Mom or Dad Has Alzheimer's... What Type of Care is Best? ©
By: Clare Absher RN, BSN
Planning ahead by exploring living arrangements and care for your parent or loved one with Alzheimer's is critical when it comes time to making the right decision. When finding the best care becomes urgent or a crisis, you are more likely to be forced in to finding a "quick fix", resulting in a choice that doesn't solve long-term needs. Caring for a parent with Alzheimer's is an extremely challenging experience for families. There is no standard answer for "What type of care is best?" The philosophy and appropriate level of care, preferred location, and budget all need to be considered. This overview of Alzheimer's care options (that I will individually go in to more depth later), offers some pros and cons of each to bear in mind when deciding what's best for your situation.
Home Care is most often the first choice, as many families prefer to keep their parents at home. Recognizing the need for outside help such as a companion, nursing assistant or homemaker can make this a viable option. Whether privately hiring an in-home helper or through a home care agency, Home Care allows your parent to remain in familiar surroundings with less disruption in routines resulting in reduced confusion. Home Care is generally less costly IF you are able to share in the caregiving duties. The biggest concern with this option is stress associated with the demands of caregiving. As a RN Care Manager, I have encountered many families with the best intentions simply "burn out". Neglecting other responsibilities, lacking confidence in caregiving skills, and resenting demands placed on your time, are a few predominate feelings. Remember the key to success here is allowing other caregivers to relieve you of some responsibilities.
Adult Day Care also affords your loved ones the comforts of home and at the same time gives families the respite they need. This care is usually reasonable priced and may even be subsidized by certain local resources. Offered in community centers and through some senior programs, Adult Day Care provides social, recreational, meals, and sometimes transportation services. Does this sound too good to be true? It may be if your loved one does not agree. He or she may vehemently resist going to day care only adding to your stress. I will go in to more detail for help with this problem later when addressing this option individually. Unfortunately, in some communities, day care isn't available or the center does not accept those with Alzheimer's. Due to popularity and growing demands for such care, hopefully your community is one that offers this care.
Retirement Housing provides every resident with an apartment that has cooking facilities where your loved one must be able to safely manage meals in addition to caring for him or herself. Most retirement homes don't have staff trained to care for those with dementia and staff is not onsite around the clock. Only those in the early stages of Alzheimer's are good candidates for this housing with the biggest pitfall being the need to move later. Maintaining independence, living among peers, being free from home maintenance, and having adequate security, are some of the benefits to consider.
Assisted Living is probably the most popular choice of residential care for many aging parents including those with Alzheimer's. Facilities typically offer personal care assistance, supportive services such as housekeeping and transportation. This housing is ideal for those in early to middle stages of Alzheimer's, as your parent is able to live fairly independently among their peers. Trained staff along with specialized Alzheimer wings and dementia programs in many facilities can move this option to the top of your list. The benefit of maintaining independence for a certain period of time can outweigh the disadvantage of having to relocate to a skilled care facility later on during illness.
Skilled Care or Nursing Homes are frankly our parent's most dreaded option and least popular for us to consider. When dependent on 24hr skilled care provided by licensed nurses and other options are no longer feasible, then this care is often the only answer. Explore Medicare/Medicaid certified homes because your love one may be eligible for benefits related to skilled care requirements. Try finding a facility that has a special care unit as many do now, that is designed to meet the unique needs of Alzheimer's.
Hospice care is an alternative to nursing home care that is often overlooked for those in late stages of this disease. These homes emphasize dignity and comfort and provide necessary skilled care. To qualify for this care the doctor must determine that your parent is terminally ill with a prognosis of usually less then 6 months to live. Verify that the facility is Medicare/Medicaid certified to be eligible to receive benefits. Accepting this type of terminal care is difficult for many, but may be the most appropriate option.
Continuing Care Retirement Communities (CCRCs) have campus-like environments that provide all the levels of care ranging from independent and assisted living to 24 hr skilled care. When the only moving that your loved one must endure is perhaps from one building to another, then this progressive concept of care might be your answer. Sounds perfect…so what's the drawback? Mainly the cost as you may have already guessed. The variation in the types of contracts offered may enable you to find one to fit your budget. Compare entrance fees closely taking into consideration which ones are refundable. Bear in mind that CCRCs require that your parent enter the facility at an independent or assisted living level of care, creating a vital need for early planning.
This overview will serve as a guide to get you started on your research. More details on each individual care option are forthcoming. Good Luck with your search.