If Necessary Provide Adequate Preparation For The Final Stages Of Alzheimers Disease
Nursing care for dementia and Alzheimer’s patients becomes especially critical during the final stages when patients experience memory loss, depression, hallucinations, and psychosis. Kriebel-Gasparro emphasizes the importance of skilled nurses with extensive dementia and Alzheimer’s knowledge at these severe stages. Nurses not only provide treatment to patients but also help families prepare for end-of-life decisions.
While families may find it difficult to face these issues, nurses with gerontological training can help them make important end-of-life decisions. These nurses can facilitate conversations with family members about hiring elder-law attorneys and preparing necessary documents such as living wills, medical power of attorney, and end-of-life directives. They also provide emotional support to family members and suggestions for preparing emotionally for the final stages.
How Are They Different
Compared to the similarities, the differences between memory care and nursing care facilities are vast:
- Nursing care communities are required to have a nurse on-site 24/7 , whereas most memory care communities only have a nurse part time.
- CertifiedAlzheimers nursing care requires a ratio of 1 staff member per 6 residents. Most memory care does not meet that standard.
- Nursing care administrators must have a bachelors degree, go through a 1,000-hour internship and take a state licensing exam, whereas memory care managers only need a GED and 24 hours of training. The nursing home license requires the Administrator to have a Nursing Facility Administrator License to lead the nursing home.
- Additionally, the nursing care license requires:
- Front-line nursing aids to be certified through the state as certified nursing aids, which is a 100-hour certification. Memory care resident attendants do not have to have specialized training.
- A licensed nurse to pass out medications, whereas memory care permits unlicensed staff to pass out medications.
- A social worker who leads a quarterly care plan with families and helps counsel them through the challenges of this disease memory care facilities do not.
- Physicians to do weekly rounds, whereas memory care does not.
- A medical director to oversee the residents care, which is not required in memory care.
Pros And Cons Of Facilities For Combative Dementia Patients
Some care facilities may seem like they are more exclusive, and therefore better, if they will deny certain kinds of patients. But that isnt necessarily true.
Its important to remember here that how a care facility deals with an aggressive resident will be a sign of its worth to you, and your loved one.
For example, if a care facility says they deal with aggression by using frequent and heavy sedation then this is probably not the ideal place. This is because they are not really dealing with the aggression but rather are just knocking the patient out so they cant do anything.
This may lead to questions like well, how do you know exactly how the facility deals with it when you are not there?
There are a few ways you can make sure you are choosing the right nursing home care for your loved one who may become aggressive as their dementia progresses.
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How To Find A Care Home For An Aggressive Dementia Patient
There are many facilities available to patients living with dementia who specialize in providing the kind of care they need, especially as their condition starts to decline.
As the illness of dementia progresses, many people living with it start to have the inability to understand what is going on around them. When this happens it can be scary and patients can become verbally and physically aggressive.
Trying to deal with a person whose cognitive function is impaired but they are still aggressive can be difficult. For this reason, some care facilities will have rules around the kinds of patients they will accept into their care.
If you have a combative dementia patient at hand and are looking for a facility to care for them, you may have to do some looking around.
Heres a little more information on what you need to know.
Using Reverse Mortgages For Alzheimers Care
The decision on whether or not to use ones home, through a reverse mortgage, to help pay for care is not an easy one. In many cases, it does not make good economic sense, but in other situations it does.
Reverse mortgages come due one year after the homeowner moves from their home. Given that most individuals with Alzheimers will eventually require residential care, it becomes a question of how many years until that point. Should one be at the early stage of the condition and wont require residential care for 5 years, a reverse mortgage might make good sense as a funding resource for occasional assistance around the home. However, if one might need to move within 2 years, a reverse mortgage would be considered an expensive source of funds. The exception to this rule is when the individual with Alzheimers has a healthy spouse who will continue to live in the home when the spouse with Alzheimers moves into a care facility. In this situation, a reverse mortgage could be a sound decision.
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Types Of Dementia & Alzheimers Care Available
There are three types of care offered at most nursing facilities: Custodial, Intermediate and Skilled. Custodial care is the lowest level of care available. It consists of basic personal care managing normal daily activities such as bathing, dressing, and eating. This level of care is designed for older adults in the beginning stages of dementia or Alzheimers, or those in the beginning stages of early onset of dementia or Alzheimers disease. Intermediate care offers the same assistance for basic care, as well as periodic medical monitoring of blood pressure and glucose levels. This level of care can also include reminders to take medicines or medicine distribution. The intermediate care level offers the care your loved one needs when the dementia or Alzheimers disease begins to progress but hasnt yet made them completely dependent on assistance. The final level is skilled care. This is specialized care provided by medical professionals trained to provide 24-hour medical care and supervision. Skilled care is the level of care a dementia or Alzheimers patient needs in the later stages of the disease. Trained doctors, nurses and nurses aides provide complete care at this point. It is important to note that nursing facilities are able and prepared to care for those with early onset of dementia as well. Age is not a factor in most memory care facilities.
How Do You Move From Dementia To Assisted Living
If your loved ones memory loss is not yet severe, started a conversation about looking ahead and what to do when the disease progresses. Talk about what should happen if the loved one is no longer capable of living an independent life safely at home.
Next, select the best available assisted living community that specializes in memory care. Choosing the best place first is imperative to ensure you will not have to relocate your loved one when their condition progresses.
Use all available counseling services, especially those that provide a transitional program to help your loved one readjust to a new life.
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Prioritize The Care Of Your Loved One
Remember that your loved one is living in this community. If you feel that the community is not prioritizing the care of their residents, it may be time to find a new more suitable home for your family member.
Its also important to approach the community staff and leadership with a collaborative attitude to find effective solutions to keep your loved one safe and living the highest possible quality of life without jeopardizing other residents or staff in the community.
If your loved one does actually need more intensive care than what their current community can provide, it is best for all involved to find a better setting where they can get the care they require.
If it is time to look at new memory care facilities, it could be effective to ask your physician or staff from their previous assisted living facility for recommendations.
How To Make Moving Day Easier
Moving is very stressful. Moving the person with Alzheimers 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 Alzheimers 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 Alzheimers about why he or she needs to be there.
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Final Thoughts Facilities For Combative Dementia Patients
Families may feel a little better when the care facility is taking steps to be proactive in keeping their loved ones healthy and preventing any feeling of discomfort or being overwhelmed.
When a loved one is moving into a care facility, there is a lot of emotional strain on their family. Seeing them go into full-time, around-the-clock care is never something we want for the people we love the most.
Your family member might feel abandoned and especially confused when they need memory care they really have no idea where they are or why they are there.
We know that there really isnt anyone out there who will love your parent or family member like you will, and wont care for them exactly like you will.
So leaving your loved one in a care home can be really stressful.
You will always have questions like will they be properly cared for? How will they be talked to if they are having an especially difficult day? Will aggression be dealt with by sedating the resident or does the staff have proper training?
But if you choose a facility meant to accommodate combative dementia patients, things will be much easier. The right care homes have the training and expertise to provide the right kind of care that people living with dementia need.
Its really admirable if you want to care for your loved one, however it may not really be the best thing for them. Do you know how to care for someone with advancing dementia?
What To Look For In A Dementia Care Home
Finding an assisted living facility for a loved one with dementia can be difficult, especially if they show aggressive behavior. Considering facilities dont necessarily promote themselves as aggressive dementia care homes, working with your physician would be an effective place to start.
If you end up searching on Google, you should start with finding well equipped facilities with highly rated memory care units. Once you have a few of these assisted living facilities identified, youll have to call for more information and explain the situation. Make sure to be completely honest about the situation and any history of physical or verbal aggression. While it might be tempting to leave out the details, the priority is finding a well equipped facility that is aware and can handle the situation appropriately.
Here are some key factors to look for in your next memory care community:
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Communicate In A Way That Will Not Distress Patients
As dementia progresses, Kriebel-Gasparro reminds nurses not to make assumptions about a patient’s ability to communicate and comprehend. The symptoms of dementia and Alzheimer’s disease affect each person differently from the early to moderate states. Patients need to be treated with kindness and support, using these communication techniques:
- Maintain eye contact and direct one-on-one interaction.
- Be patient and offer assurance when the patient makes mistakes or feels embarrassment.
- Ask clear and simple questions requiring yes or no answers to minimize confusion.
- Do not interrupt or argue.
- Engage in conversations in quiet spaces without distractions.
Do All Nursing Homes Accept Dementia Patients
Medical and hygiene care in memory-care nursing homes or assisted living communities are not always available to every individual diagnosed with Alzheimers or other related dementia conditions. Typically, the state will require that an individual with dementia must need assistance in performing up to three necessities , including dressing, eating, or bathing.
Usually, people with dementia can perform most of their activities until the mid-end late stages of the disease when debilitating problems like confusion and disorientation set in. At the last stage, dementia patients require the highest level of care, including ongoing supervision, that assisted living residences and senior living memory care facilities can provide.
Not all senior living communities have specialized care units to provide the level of care the patient may need to ensure their quality of life is maintained while controlling their debilitated condition with nursing care, supervision, and medications.
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Nursing Home Care Quality
Families have many concerns, rightfully so, about the quality of care at the nursing home into which they are placing a loved one. Fortunately, information about care quality is readily available. Because Medicaid and Medicare pay for the vast majority of nursing home care in the US, they have available to them vast information about the care quality at nursing homes that accept Medicare and / or Medicaid. To its credit, the government makes this information available to the general public. One can search on this website by zip code or nursing home name and compare care quality about the vast majority of nursing homes in a specific area.
Does dementia get worse in a nursing home? Does putting someone in a nursing home accelerate their cognitive decline? One recent reputable study found that persons with dementia did no better or no worse than others because they were placed in a nursing home. Having said that, it is believed in years past, this was not always the case. Today, approximately 15% of nursing homes have Special Care Units with staff trained specifically to assist individuals with dementia. When choosing a nursing home, it is recommended that families 1) Use Medicares nursing home compare tool and 2) Seek out a nursing home with a dementia special care unit.
What Is The Specialized Dementia Care Program
The Specialized Dementia Care Program is for a person with dementia who can no longer live at home and needs state-funding to help pay for long-term care services in a facility. Learn more about alternatives if the person is not eligible for Medicaid.
Offered through the Department of Social and Health Services , a person with dementia receives a package of specialized dementia care services while living at an Assisted Living Facility. Learn more about what an Assisted Living Facility is.
The goal of the program is to help a person with dementia maintain the highest possible quality of life and physical health while living with the losses typical of dementia.
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Paying For A Care Home
Who pays for care will depend on individual circumstances.
If you’re entitled to local council funding, the council will set a personal budget. This will set out the overall cost of a care home, what the council’s contribution will be, and what you’ll have to pay.
The council must show there’s at least 1 suitable care home available at your personal budget level.
If you choose a care home that’s more expensive than the council considers necessary, top-up fees may have to be paid.
If the person with dementia isn’t eligible for council funding, they’ll have to pay the full cost of the care home .
Lewy Body Dementia Canada
Learn to live best with LBD
Ive done it wrong. Not just once, but twice. This is despite having clarity of mission in my aggressively pursued quest to find a good place for my husband, Bruce.
Like most caregivers, I had always hoped and planned to keep him at home until the end. Also, like most caregivers, I realized that doing so was a very tall order. His needs are limitless and my abilities to meet them are not. Your story likely has much in common. There are valid reasons that the vast majority of dementia patients reside in institutional careand its not because nobody loves them. In so many cases, at least one person has given all but their life to provide care at home until their ability or health breaks under the weight of caring.
My extensive personal experience and that of others has led me to conclude that most institutional care facilities are merely adequate, achieving mediocrity as the norm. A few are horrible. A few others are wonderful, the pinnacle that we caregivers seek. But this is a search fraught with pitfalls and perils. I hope to help you avoid at least a few of the many mistakes I made.
Successfully Choose a Dementia Care Facility.Heres What to Do, and What NOT to Do
> > LESSON LEARNED: Be sure to bring and use your pen, notebook, and best questions and start investigating potential facilities NOW.
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Ask A Physician To Assess The Situation
If the cause for eviction is the community can no longer meet the level of care the resident requires, ask a physician to come in and assess the situation. Getting the residents healthcare team involved can help find solutions to issues or concerns about the resident continuing to age in place. Having multiple professionals involved in decision-making will help keep everyone accountable.
While many communities have the residents best interest in mind, there may be other hidden motives involved. Your physician can evaluate the level of care needed and determine if the community is able to provide appropriate care. Documentation from physicians and other healthcare professionals can help persuade whether or not an eviction is necessary.