Alzheimer’s and Assisted Living: Four Considerations

For several years I worked with a family and their aging parents. Along  the way family members came to discover their mother had dementia. As the children became aware of her dementia (possibly Alzheimer’s), many conversations ensued about the “what ifs.” “What if she lives longer than Dad does – what will we do?” “If it is Alzheimer’s – what steps will we take for her care?” “What will we do when Dad can no longer manage as her “caregiver?” “How will we know when it is time to move her to assisted living?”

When assisted living is the direction a caregiver or family is considering, it is important to understand the options. There are medium to large assisted living facilities that come with many benefits – activities, socialization, three meals a day, housekeeping and laundry services, medication management if needed, transportation for doctor appointments, church, outings, and grocery and drug stores. There are also smaller assisted living facilities that include private homes with 6 – 8 residents. Quieter and located within residential neighborhoods, these facilities may be the way to go for some.   Smaller assisted living homes are especially appropriate when a resident has no interest or need for the extra services of a larger facility.

How Will We Know it is Time?

As it happens, the answer to this question has many factors. Any one of the factors, or a combination of them, can put the process of moving to assisted living in motion. The factors can fall into one of four categories—safety, general health and well-being, behavior, and caregiver burden. Let’s take a look at them.

Factors to Help You Decide

• Safety: Of all considerations, safety is first. Your loved one must be safe in his or her environment. Have they wandered? If it has happened once, it is likely to happen again. Are they a fall risk? A fall can change everything, and frequently precipitates a move to assisted living. Are there stairs in the home that are becoming too difficult or unsafe? Would it be safer for them with one-level living, staff to monitor their whereabouts, and activities to keep them occupied?
• General Health and Well-Being: How is their physical health? Do they have other health issues or a chronic illness? Are they able to get daily exercise? Have you noticed a weight change? What is their ability to manage their own activities of daily living (ADLs)? ADLs include eating, bathing, dressing, toileting, transferring (walking) and continence. Are they socially engaged, or are they becoming more socially isolated? Do they see friends or family on regular basis? Have they given up driving, or should they?
• Behavior: Are they experiencing more forgetfulness, confusion, episodes of aggression, sundowning, or combativeness? Is their behavior becoming difficult to manage?
• Caregiver Burden: If you are the caregiver, are you able to get rest? Is the person with Alzheimer’s keeping you up at night? Are you able to get respite from caregiving? Is the rest of your family feeling ignored? What support system do you have? What about resources? Are you continuing to work? Is there adequate income? Is caregiving just too much? Would moving your loved one to assisted living give you time needed for family or work?

When the Decision is Yours to Make

If this decision is yours alone to make, are you ready to move your loved one to an assisted living facility?

If you are finding it difficult to make this decision, many resources are available. Tour some facilities and talk to the staff. Reach out to your local Area Agency on Aging or Adult and Aging Services. An Aging Life Care Specialist is also available to discuss this option, as well as others. Finally, other caregivers are traveling the same journey and understand. Find them through any of the resources above.