Should You Put Your Parent in a Nursing Home?
Caring for Relative with Alzheimers
How Alzheimer's Facilities Can Help
If you are worn-out with caring for your loved one with Alzheimer's or other dementia, you are not alone. Some caregivers end up having worse health issues than the ones they are caring for. The best advice I got when caring for my two in-laws with Alzheimer's came from my cousin who has been a hospice nurse for many years.She told me:
"Let the professionals do what they can, so you can do what only you can."
Types of Alzheimer's Care Facilities
Professional service for a person with dementia's daily needs can help you be a better caregiver. There are many types of services for Alzheimer's care:
- Respite care in your home.
- Daycare at a facility.
- Independent living facilities with some daily needs support.
- Assisted living care.
- Combination care facilities which have graduated care from independent living, to assisted living to nursing care.
- Long term care nursing homes.
- Specialized Alzheimer's Units in Long Term Care Facilities.
- Alzheimer's Facilities which specialize in Alzheimer's and dementia patients.
The type of Alzheimer's facility and care you choose will depend on your loved one's needs. However, it is important to look at the future needs of a person who is moving toward Advanced Alzheimers.
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Advantages of Nursing Home Care
When to Seek Long Term Care for Alzheimers
Many times, families feel guilty about not being able to care for their loved one with dementia. Often, when a person is in the early stages of dementia, changing schedules and reducing work can allow families to provide the assistance their relative needs to continue to stay in their home. However, as Alzheimer's enters middle and late stages, caring for a person can be overwhelming. Long-term care should be considered when:
- Alzheimer's patient needs 24-hour supervision.
- Health status of loved one requires more medical monitoring and nursing care than can be provided in a home.
- The main caregiver is facing health problems, feel overwhelmed, don't get enough sleep, feel isolated or depressed (often the case when a spouse is the main caregiver).
- Health concerns of caregiver begin to be as much as those of Alzheimer's patient.
- Caregiver and Alzheimer's patient are having difficulty in their relationship because of caregiving.
- Safety of loved one with Alzheimer's is a concern.
- If the person lives alone, are they becoming unable to continue daily living tasks, feed themselves and take medicines appropriately?
- Do doctors and other professionals recommend long term care?
- The family is beginning to have troubles related to caring for Alzheimer's patient.
When Long Term Care Might Help
Alzheimer's Facility vs. Nursing Home
You may wonder if a person with Alzheimer's needs to be in a facility which specializes in Alzheimer's patients. Here are some things to consider:
- Special Alzheimer's Facilities May Cost Much More: While many of these facilities might have resources which could help your loved one with dementia, the added cost of many of these types of long-term care homes may not be necessary. In our town, long term Alzheimer's facility care is about 30% more than other nursing homes in the area.
- Most Long Term Care Facilities Have Alzheimer's Patients: A large majority of people in most nursing home facilities have Alzheimer's or other dementia, so they are used to handling the different needs of memory challenged individuals. So even if the nursing home does not state a specialty in Alzheimer's care, they may very well be quite competent at taking care of your relative.
- Alzheimer's Patients are Difficult. No matter where your loved one is taken care of, whether at home or in a care facility, you will probably struggle with the difficulties of caring for a person in middle to late stage Alzheimer's, and so will the people caring for your loved one. Delusions, hallucinations, anger, sundowning (mixing up days and nights) and other behaviors make caring for a person very difficult. Even the best caregivers will sometimes be stumped at how to handle a behavior. No matter what long-term facility you choose, you will need to be involved in the care taking of your relative and there may be some difficult decisions and situations along the way.
Long Term Care Starts with Crisis
Crisis Starts Long Term Care Search
Like many people caring for loved ones with Alzheimer's, it took a crisis for us to consider long-term care. In our case, the problem was compounded by the fact that we were caring for two Alzheimer's patients at once, Michael and Nicole, my husband's parents.
For two years, we managed to help them stay in their own home. I stopped working so I could be available for their emergency needs and medical care. We assisted in caring for them and changing their routines so that they could cope with their changing abilities. Eventually, however, there came a medical crisis which put Nicole into the hospital. Within six months, both Michael and Nicole needed 24-hour care. Many of the items on the list above were true for us. We considered the special Alzheimer's facility in town, but they did not have beds at the time; moreover, as we investigated our choices in long-term care facilities, we realized that we needed to consider the different needs of each of them:
- Nicole needed 24-hour nursing and medical supervision of her condition. She needed people who were very compassionate but able to deal with her explosive anger.
- Michael needed to be assisted living services to help with daily living and activities to keep him busy. He also needed a locked facility that he could not leave. He also needed people who could re-direct his paranoia.
Nursing Home Facilities Vary
Best Alzheimer's Facility
In the end, we visited with many Alzheimer's facilities, assisted living facilities and nursing home facilities. Since then, we've had many friends who have had parents in other long-term facilities in our town as well. The answer to which is the best Alzheimer's facility is:
The Best Alzheimer's Facility is the One Which Meets Your Loved One's Needs
The most important factor in choosing an Alzheimer's facility is determining what your loved one must have to be safe, stable emotionally and taken care of physically. Here are some of the typical needs your Alzheimer's loved one might need:
- Alarmed doors or monitors to prevent wandering?
- Lots of activities to keep them busy?
- Socialization and community meals?
- Privacy? A place without much noise?
- Regular schedules?
- Access to therapy and doctor's visits in-house.
- To be close for you to visit easily?
- Compassionate and patient caregivers?
- One consistent caregiver or a variety of different faces?
- The constant presence of a nurse on-site?
- Help with daily living activities?
- A place which allows them to move from assisted living to nursing home care as needed?
- A place where they can be outside safely?
- A physically attractive facility?
- A place where family involvement is encouraged with activities to involve other family members in special events?
- A facility which is adept at handling psychotic medications for individuals with difficult behaviors.
Nursing Home Red Flags
Best Alzheimer's Facility May Change
In the end, we used three different long-term care situations in our town during the three years Michael and Nicole needed Alzheimer's long term care. What caused us to change care?
- One facility was not able to handle the two of them together.
- Another facility had staff changes which made safety concerns.
- Michael initially needed the stimulation of assisted living, but as he declined he needed to have the medical services of a nursing home facility.
In the end, we found that caring staff made the biggest impact on how well Michael and Nicole adjusted to the facility and felt about their time living there. Caring and gracious staff would be the first thing I would look for in touring any facility in the future.
Have you chosen a long-term care facility for your relative with Alzheimer's or dementia? Please share your stories and ideas for making the choice in the comments below.
Alzheimer's Caregiving Changes Family
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