewy body dementia diagnosis can also be the cause of hallucinations, daytime sleepiness, and physical movement issues, such as trembling or slowness. Patients with Parkinson’s disease have a 50 to 80 percent chance of developing Parkinson’s disease dementia, which is similar to DWB.
Memory care for dementia patients depends on the specific type of dementia a patient is suffering from and the associated symptoms. The good news is that, unlike Alzheimer’s, some forms of dementia may benefit from steps taken to slow the progression of the disease. For example, addressing the underlying cause of the vascular disease may help slow the progression of vascular dementia.
Sundowner’s syndrome (or sundowning) is the commonly used term for the sudden appearance or worsening of neuropsychiatric symptoms in the late afternoon. Although it can occur in older people without dementia, Sundowner’s Syndrome may affect up to 66% of people with dementia. Doctors are still not sure why Sundowner’s Syndrome occurs, but there are several factors that seem to exacerbate it:
Any physical cause that increases the patient’s difficulties in distinguishing dreams from reality can make it more likely for them to experience Sundowner’s Syndrome.
A combination of risk factors, rather than genetics alone, causes most cases of dementia. That said, there are some forms of dementia where genetics play a key role, and scientists are using that information to search for ways to address the disease, to explore what causes Alzheimer’s Disease, and to uncover methods for Alzheimer’s Disease prevention.
As the frequency and acuity of symptoms increase over time, Alzheimer’s and dementia patients can face many safety challenges. Confusion, memory loss, and poor cognitive function can present serious risks, as routine activities become increasingly difficult in a home environment.
Over time, safety-proofing homes for those living with progressive degenerative memory conditions can become nearly impossible in terms of time, cost, and knowledge. This is why many families choose memory care living to provide better care. Some key elements of a memory care home include:
A dementia care plan requires a personalized approach. The first step is to assess the resident’s individual capabilities as well as likes and dislikes. When developing a care plan, caregivers will usually address some or all the following:
Nutrition and exercise needs can also be taken into consideration.
Memory care activities typically include
speech or art therapy, memory games, inhouse worship services, pet therapy, and more. However, activities don’t always fit neatly into scheduled intervals throughout the day. For example, simple activities like making the bed, tidying up the room, and watering plants can help residents who dislike group activities engage with a task that promotes cognitive function.
Most experts agree that a few guidelines should drive the design of all memory care services.
A person-centered assessment is a very important part of your loved one’s memory care home experience. Staff should carry out a holistic assessment of their abilities, limitations, and history; based on this information, a care plan can then be created. The assessment should take inventory of the patient’s physical and cognitive health; their vision, hearing, and other senses; and their ability to make decisions and communicate. Family members should be invited to contribute to the assessment and asked to provide the patient’s medical records.
The assessment is not a stagnant document. Because dementia and Alzheimer’s are progressive conditions, assessments should be updated and re-evaluated periodically.
Memory care requirements are much more intensive than typical long-term care. As mentioned before, the higher the staff-per-resident ratio, the better your loved one’s needs can be met. The very best institutions offer a ratio of 1:3, which means there is one staff member for every three residents. But be aware that these ratios are based on the day shift—meaning nighttime staffing could be much lower. Another important question to ask is who is counted in the staffing ratio. Some facilities will include non-caregivers, such as cleaners or gardeners, in their ratios. A good staff-to-resident ratio with around-the-clock nurses and certified nursing assistants means a memory care facility can provide high-quality 24/7 supervision and support.
Residents will often require medical intervention. When choosing a care home for dementia, be sure to ask if the facility has a medical director and provides on-staff physicians and psychiatrists, as well as speech, physical, and occupational therapists to address patients’ needs without requiring them to leave the facility. In addition, remember that Alzheimer’s treatment requires stability in a patient’s life. Thus, a high-quality memory care facility will ensure consistency and dementia care training for the staff members who care for your loved one.
At the right time, moving a loved one to a memory care facility ultimately benefits the patient, family members, and caregivers. The following chapter explores how the right provider can support you as you and your family navigate this journey.
Made up of fellow Alzheimer’s caregivers, support groups provide a non-judgmental environment in which caregivers can express their feelings with people who understand one another’s experiences. You can find a complete listing of groups. The Alzheimer’s Association also offers an online support group, for caregivers who would struggle to get to an in-person meeting.
Alzheimer’s sufferers will eventually lack the legal capacity to make decisions about their care or manage their own finances. Caregivers will face critical decisions once their loved ones are no longer independent, such as, “when should dementia patients go into care.” An attorney who specializes in elder law can advise on issues such as seeking power of attorney, legal guardianship, or a living will. Elder law specialists can be found on the Alzheimer’s Association website.
Homecare services can be as comprehensive as a full-care service, such as overnight stays, or as simple as a professional who provides a caregiver an hour’s break a few times a week. Of course, any home support service should be carefully vetted—seek advice on questions to ask before signing a home support agreement. If all that you need is some help providing meals for your loved one, consider contacting a meal service provider.
Adult day care services provide a safe setting for people whose disabilities make them unable to care for themselves. These centers can also provide brain-stimulating activities that help with memory care. For advice on selecting a center and a list of centers in your area, visit the National Adult Day Services Association website.
Caring for a family member with dementia, whether at home or at a memory care center, may seem like a daunting challenge. Memory care professionals recommend the following strategies to help you care for your loved ones.
Today’s memory care facilities have improved radically, offering high levels of care that maximize the patient’s quality of life. Even so, deciding whether a loved one with Alzheimer’s or dementia should go to a memory care facility can be extraordinarily difficult. Caregivers may feel guilty or anxious about placing a loved one in an assisted living home. They may even feel that they are taking the easy way out or letting the patient down.
As you contemplate your options, consider the following questions:
How far have symptoms of Alzheimer’s and dementia progressed?
Alzheimer’s is a progressive disease, and patients at the beginning stages of dementia may need only minimal care. If they are not placing themselves at risk, patients with moderate Alzheimer’s can manage day-to-day activities and are able to take basic care of themselves with some family or outside caregiver support. However, eventually the disease will progress so that full-time care at a long-term memory care facility may be the best or only alternative.
There are several factors that affect whether you can realistically offer home care:
Alzheimer’s disease can cause sufferers to put themselves at risk. For example, they leave pans on the stovetop or slip and fall. Although there are ways to make the home safer, with the onset of late-stage Alzheimer’s symptoms, you may feel that your loved one would be more secure in long-term care.
If you are not physically strong enough to care for the patient as they become more physically dependent on you, you may not be able to protect them from falls or safely lift them up. Furthermore, some Alzheimer’s sufferers develop aggressive behaviors that could put others around them at risk. Or, if they are living together with family members, the patient’s forgetful behavior could cause harm to their co-habitants.
A consistent, structured daily routine that includes a healthy diet, regular physical activity, and mental and social stimulation is very important for Alzheimer’s patients. If you work long hours or depend on support from family members who cannot commit to regular hours, the patient’s routine may be frequently disrupted, which is not ideal.
The cost of dementia care depends on the stage of the individual’s condition and the level of care required, the patient’s preferences, and the family’s financial, emotional, and time resources.
On average, the cost of memory care facilities in the U.S. is about $6,935 per month, which is more than the average cost of assisted living ($5,380) but much less than a nursing home ($10,562.) Costs also vary state by state. For example, residential memory care costs $3,800 in Hawaii but is more than $7,000 in Vermont.
Although most families will have to pay some amount out of pocket, Medicaid and Medicare generally will cover room and board in certified long-term care facilities and nursing homes as well as medical expenses. However, that coverage varies by state. Patients must also meet specific criteria to be eligible. States with better-funded programs may offer more extensive coverage.
Another tip to reduce the cost of memory care is to take the “preemptive strike”—people who visit their doctors regularly tend to get diagnosed earlier. They have more time to weigh their options, manage the progression of their conditions, and find a long-term solution that meets their needs.
Many states have assisted living waivers, which extend Medicaid coverage so that seniors can receive long-term care in settings other than nursing homes. Depending on your state, Medicaid benefits for Alzheimer’s and dementia may cover care provided at home, adult day care centers, assisted living or memory care facilities, adult foster care, and nursing homes.
Medicare pays for some services—including hospital stays, cognitive assessments, care planning, and home safety evaluations—at various stages of dementia care. Medicare Part D also helps pay for prescription medications for dementia services.
In the early stages of dementia, Medicare pays for up to 35 hours per week of home health care for homebound seniors while Medicaid can be used to help pay for in-home care or adult daycare centers. In the later stages of dementia, Medicare usually covers the first 20 days of a patient’s nursing home stay but Days 21 through 100 typically require an out-of-pocket copay. Coverage approval and co-pay amounts depend on the Medicare program the patient is enrolled in.
After 100 days, patients can use Medicaid, their personal resources, or a combination of the two to cover nursing home care. Medicare also pays for hospice, covering medical and personal care, prescription drugs, and counseling for patients and their families. Other waiver programs are diagnosisspecific (for example, mental disability) or service-specific (for example, technology assistance). But if the patient also has Alzheimer’s or dementia, the services are still available.
Beyond Medicare and Medicaid, you can consult Medicaid’s Program of All-Inclusive Care for the Elderly (PACE) for other potential resources. Those eligible for Social Security Income (SSI) may apply for the Optional State Supplement (OSS) to help pay for memory care. The Personal Choices Program offers more flexibility than the E&D Waiver, while the PACE program focuses on community-based care. The Veterans Affairs Department (VA) offers resources for veterans.
Another option is long-term care insurance, which provides payment based on the number of days spent in a nursing home. You can also tap into other disability resources (e.g., insurance programs from previous employers) or draw on social security or Medicare early.
Even when you’ve done your research, selecting the right memory care services for your loved one can be daunting. How can you evaluate your options to make the right choice? Touring facilities and meeting with the staff to inquire about memory care services is one of the best ways to know if you’re making the best choice.
If your family is struggling with how to best care for a loved one with Alzheimer’s Disease or dementia, it can be a difficult time. You may want to speak with experts to discuss your options. At Rehab Select, we have staff that are specially trained to provide the kind of safety precautions that can safeguard those experiencing symptoms of Alzheimer’s and dementia. At our five long-term care locations in Alabama, we provide 24-hour supervision and care, as well as Wanderguard monitoring for optimum security. Our staff are trained to care for patients’ physical well-being, and also their emotional and mental needs. Our memory care services include structure interactive programming tailored to each individual’s interests and abilities. If you feel a skilled nursing facility that offers memory care may be right for you, we encourage you to book a tour or contact us to learn more about our Alabama memory care services.
