The Caring Corner, presented by ACORN: Caring Options for Parents with Dementia

Mom Has Dementia… Should I Put Her Into Long Term Care?

When you reach this stage with a loved one, there are two basic options.

Care for your mom at home. This probably includes getting part-time care with a nursing assistant and/or having her go to an adult daycare center for certain portions of the day.
Put her into a nursing home or other facility, such as special memory care units or assisted living.

As you evaluate these options, which is a challenging and draining process, keep in mind the following:

If your mom has Alzheimer’s or other dementia, it’s important for her to have a safe structured environment. It’s possible to do this at home, but the long-term care facility specializes in this.
Chances are your mom is going to need an increasing amount of care as she ages. At some point moving into long-term-care maybe inevitable.
At a care facility, your mom will have more people to talk to, as well as structured activities and outings. These social activities may keep her active for a longer period of time
Caring for someone with dementia at home takes a considerable amount of time and effort. The costs of home care can be very high; it also takes time away from other areas of your life. Each family has different needs and considerations.
Don’t think that just because mom is in a facility that your problems will be solved. Many families become unhappy with the care that mom or dad gets. In many cases, it will take constant supervision to ensure that staff members are paying attention to her needs the way you want.
Facilities do not provide one-on-one attention. Staffing ratios can be very high. The best place to provide one-to-one care that addresses her needs entirely may be home.
By incorporating adult day care programs and part-time home care assistance, whether through paid caregivers or friends and family, chances are you can keep mom at home longer.

What Happens When the Disease Worsens?

With dementia, the care mom needs will increase as her disease progresses. Basic personal activities like using the bathroom, bathing, dressing, eating, and simply moving around become more challenging. At some point, they will be impossible to do without assistance.

Safety becomes a bigger concern. Mom might be more likely to wander or have an accident

Keeping mom at home can be physically and emotionally challenging. Her behavior may often be frustrating… even dangerous. She might become abusive, anxious and angry. This type of behavior is frequently the biggest challenge that family caregivers face.

What Types Of Long-Term Care Facilities Are There?

We use the term “nursing home” to broadly refer to all long-term-care institutions, but there are many types, and each offers a different degree of medical care and assistance. You may not have all kinds in your community.

Skilled nursing facilities (SNFs) will give your mom nursing care 24 hours a day. This is commonly the most expensive type of facility, but it might be the only practical choice if she has advanced dementia. SNFs provide medical care, medicines, housing, meals, laundry, and assistance with personal activities like dressing, toileting, bathing, etc.

Assisted living facilities often provide private, apartment-like lodging options with assistance with meals, cleaning and laundry, and help with the personal care (dressing, grooming, bathing). Since assisted living centers provide limited medical care, it can be the right choice if her dementia is earlier stage and she can still do many tasks on her own.

Smaller and intimate, residential care homes often provide a greater level of supervision than assisted living. They typically provide community-style living arrangements, meals, laundry, and assistance with personal care. These facilities can be great fit for mom when her dementia is mild to moderate and she doesn’t require daily nursing care.

Continuing care retirement communities, or CCRCs, offer several levels of assistance. They provide independent living, assisted living and “full-on” nursing care in the same facility or on the same campus. CCRCs are expensive, but many times they offer a good choice because they can meet your moms needs from the early stage of her disease until she passes.

The costs of all of these options are high. Unless you can afford 24/7 care at home, none of them may seem ideal. Keep in mind that your own well-being — your physical and emotional health — is important and must be accounted for. If you decide to move mom into a long-term care, it is not an indication of failure.

About the Author:

Lorenzo Mejia and his wife, Mary Lynn Ryerson, are the owners of Acorn, a caregiver registry located in Chapel Hill.

They founded Acorn based on their experiences caring for his mom, who suffered with Alzheimer’s Disease. In 2013, he became a Qualified Dementia Care Specialist. In 2014, the Alzheimer’s Foundation named him the Dementia Care Professional of the Year in the United States.

Lorenzo is the founder of Dementia Friendly Orange County an effort to make local businesses more accommodating to people with dementia.

Lorenzo speaks often on dementia and the challenges associated with caring for loved ones. He has been interviewed by ABC News and National Public Radio. He is an adviser to Orange County’s OC-CARES Dementia Capable Community Project.