Finding Long-Term Care for a Person with Alzheimer’s or Dementia

Sometimes you can no longer care for a person with Alzheimer’s disease at home. You may not be able to meet all of his or her needs at home anymore. When that happens, you may want to look for a long-term care facility for the person.

You may feel guilty or upset about this decision, but moving the person to a facility may be the best thing to do. It will give you greater peace of mind knowing that the person is safe and getting good care.

Choosing the right place is a big decision. It’s hard to know where to start. The following overview of options, along with questions to ask and other resources, can help you get started.

Residential Care

Residential care options include:

  • Continuing care retirement communities (CCRCs)—a home, apartment, or room in a retirement community where people with Alzheimer’s can live and get care. Some of these places are for people who can care for themselves, while others are for people who need care around-the-clock. An advantage is that residents may move from one level of care to another—for example, from more independent living to more supervised care.
  • Assisted living facilities—a facility with rooms or apartments for people who may need some help with daily tasks. Some assisted living facilities have special Alzheimer’s units. These units have staff who check on and care for people with Alzheimer’s disease. You will need to pay for the cost of the room or apartment, and you may need to pay extra for any special care.
  • Group homes—a home where several people who can’t care for themselves and two or more staff members live. At least one caregiver is on site at all times. You will need to pay the costs of the person with Alzheimer’s living in this kind of home. Remember that these homes may not be inspected or regulated, but may still provide good care.
  • Nursing homes—a place for people who can’t care for themselves anymore. Some nursing homes have special Alzheimer’s disease care units. These units are often in separate sections of the building where staff members have special training to care for people with Alzheimer’s. In many cases, you will have to pay for nursing home care. Most nursing homes accept Medicaid as payment. Also, long-term care insurance may cover some of the nursing home costs.

Next Steps: Gathering Information

Choosing the right place is a big decision. It’s hard to know where to start. Below we list steps you can take to find the right place:

1. Gather Information

  • Talk with your support group members, social worker, doctor of the person with Alzheimer’s, family members, and friends about facilities in your area.
  • Make a list of questions to ask about the facility.
  • Call to set up a time to visit.

2. Visit Assisted Living Facilities and Nursing Homes

Make several visits at different times of the day and evening.

Ask yourself:

  • How does the staff care for the residents?
  • Is the staff friendly?
  • Does the place feel comfortable?
  • How do the people who live there look?
  • Do they look clean and well cared for?
  • Are mealtimes comfortable?
  • Is the facility clean and well-maintained?
  • Does it smell bad?
  • How do staff members speak to residents—with respect?

Ask the staff:

  • What activities are planned for residents?
  • How many staff members are at the facility? How many of them are trained to provide medical care if needed?
  • How many people in the facility have Alzheimer’s disease?
  • Does the facility have a special unit for people with Alzheimer’s? If so, what kinds of services does it provide?
  • Is there a doctor who checks on residents on a regular basis? How often?

You also may want to ask staff:

  • What is a typical day like for the person with Alzheimer’s disease?
  • Is there a safe place for the person to go outside?
  • What is included in the fee?
  • How does my loved one get to medical appointments?

Talk with other caregivers who have a loved one at the facility. Find out what they think about the place.

Find out about total costs of care. Each facility is different. You want to find out if long-term care insurance, Medicaid, or Medicare will pay for any of the costs. Remember that Medicare only covers nursing home costs for a short time after the person with Alzheimer’s has been in the hospital for a certain amount of time.

If you’re asked to sign a contract, make sure you understand what you are agreeing to.

How to Make Moving Day Easier

Moving is very stressful. Moving the person with Alzheimer’s to an assisted living facility, group home, or nursing home is a big change for both the person and the caregiver. You may feel many emotions, from a sense of loss to guilt and sadness. You also may feel relieved. It is okay to have all these feelings. A social worker may be able to help you plan for and adjust to moving day. It’s important to have support during this difficult step.

Here are some things that may help:

  • Know that the day can be very stressful.
  • Talk to a social worker about your feelings about moving the person into a new place. Find out how to help the person with Alzheimer’s adjust.
  • Get to know the staff before the person moves into a facility
  • Talk with the staff about ways to make the change to the assisted living facility or nursing home go better.
  • Don’t argue with the person with Alzheimer’s about why he or she needs to be there.

Be an Advocate

Once the person has moved to his or her new home, check and see how the person is doing. As the caregiver, you probably know the person best. Look for signs that the person may need more attention, is taking too much medication, or may not be getting the care they need. Build a relationship with staff so that you work together as partners.

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