Q After years of caring for my mother who has Alzheimer’s disease and watching her decline, we are thinking of moving her to an assisted-living facility. Are there some guidelines that will make this move smooth? I am not even sure that we selected the right facility. Many thanks.
A Dear B.E.:
This is one of the most difficult decisions one has to make. It can be a challenge to know the right time for such a move and the type of housing that meets the needs of the individual. Let’s begin with different types of residences.
• Senior housing: This usually is appropriate for someone with early stages of Alzheimer’s disease and can live relatively independent. These individuals are able to care for themselves and are safe living alone. Social activities, transportation and other services are provided. Supervision is limited.
• Assisted living: This type of housing also is called board and care, adult living and supported care. Assisted living is between living independently and living in a nursing home. This residence provides a 24-hour staff, recreational activities, housekeeping, laundry and transportation. Depending on the requests from the resident, the facility also provides help with bathing, dressing, eating and reminders to take medication. The federal government does not regulate them; the state does and it varies by state. Since not all offer services specifically designed for those with dementia, it is important to ask.
• Nursing homes: Also known as a skilled-nursing facility, long-term care facility and custodial care facility. These facilities provide 24-hour care and medical treatment. Services related to nutrition, care planning, recreation, spirituality and medical care. Nursing homes are licensed by the state and regulated by the federal government.
• Alzheimer’s special care units: Also called memory care units, they are designed to meet the needs of those with Alzheimer’s disease and other dementias. They often are a unit within various types of residential care.
• Continuing care retirement communities: Such facilities offer different levels of care consisting of independent living, assisted living and nursing-home care. A resident can move from one level to another. Such facilities typically require an entrance fee with monthly payments or, in some cases, only monthly fees.
The move from home to assisted living usually is stressful for the person with Alzheimer’s disease. To make the transition as smooth as possible, the Mayo Clinic provides several suggestions.
• Plan well ahead: If your loved one can still make reasonable choices, discuss preferences about living arrangements. Visit the facility frequently before the move. Discuss with a staff member your loved one’s background, special needs and medical and mental health history. Include a detailed medication list.
• Make the room familiar: Create a living space that is familiar; decorate it with treasured items such as a favorite chair, afghan and anything that has meaning. Familiar belongings give the individual a sense of security and connection. Include pictures, photo albums and remember to label the pictures with names.
• Moving day: Follow your loved one’s normal routine. Make the move during the best time of day, which might be morning or afternoon. Remain positive and reassuring. To lessen the difficult moment of separation a staff member might immediately engage your loved one in an activity as a distraction.
• Stay in touch: It may take time to adjust to the new living arrangement. Deb Newquist, an elder care specialist in Irvine, suggests that family members stay away for a short period of time so the individual can adjust to the new environment. She suggests that little white lies are acceptable such as “You need to be here for a time while our house is getting renovated.” Then visit often and encourage friends to do the same. Note: Having feelings of guilt, grief and loss combined with a sense of relief is normal.
For resources, advice — such as the right time for a move — and support groups contact the Alzheimer’s Association at www.alzgla.org or call 844-435-7259. Consider consulting with an elder-care specialist, also known as a geriatric care manager, for issues that might arise or decisions that have to be made.
Newquist commented, “We help navigate elder care problems.”
To find one in your area, Google “geriatric care manager.”
Thank you, B.E., for your good question. Best wishes for smooth sailing for your mother, you and your family. And make sure to take care of yourself.