Alzheimer’s Disease: Choosing the Right Type of Care

One night, you’re out with your spouse, enjoying dinner and a movie.  Your children are safely with your babysitter, and everything seems to be fine.

The cell phone rings.  On the other end, a man in a gruff voice explains that he is a police officer, and he found your father wandering around the neighborhood, unaware of how he got there.  You need to come immediately.

You knew your father has Alzheimer’s, but you realize he can no longer be left alone.

Sadly, this is what several million families have gone through or will go through in the next few years.  When this happens, they have to decide on the right level and type of care for their loved ones.

This can be a challenging and heart-wrenching process.

There are three main types of care that you can choose for your loved one:

• In-home care
• Assisted living
• Skilled nursing

The most important asset at your disposal is information.

In-home Care     

In-home care, also known as home care or custodial care, allows the individual to remain living in his or her own home.  A caregiver can be hired for any number of hours per day or for round-the-clock care, depending on the needs of the client.

The obvious benefit of this type of care is the ability to remain in one’s own home.  However, it is harder for the individual to receive the proper social stimulation, and there is always the risk that the caregiver, largely unsupervised, will not be the right fit, or worse, may pose a danger to the client.

In addition, in-home care is very expensive, often costing as much as $10,000 to $15,000 per month.

Assisted Living

Assisted living is the type of arrangement known to most people.  You may often see very elegant, multi-story buildings on major streets that cater to the needs of the senior population.

For many, assisted living provides the right option.  These facilities are well-maintained, and they provide an intermediate level of care in which residents are largely independent, but are supervised for safety, and have certain services performed for them, such as meal preparation, housekeeping, etc.

In addition, assisted living facilities generally provide a high level of stimulation in the form of a robust activities program, especially important to those suffering from dementia.

However, the main drawback of assisted living is that such facilities often have a rather low staff-to-resident ratio, meaning they do not have enough staff to fully care for each resident.  This can be especially true even in special units designed for residents with dementia.

As such, residents do not always have a caregiver to help them with each of their activities of daily living, or ADL’s, and often do not have anyone to remind them of the activities taking place or to take them to those activities.

Board and Care

In the Western part of the United States, especially California, a phenomenon exists that is not really present on the East Coast.  This phenomenon is known as board and care.  A board and care is a small assisted living facility in an actual single-family home.

Residents living in board and care homes enjoy a high level of care (higher staff ratios), and a more intimate, family-style setting.

These facilities are designed for residents, such as those with dementia, that need a higher level of care, and whose conditions are generally more progressed than individuals in a typical assisted living facility.

Skilled Nursing

Skilled nursing facilities, often called nursing homes or convalescent homes, are only for patients whose conditions are so progressed that they require round-the-clock medical care.

Sadly, many families often place their loved ones in skilled nursing facilities, unaware of the other options that exist.  Elderly individuals are then forced to spend their last days in a miniature hospital, sharing a room with one or two other patients, in a cold, depressing atmosphere.

Often, patients in nursing homes can be cared for in a more intimate assisted living environment, but their families are unaware of these options.

Nursing homes should be reserved only for patients that cannot, under any circumstances, be cared for in an assisted living or board and care environment.

Making the Choice

Obviously, there many issues involved with making the right decision regarding care for a loved one.  For more information, visit the Alzheimer’s Association’s Caregiver Center at:

http://www.alz.org/care/overview.asp