This article is added
with the permissions of India Ledward, Outreach Specialist at Caring.com
While there are no definitive guidelines for when
to move a loved one to dementia care, you can be on the lookout for signs that
it may be time for memory care or assisted living.
“Part of the problem is that people set arbitrary
guideposts. They’ll say that they will move their parent or spouse if he or she
forgets their name, or forgets how to toilet, but it’s possible that your loved
one won’t experience those changes,” says Michelle Toft, MSW, M.Ed, director of
Memory Care Programs with Cypress Home
Care Solutions in Phoenix, Arizona.
Meanwhile, you and your loved ones might be hanging
in there to try to help care for someone with dementia at home when they – and
you! – could benefit from moving them to dementia care.
Be on the lookout for any of these signs that it
may be time to move to a memory care facility:
“The main reason to move out of a home to assisted
living is when there are not enough resources to safely care for the person
with dementia at home,” explains neurologist Douglas Scharre, MD, director of
the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center.
The experts we consulted recommended taking a look
at these safety issues to assess your loved one’s situation:
·
Is your loved one
missing medication doses, or taking too much medication?
·
Are they eating
regularly? Or do they seem to be losing/gaining unusual amounts of weight?
·
Can they store and
prepare food safely?
·
Is your loved one
physically aggressive to you or others?
·
Has your loved one
fallen recently? More than once?
·
Is your loved one
wandering and/or forgetting where they are when out of the home?
·
Is your loved one
leaving burners on if they try to cook?
·
Is your loved one
driving even if they have been told not to?
·
Has your loved one
been victimized by a financial scam, or are they vulnerable to that?
·
Do you suspect that
your loved one is in some way being physically harmed by a caregiver?
“Burned out” is an umbrella term that encompasses a
lot of difficult situations for care partners. Some become physically exhausted
because of their loved one’s needs, and because their own health suffers.
Others become emotionally worn out, socially isolated, or feel that they are
losing themselves.
Guilt also contributes to burnout, says Toft. If
you’re locked in a cycle of feeling stressed out, angry, or poorly equipped to
care for your loved one, and then feeling guilty for having those thoughts,
it’s time to look for dementia care. “Guilt is what we should feel if we’ve
done something wrong,” says Toft. “Feeling angry that your loved one has
dementia or wishing you could go out with friends is not something to feel
guilty about.”
“When your loved one is constantly following you
around, asking what you are going to do, they need more stimulation,” says
Toft. She points out that memory care communities have activities specifically
planned for people with dementia, and also allow people to be with others who
are in a similar situation.
“It’s about having meaning and purpose in their
day,” she says. Don’t feel badly if you aren’t meeting this need any longer.
“Caregivers can be so burdened that the person with dementia at home is getting
no stimulation and their decline is faster,” says Dr. Scharre.
Knowing that you have to start looking for dementia
care is only the first step in a lengthy process. To help you locate memory
care facilities near you, Caring.com provides a comprehensive
directory of memory care communities nation-wide. There you can find
details about the care that different communities provide as well as thousands
of consumer reviews.
We’ve outlined some additional steps you can take
to aid your research:
Your local Alzheimer’s Association can provide
information about resources – and perhaps more importantly, emotional and
social support for you as you go through this process.
Toft recommends researching communities in your
area as soon as possible, so you do not have to make a decision in an emergency
situation. Know that if you choose an assisted living community without memory
care, you might be facing increased costs or a move to another community later
on.
“Make sure you evaluate the facility's activities
program as that will provide important brain stimulation to the patient for
better quality of life,” says Scharre.
There are a number of professionals who specialize
in helping care partners research assisted living options. Toft points out that
the advantage to hiring someone to help you and your family find a good match
can make difficult conversations easier, since they can facilitate discussions
around the move. Start your search for assistance with the Aging Life Care Association.
Ideally your loved one and family will tackle the
legal and financial planning issues soon after diagnosis, says Pasquale
Fonzetti, M.D., Ph.D., director of Memory Evaluation and Treatment Service
(METS), Staff Neurologist at Burke
Rehabilitation Hospital in White Plains, New York. He advises that a
person with dementia can and should be involved in outlining their wishes for
care as dementia progresses.
This process should provide care partners with
powers of attorney and health directives that can help when it is time to make
a move. If you do not have these, and your loved one is resisting a necessary
move, you have two choices: (1) invest in a web of paid and volunteer care at home
as well as day programs
or (2) hire a lawyer to facilitate the legal paperwork needed to give you the
power to make decisions for them.
“There are certain things that happen with the
disease no matter where your loved one is living,” explains Joshua Grill, PhD,
an NIH-funded Dementia & Alzheimer’s disease researcher who is also the
Co-Director of the Memory
Impairments and Neurological Disorders (MIND) Institute at University
of California, Irvine. Understanding how dementia affects your loved one will
help you know how to handle situations you are in together. See Caring.com's
articles on navigating
dementia & Alzheimer's issues.
If your loved one is undecided about moving to an
assisted living community, invite them to make a few visits for lunch or to
attend other events with you at the one or two places you’re looking at. Making
these activities fun and social can increase warm familiarity with the
communities.
Jytte Lokvig, author of Alzheimer's A to
Z: A Quick-Reference Guide, has this suggestion, "Ask the staff
to pair you with one or two other residents who are outgoing and social. Don't
mention to your loved one that you're planning for her to live there. Instead
introduce her to your table mates with something complimentary about her. An
example: 'This is my mother, Sarah. She is a wonderful cook.' After a few more
visits, you can suggest that she might want to spend more time with her new
friends. You can give her the 'good news' that they have a really nice room
where she can stay for a few days."
People with dementia who do not want to move
permanently can sometimes make the transition more easily if you tell them the
move is temporary and for a practical purpose. For example, says Diane Kibbin,
director of assisted living at OceanView, “You might say that they need to be out of the
house while it is painted, or that they have to go somewhere where some aspect
of their health can be properly taken care of for a while.”
Typically, she explains, families will make all the
arrangements, select and decorate the new room or apartment in the memory care
facility, and work with the staff so that everyone knows what excuse has been
given for the move. Once your loved one is engaged in their new community, they
often accept the permanent situation, she says.
Lokvig adds, "Keep your tone joyful, as hard
as that sounds and bury whatever guilt feelings you may have. It may be hard
for you to use 'loving lies,' but keep in mind that telling your loved one the
truth would be unnecessarily hurtful."
Once your loved one has moved in, Lovig suggests
making your first visit short and sweet. "Keep the conversation really
positive. She'll likely ask you repeatedly when she's going home. Avoid telling
her that she's now living there, rather divert her by talking about her new
friends, activities, and food." Stay in touch with the staff. If the staff
reports that she's agitated after your visit, you might want to give your loved
one more time to adjust before resuming regular visits.
Ultimately, says Fonzetti, the decision about
moving to dementia care should be a team decision. “The only guideline is to
make the decision with your team, which includes the person with dementia, your
family, and their doctors,” he says.
No comments:
Post a Comment