Care Options For People with Alzheimer’s or Other Dementias

care options for dementia

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When it comes to care options for dementia, no single option fits everyone’s needs. We have listed some different options below.

Those living with dementia or Alzheimer’s usually desire to stay in their home as long as possible. Thankfully this is possible with home care options as well as the help of caretakers. More support may be needed when the time comes, and other care options for dementia may be a better fit. 

These care options for dementia include:

  • In-home health care
  • Adult Day Centers
  • Long-term care
  • Respite Care
  • Hospice Care

5 Care Options For Dementia

#1. In-Home Health Care

There are several in-home care options for dementia. In-home health care benefits the person living with dementia so they can still live at home with their family. 

Types Of In-Home Services

There are all different types of in-home services for dementia care. Some of these services provide nonmedical help, while others involve medical care by a healthcare professional. 

Some of these types of care include:

1. Companion Services

These individuals help with supervision, recreation activities, and visiting the individual who is living with dementia. 

2. Personal Care Services

Individuals who provide personal care services help with day-to-day activities, which include bathing, getting dressed, using the bathroom, eating, exercising, and other personal care items. 

3. Homemaking Services

These individuals help with laundry, housekeeping, shopping, and preparing meals. 

4. Skilled Care

Those who help with skilled care typically help with nursing, wound care, occupational therapy, physical therapy, speech therapy, and other needs that need to be done by a licensed professional. Home health care agencies can help coordinate these services once the doctor prescribes them.

How To Find In-Home Services?

You want to find the right in-home care service provider that meshes well with your loved one who is living with dementia. Here are some resources that can be used. 

  • Talk to your healthcare provider: Starting the conversations with your loved one’s physician is a great place to find the resources you need. He may be able to give recommendations of different home health providers in your area that work with those living with dementia. 
  • Medicare Online Tool: Medicare has a great online resource to help find providers in your area that can help. 
  • Ask others: Asking those in the area is a great resource. These people will have first-hand knowledge of who have used in-home care services and be able to point you to those individuals that they recommend or tell you who to avoid. 

How To Choose An In-Home Provider?

HOW TO CHOOSE AN IN-HOME PROVIDER FOR THOSE LIVING WITH DEMENTIA?

Choosing the right in-home provider is important. For some families, using a home health care agency is the better choice, while others find a variety of care providers from different companies is the best fit. Use these tips when finding your in-home providers. 

1. Create A List Of Care Needs

You will want to create a list of needs that your loved one who is living with dementia needs help with so that you can contact the right people. Are there certain expectations you have? You will want to note these as well.

2. Call First

You will want to contact potential providers to determine what services they offer and if those fit your loved one’s needs. 

3. Conduct An In-Home Interview

Be sure to invite potential providers into your home to conduct an in-home interview. Be sure to have questions on hand to ask. These questions can include the following:

  • Are you CPR certified?
  • Do you have experience helping patients living with dementia? 
  • Do you have dementia training?
  • Are you with an agency? 
  • Are you bonded and insured?
  • May I have a list of references?
  • Are you available when it is convenient for our schedule?
  • Do you have coworkers that fill in for you if you are sick or out of town?
  • Is this a case that you feel confident taking?
4. References

Once you complete the in-home interview and receive references, call them and ask questions as well. See if they still seem like a great fit.

5. Share Information

Once you decide to hire a caretaker, you would want to give them as much information as possible about your loved one. So, share memories, history of special events, etc. This will help them bond quicker with one another.

Costs Of In-Home Care

The cost of in-home care for those living with dementia will vary based on insurance, the services being given, and where you live. 

Medicare will cover some in-home health care services if they meet certain eligibility requirements. 

Providers can come to the home for just a couple of hours or several hours at a time, depending on the needs of your loved one living with dementia. 

Home Helpers And Companions 

There are several in-home dementia care options to provide help. A home helper and companion is one of these individuals who help give your loved one more assistance. These individuals can help with house cleaning, laundry, grocery shopping, and even visiting with your loved ones to keep them entertained. These individuals do not help or assist with medical care. 

Meal Delivery Service

Mel services are available if remembering to eat becomes challenging. Meals on Wheels is a great community program that delivers ready-to-eat meals to the doors of individuals who need them to help maintain an adequate level of nutrition and hydration. 

#2. Adult Day Centers

Adult day centers are a great option to get your loved one living with dementia in social situations, mingling and participating in activities that are safe for them. 

Benefits Of Adult Day Centers

BENEFITS OF ADULT DAY CENTERS FOR THOSE LIVING WITH DEMENTIA

There are many benefits to adult day centers for those living with dementia and the family caretakers. These benefits include:

  • Adult daycare centers can give caretakers a much-needed break. You can catch up on tasks, run errands, and have some self care time. There are some that require direct supervision of a caretaker, so check with your local day center to ask about the requirements.
  • If you work during the day, adult care centers are available to help with your loved one. Typically they are open for 7 to 10 hours a day, and some are even open on weekends. Transportation can be provided as well as meals to help. 
  • Adult centers provide time for your loved one living with dementia to socialize and be involved in various safe activities. While some may fight going at first, most of the time after they go, they look forward to the activities and meeting up with their friends. 

What Services Are Offered At Adult Day Centers?

The services that are offered vary from center to center. Some of the services may include:

  • Counseling
  • Health services
  • Nutrition and meals
  • Help with Personal Care
  • Activities such as music, art, recreation, and support groups. 
  • Behavior management
  • Therapy

How To Select An Adult Day Center?

1. Learn About Your Options

You will first want to learn about the available options in your area. 

2. Consider The Needs

Adult Day centers vary from one to another. Find a center that works with your time, offers the services you need, and can help you most with your loved one. 

3. Ask Questions

It is important to ask questions of the staff at the adult day center. These are some questions you may want to include:

  • Is the staff trained in dementia?
  • What are your hours, fees, and the services that you provide?
  • What programs are available for those who are living with dementia?
  • Will the needs of my loved one be evaluated?
  • How do you ensure guests do not wander?
  • Are their healthcare providers on staff?
  • What happens if there is an emergency?
  • Is transportation available?
  • Is there a contract I have to sign for a certain length of time?
4. Trial run

When it comes to picking an adult day center, give it a try and have your loved one attend at least two times a week for a month. After this, you can decide if the center is meeting all the needs of your loved one. 

5. Continue To Re-Evaluate

Just because the adult day center is a great option now does not mean that it always will, as the needs of your loved one living with dementia will change over time. Continue to evaluate if the center is still a good fit. 

Costs Of Adult Day Centers

Many centers offer services on a sliding scale based on the family’s income. In some cases, Medicaid may help cover some costs. Be sure you know all the fees upfront and check if financial assistance is available. 

#3. Long-Term Care

VARIOUS LONG-TERM CARE OPTION FOR THOSE LIVING WITH DEMENTIA

If your loved one needs more care than you are able to provide while they are living at home, a long-term care facility is another option available. There are different long-term care options for you to consider. 

1. Retirement Housing

If your loved one has mild cognitive impairment, then retirement housing might be a great option. In these homes, you are able to still live independently. These housing types typically have limited supervision, social activities, and transportation to amenities like the grocery store. 

2. Assisted Living

Assisted living is the gap between living on your own and living in a nursing home. Typically, these facilities offer meals, housing, support service, and on-sight healthcare when needed. While assisted living is great for those who are aging, you will want to confirm with the individual facility that they have experience working with those who are living with dementia. 

3. Nursing Homes

Nursing homes are also sometimes referred to as skilled nursing facilities. These establishments offer around-the-clock care and are a long-term solution for your loved one. Most nursing homes have services that help provide nutritious meals, care planning, recreation, medical, and spiritual activities. 

4. Memory Care Units

Memory Care units are also known as Alzheimer’s Special Care Units. These are facilities that are specially designed for Alzheimer’s and dementia patients. 

How To Choose A Long-Term Care Center?

HOW TO CHOOSE A LONG-TERM CARE CENTER FOR THOSE LIVING WITH DEMENTIA?

When it comes to choosing a long-term center, you will want to look at several options. These tips can help you make the right decision. 

  • Make an appointment: Make an appointment to visit your long-term care facility that you like. Visit at different times of the day, including mealtime. Be sure to make at least 1-2 unannounced visits and see how the staff and residents interact. 
  • See Inspection Report: It is important to view the center’s inspection report. They are required to show you if you ask to see it. 
  • Find out if they have rooms available or the average wait time on the waiting list. 
  • Ask about the cost
  • If you are paying out of pocket, find out what the policy is with the person living with dementia running out of money. 
  • Ask questions: These are some that we recommend. 
    • How involved are the families in decisions of care planning?
    • How are families informed about the care and needs of the individual living with dementia as conditions change?
    • How does staff communicate with family?
    • Do you provide medical care?
    • How often are doctors and nurses on-site?
    • Are you trained with dementia care?
    • On average, how long have staff members worked at this facility?
    • What is the staff to resident ratio?
    • What services are available?
    • Are there planned outings?
    • Is transportation provided to appointments and the store?
    • What therapists come on-site to work with residents?
    • What are the visiting hours?

Things To Think About While Visiting

When visiting the long-term care facility, you will want to take note of the following. 

  • Are the residents clean and dressed appropriately?
  • Do residents appear happy interacting with staff members?
  • Does the facility have any unusual odors or smells?
  • Does the facility promote independence while keeping the residents safe?
  • Are the rooms clean and spacious?
  • Can residents bring back their belongings?
  • Are there regular meals and snacks provided?
  • Can family members come to eat with residents?

Costs Of Long-Term Care

The cost of long-term care varies based on the type of facility. The family usually pays these costs. Some of the costs may be covered by Veterans benefits and Medicaid. Medicare does not cover these costs. 

#4. Respite Care

Respite care gives you a much-needed break as a caretaker. Respite helps continue to provide a safe environment for your loved one living with dementia. 

What Respite Does?

Benefits of Caretaker

These are some of the benefits of respite for the caretaker. 

  • Respite gives the caretaker the ability to relax or spend a little time with friends and family without the caretaker’s responsibilities weighing on them. 
  • It gives the caretaker time to shop, get haircuts, exercise, or attend their own medical appointments. 
  • Provides peace of mind knowing that the person with dementia is being taken care of while you take care of other responsibilities. 

Benefits of individual living with dementia

  • Interact with others.
  • Spend time in a safe, supportive environment. 

Types Of Respite Care

Respite care can be a variety of different options. It can be provided by friends or family and paid or volunteer service. It can even include adult daycare or long-term care facilities. 

In-Home Care Services

VARIOUS IN-HOME DEMENTIA CARE SERVICES

In-home respite care typically  includes the following:

  • Companion services to help with supervised activities. 
  • Personal care or home health aides to come help with bathing, using the bathroom, getting dressed, and exercising. 
  • This could include help with housework which includes but is not limited to meal prep, laundry, shopping, and light cleaning. 
  • Skilled care service to help with in-home medical needs and medication. 

Concerns About Respite

It is natural to have concerns when starting out. Some concerns may include:

  • Cost: You may be worried about the cost of respite and how you will afford it. Some programs provide financial assistance and scholarships if you qualify. There are also sliding scale fees available at some locations. 
  • Reliability: You may worry if your respite work is reliable. Before hiring, ask about their level of training and qualifications. Are they trained? Are they certified? 
  • Guilt: Most family members who use respite for a loved one living with dementia feel quite a bit of guilt at first. This is common, but it is important to remember that respite service benefits both the caretaker and the individual living with dementia. 

#5. Hospice Care

Hospice care is a great benefit to the individual living with dementia and the family during the final stages of dementia. Hospice is used toward the end of your loved one’s life who is living with dementia. They focus on the comfort of your loved one. Hospice care is a great benefit to the individual living with dementia and the family during the final stages of dementia. 

The purpose of hospice is to manage pain and symptoms during the last six months of life where the treatment plan turns towards comfort rather than trying to cure the disease your loved one is living with. 

Hospice is made up of an entire team that is specially trained to help during this time of your loved one’s life. It includes doctors, nurses, home health aides, social workers, counselors, clergy, and other volunteers. It is common for the family to play a very active role on the hospice team as well. 

The hospice team may provide the following:

  • Medications to alleviate symptoms and pain. 
  • Medical equipment to relieve symptoms and pain. 
  • Counseling about the end of life. 
  • Respite care to provide relief to the caregivers. 
  • Grief support for the family. 

When Does Hospice Begin?

Hospice begins when you are given a life expectancy of six months or less. A referral is given to you by your doctor. 

Before services begin, the hospice team will meet with the family and referring healthcare provider to discuss a care plan. Once hospice care begins, you will typically have 24-hour on-call access to the hospice staff. 

How Long Can You Receive Hospice Services?

Hospice is available for as long as needed. If you need hospice care beyond six months, it is typically still covered by your insurance as long as a healthcare provider recertifies that your loved one is terminally ill and still meets the hospice requirements. 

Costs

Typically hospice is covered by Medicare, Medicaid, and private insurance. Medicare has no deductibles and limited coinsurance payments for hospice services. 

Medicare covers hospice care if:

  • The individual receiving care has Medicare Part A
  • The healthcare provider and hospice director certify that they are terminally ill with a life expectancy of fewer than six months. 
  • The individual receiving care elects to receive hospice care and waives the right for Medicare to pay for other services that can treat the terminal illness. 

You may want to ask potential hospice providers the following questions. 

  • Is there a 24-7 call line to the provider?
  • Has the hospice team provided care to other patients with dementia?
  • How long have you been providing hospice care?
  • Are there any services you specialize in to help with hospice patient comfort levels?
  • Is this program Medicare-certified?
  • Do you take insurance?

Resources

https://www.alz.org/help-support/caregiving/care-options/in-home-care

​​https://www.alz.org/help-support/caregiving/care-options/adult-day-centers

https://www.alz.org/help-support/caregiving/care-options/long-term-care

https://www.alz.org/help-support/caregiving/care-options/respite-care

https://www.alz.org/help-support/caregiving/care-options

https://www.alz.org/help-support/caregiving/care-options/hospice-care

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