When Should Someone With Dementia Go Into A Care Home

Moving To A Care Home

If the persons needs become too great for you to manage at home, you may need to consider other long-term options. If youre becoming exhausted or the person with dementia is becoming harder to care for, a care home can be the best option for you both.

A move to a care home can be a difficult decision, but there are limits to the care you can provide.

If the person you care for is moving into a care home, familiar furniture, belongings or music can help them feel more settled.

What Are The Choices For Part

Some people find that part-time help allows them to keep their relative at home for a longer time. Part-time care may take place either at home or in an adult day care.

As in long-term care centres, home care can provide whatever help a person needs. For example, a home health aide can help the person bathe and can wash clothes and linens. A nurse can give medical care and help with behaviour issues.

Adult daycare and respite services take care of the person so that the regular caregiver can take a break. This may relieve some of the stress of caregiving.

Planning For The Move

Once a place becomes available in a residential facility a decision may need to be made very quickly, so it is helpful to plan the move in advance. Many people with dementia can be disturbed by change. Explain simply and gently where and why they are moving. Emphasise the positive aspects such as new friends and enjoyable activities. If at all possible, introduce the person with dementia to the new facility gradually so that the place becomes a little more familiar and a little less confusing and frightening. Sometimes of course this is just not possible, especially if the move has to be made quickly.

Ensuring that their new room has as many familiar items as possible may help with the move. Family photos and familiar prints or paintings on the wall and familiar bed coverings can make the new room look a little like their own bedroom at home.

Label all personal items with large, easy to read identification. During this initial moving stage it will take time for both the person with dementia and their family and carers to adjust to the new situation. Expect a period of adjustment. People do settle. Many actually do better in a structured environment they feel more secure and get more stimulation.

There is no right number of times to visit or length of time to stay. Some people want to visit frequently during this time. Others will want to rest and recover from the strain of caregiving. The important thing is to make each visit as rewarding as possible.

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Detailed Discussion Of Needs

In addition to researching local dementia care homes, it is very important that you have a full and detailed discussion with the home manager about all aspects of your loved ones behaviour and needs. Above all, the safety and care of your loved one is the most important. It is vital that a persons care needs are fully understood and explored before committing to a placement to ease the stress for the individual and their families.

Furthermore, going into a care home with dementia, mental and physical requirements WILL change over time, so ongoing monitoring and discussion is critical.

A Mental Status Exam Can Help Decide When Its Time For Memory Care

In the office, we can perform a very easy, reproducible test that only takes a couple of minutes, says Branshaw. If the patient can read, the mental status exam may give a reliable baseline for tracking dementia symptoms and memory loss. This exercise measures short-term recall, concentration, and spatial awareness, and may test a seniors ability to:

• Repeat words a doctor says, then remember them later in the appointment
• Spell simple words backward
• Add and subtract basic equations
• Name objects properly
• Understand visual and spatial cues, like the distance and location of objects

Another common test is to ask someone to draw a clock, says Branshaw. Many people with dementia will draw all of the numbers up in one corner, rather than around the circle.

Most of the time, aging adults will visit their primary care doctor or geriatrician, who will perform these baseline tests if they suspect memory problems. After that, they may be referred to a neurologist or other specialist for further analysis and a specific diagnosis of Alzheimers or another type of dementia.

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How Will I Know When Its The Right Time For A Care Home

The decision to move into a care home is rarely straightforward. There are no fixed rules that tell you when is the right time to take this step. The decision should be based on an individuals needs and circumstances.

For some people the need for residential care might;happen quickly, because of a sudden illness, fall or a bereavement. Others will experience a gradual increase in their care needs before residential care has to be considered.

Despite what other people might tell you, dont assume that a care home is the only option when an older person needs extra care. Solutions such as home adaptations, care at home or sheltered housing can be suitable support options, which;can help someone to maintain their independence for longer. Make sure you research all the options before making a decision.;See more below – the alternatives to a care home.

Reducing Antipsychotic Medications Combined With Social Interaction Programs

There is a strong push to decrease the use of antipsychotic medications for people with dementia in nursing homes, and as a nation, we have made much progress in this area. However, some research says that’s not enough. It found that reducing the usage coupled with the provision of increased social interaction improved survival rates in facilities. Simply decreasing antipsychotic medications without adding other interventions resulted in an increase in the challenging behaviors and emotions related to dementia and did not improve survival rates.

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Differences Between Memory Care And Nursing Homes & Assisted Living

Memory care is not the same as assisted living or a nursing home. The difference between memory care and assisted living is that memory care is specifically for people with Alzheimers disease, or related dementia, because they require a higher level of skilled care and supervision. Also called Special Care Units or Alzheimers Care Units, memory care communities usually offer shared and private spaces. Sometimes memory care exists as a wing within assisted living communities or nursing homes.

When compared to memory care, nursing homes are more expensive, more restrictive to the individual and provide a higher level of care. Nursing home candidates are typically accessed and found to require a nursing home level of care, which is a formal designation. Not all, not even close to all, persons with Alzheimers disease require nursing home level of care at the early or middles stages of the disease.

Memory care has more frequent safety checks than assisted living , and staff is specially trained to meet the needs and demands of residents who have difficulty with basic tasks because of dementia symptoms, from early to mid and late stages. Memory care units, therefore, offer most of the same services as assisted living, but with increased supervision and more routine, including structured activities to stimulate memory and hopefully slow the diseases progression. These activities might involve music or pet therapy, games, arts and crafts, etc.

When Should You Consider A Care Home

A move into a care home is a big step. Many people only consider it;when other care options have been exhausted or are no longer suitable. But if residential care provides greater benefits for the individual than any other available option, then its often the right choice.

Some typical situations when it might;be time to consider residential care:

• When an older person is struggling to live alone, even with the help of carers, friends or family.;
• If they have recently suffered a significant deterioration in their health or mobility, caused by an illness or a fall.
• If they need extensive support and supervision to live safely and comfortably, and this can no longer be provided at home by family and/or carers.
• When someones home is no longer a suitable environment in which to have their care needs met.
• When a;social careneeds assessment indicates that a care home is the best place for you to live, following a fall or a stay in hospital, for example.

Residential care homes provide living accommodation with 24-hour support and supervision, including help with personal care needs, meals and social activities.;Nursing homesprovide all of the above services, plus on-site medical care from a registered nurse.;

For more information on the different types of care home and the range of services they provide, see our article on the differences between a care home and a nursing home.

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The Potential Drawbacks Of A Care Home

• Cost;Care home fees can be very expensive, particularly when someone has to fund their own care. To access local authority funding, you must be assessed as needing residential care and undergo a means test.
• Choice;There might;be a limited choice of suitable homes with rooms available when you need one.
• Unfamiliar surroundings;Moving somewhere completely new can be unsettling.
• Loneliness;People might miss contact with neighbours and old friends.
• Emotional effect;Families can feel guilty that theyre not looking after their loved one themselves, even though this might;no longer be practical. And the person moving into a care home might;feel rejected. It can help if you talk things through beforehand, so that everyone understands the need for the move. Regular contact once theyve moved in will also help.
• Loss of independence;A;good care home will encourage residents to be as independent as they can be, but it might;still feel like losing your independence.;;
• Lack of privacy;It can be difficult to adjust to a communal environment.
• Small living space;You might;not be able to take all your furniture and personal possessions with you.
• Variations in care;All homes have to achieve a minimum standard to ensure they can be registered, but quality of care might;vary from home to home. Doing your research and asking around for recommendations;should help you avoid the less suitable homes.

Kind Calming Ways To Respond To I Want To Go Home

These suggestions will put you on the right track, but its a good idea to get creative and come up with responses that are tailored for your older adults history, personality, and preferences.

1. Reassure and comfort to validate their needsSometimes saying I want to go home is how your older adult tells you theyre tense, anxious, scared, or in need of extra comfort.;

Approach your older adult with a calm, soothing, and relaxed manner. If you remain calm, it often helps them calm down too.

If they like hugs, this is a good time for one. Others may prefer gentle touching or stroking on their arm or shoulder or simply having you sit with them.

Another way of giving extra comfort and reassurance is to give them a soothing blanket, therapy doll, or stuffed animal.

2. Avoid reasoning and explanationsTrying to use reason and logic isnt recommended when someone has a brain disease. It will only make them more insistent, agitated, and upset.

Dont try to explain that theyre in their own home, assisted living is now their home, or they moved in with you 3 years ago.

They wont be able to process that information and will feel like youre not listening, you dont care, or that youre stopping them from doing something thats important to them.

3. Validate, redirect, and distractBeing able to redirect and distract is an effective dementia care technique. Its a skill that improves with practice, so dont feel discouraged if the first few attempts dont work perfectly.

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Signs Its Time For Memory Care

While many seniors with;early stage;dementia can live independently or with the help of family caregivers, those with greater cognitive decline may need help from specially trained dementia care professionals in;memory care communities.;But because dementia symptoms;can vary day to day or moment to moment, its not easy to pinpoint when its time for memory care.; When talking about memory care, or some form of a different living arrangement, Ill center the talk around ability to perform activities of daily living and safety, says Dr. Philip Branshaw, an internal medicine specialist in Batavia, Illinois.

Learn;signs of Alzheimers;or another type of dementia doctors look for, and some simple tools they use to measure cognitive decline. Then, answer 13 questions about your loved one and their caregiving situation to see;if its time for a memory care facility.

Care Plans For Dementia

A care plan for someone with dementia will ultimately be made by either the care home they move into or a community care provider.

But thinking about what should be in this care plan yourself will be a very useful step when considering when should someone with dementia go into a care home. ;

To do this you will need to understand the current care needs of the person.; This includes their ability to carry out domestic activities of daily living such as cooking, cleaning, laundry, managing their diary, managing their finances etc.;

Now look at their personal activities of daily living and decide which they need help with. These include: washing, grooming, getting dressed, toileting and incontinence, feeding themselves etc.;

Next have a think about if the person has any specialist nursing needs. For instance: dressings, blood sugar monitoring, behavioural issues, uncontrolled pain, specialist feeding requirements.

Does your parent want to stay at home? Hourly home care could be an option. If you want to find out how to shortlist home care providers near you, or find out more about what home care is, then read our article!

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Escalating Care Needs For Adls

Dementia patients are very prone to falling. Their cognitive impairment makes them unable to perform any ADLs . As the term implies, it refers to the six basic human skills:

Not only ADLS but doing IADLs can be a challenge for patients with dementia. While ADLs are basic self-care tasks, IADLs are more complex skills. These activities include the use of appliances, cooking, housekeeping, money management, shopping, leisure activities, and medication management.

Having minimal mobility at home can be risky for a dementia patient, even with a caregivers help. For example, a 70-year-old man can easily hurt himself trying to get his 180-pound sick wife to the toilet two or three times every day. Caregivers get stressed, too. Dealing with dementia patients might be their forte, but doing it alone can be very taxing.

Conversely, assisted living communities are equipped with facilities intended for dementia patients, which are far better than your own home. They are primarily designed to support dementia patients and prevent them from getting into any accident 24/7. If you are putting you and your caregivers overall well-being at risk, its time to give an assisted living residency a call.

Practice Example: Mr Wang

Mr Wang is 73 and was recently admitted to his care home, because his wife and family feel they are unable to care for him at home and need some additional support. He has had Alzheimer’s disease for five years. He settled into the home fairly well and saw his family regularly through window visits due to COVID-19 visiting restrictions. Mr Wang has made friends with another Chinese gentleman in the home who is on the same unit and enjoys spending time sitting in the day room with him. One morning, his carer notices that Mr Wang is particularly tired, which isnt surprising as the night staff reported that Mr Wang was up for three hours the night before, pacing around the home. He was gathering up items of clothing and laundry which were being organised by one of the carers.

Infections can present in different ways in older people, and infections of the urine are common. Using something like This is me from the Alzheimers Society helps bring a persons history to life and can help carers understand behaviours. Confusion in people with dementia and COVID-19 can be prolonged and the symptoms can be more severe.

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Concerns About The Care That My Loved One Is Receiving In A Care Home

If you have any concerns about the care of a person in the care home or the ability of staff to meet their needs, please speak to the manager in the first instance. State what the concerns are and what you would suggest could address these. If this does not resolve the issue or you are dissatisfied with the response, ask the manager for details of their line manager so you can express your concerns to them. In cases where there are still concerns or the situation is a safety risk, indicates neglect or poor standards of care you could then raise this with the Care Quality Commission , Care Social Services Inspectorate Wales, Care Inspectorate or Regulation Quality Improvement Authority .

When Is The Right Time For A Care Home

If your loved one is living with dementia, there is a point at which a care home may be the right thing to do. However, this decision comes with an array of emotions, preferences and questions. Here at Lovett Care, we understand that and work hard to provide the best advice possible to help with such a tricky decision. From our experience, most of our residents join our homes following a noticeable deterioration in their condition. This can often happen suddenly, almost forcing your hand to look for some form of residential care. However, not all cases are like this. You may feel as though your loved one is starting to show signs of slower deterioration and be worried as to when a care home will need to be called upon. Often, if youre the one looking into making the decision, its because your loved one can no longer make this decision for themselves.

When making the decision, its important to recognise that its in the best interests of your loved one. For example, you may have been previously caring for this person, but you can no longer cope. If this is the case, there is no shame in asking for help. You dont necessarily have to fully relinquish your caregiving duties either, as a short-term break like respite care can give you the rest that you need to continue providing your loved one with the best service.

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