Believe me when I say everyone has a hard time addressing the topic of future long-term care plans with an aging loved one recently diagnosed with Alzheimer’s, or any other stages of dementia or types of dementia.
Ever since you can remember, your parents have taken on the responsibility of raising you and taking care of your basic needs. However, as the aging process takes its toll, the roles are reversed and children end up being caregivers of our elderly parents. While this can be a difficult transition and create stress for both you and your parent, it is especially challenging when the senior has been diagnosed with Alzheimer’s disease or dementia.
Before we talk about care options, it may be helpful to understand some of the signs and symptoms associated with Alzheimer disease and dementia to determine if a long-term care facility is the best route to take. All older adults are prone to a reduction in cognitive functioning, mental impairment, some type of age-related memory loss, memory lapses, forgetfulness, depression, and lack of alertness. While these may seem like dementia-like symptoms and they can be early signs of Alzheimer’s dementia, there are other risk factors associated with brain function and cognitive decline that go above and beyond the normal aging process. Dementia is a more severe case of memory impairment and a significant decline in cognitive function that inhibits people from living a normal life and completing daily tasks. Dementia includes Alzheimer disease, the most common form of dementia, and other neurodegenerative diseases. Alzheimer’s targets the brain and nerve cells as it progresses. Your loved one may be more at risk of dementia or developing Alzheimer’s just based on their genes or if they have an excess of beta-amyloid protein deposits in the brain. This abnormal protein, found in brain tissue, create plaques that don’t allow brain cells to communicate the way they are supposed to which contributes to major cognitive impairment.
In the early stages of Alzheimer’s, a person may experience mild cognitive impairment, short-term memory loss, confusion memory loss, and a noticeable difference in thinking skills. In a more moderate stage, there are both short-term memory and long-term memory problems, physical problems, personality changes, and an overall change in health and well-being. As the disease progresses from moderate to severe, a person will need constant care and treatment as they experience a significant decline in cognitive function and lose control over their body. If you notice any of these warning signs in your loved one, seeking medical attention early can help delay the progression of the disease.
Once a diagnosis of dementia or Alzheimer’s disease is made, there’s an immediate rush to take action and determine the right long-term care plan for your aging loved one, especially if they have progressive dementia and require treatment. The sooner the better, before the grasp of dementia takes away their ability to properly reason and affect other aspects of brain health.
In this article, we will cover the top Alzheimer’s care options for seniors and which one would be the best fit for your aging loved one.
Alzheimer’s Care Options & Long-Term Planning
When a loved one is diagnosed with Alzheimer’s disease or any other form of dementia, ensuring their safety and helping them settle back into daily life should be the first step you take. However, once that’s done, holding a family meeting to discuss future long-term care options will need to take place. The main focus of this meeting is to have the family come together and cover what memory care options are available in the area, how you’ll be paying for this care, understanding the different levels of dementia care and how the needs of your loved 
one will change as the disease progresses over time.
Of course, every situation is unique and there will be a different set of factors that need to be considered, depending on your individual circumstances. It’s common for families to choose home care for their loved ones, particularly when choosing a place for them to reside immediately after receiving a diagnosis. In the early stages of the disease when signs of Alzheimer’s disease are just beginning to show up, home care can be a great option so a person with dementia can remain in familiar surroundings and enjoy as much independence as possible. That said, as the disease progresses, residential care in a memory care facility or long-term care facility may be necessary in order to provide your loved one with the level of care and support they will require once they reach the mid-stage to late-stage point dementia.
There’s a wide spectrum of services offered to seniors with Alzheimer’s or seniors living with a type of dementia, including memory care facilities and in-home care options. When making a long-term care plan, make sure to carefully evaluate each and every option, as it will affect your aging loved one’s mental health and overall quality of life. Among the many factors you’ll need to consider, keep their safety in mind – particularly if their Alzheimer’s has caused them to exhibit aggressive behavior or an increased tendency to wander.
In-Home Care / Home Health Services
In-home care services allow a person with Alzheimer’s or other dementia symptoms to stay living in his or her own home, by receiving care “in place”.
Not all in-home care services are created equal. For example, some in-home care services provide non-medical care, while others may offer some level of medical assistance. Often, when in-home services involve medical care given by a licensed health professional (such as licensed nurses or physical therapists), the services will be referred to as “home health services”.
Companionship services, physical activity services, personal care, and hygiene services, homemaking services, and skilled nursing care are among the most common in-home care services provided to seniors in the U.S.
Adult Day Care Centers
Adult day care centers provide family members and caregivers an opportunity for respite, whether they need a self-care day or if they have other obligations to fulfill for a day. However, when it comes to seniors with Alzheimer’s disease or another form of dementia, caregivers tend to get nervous about their aging loved ones’ safety and ability to attend an adult care center. That said, it’s important to realize that there are adult day care centers that specialize in providing daycare services for seniors with cognitive impairment and dementia and Alzheimer’s disease.
Both senior attendees with symptoms of dementia and their family members and/or caregivers benefit from the safe and enriching environment adult day care centers provide. Seniors will have the chance to engage in stimulating activities, such as arts and crafts, movie viewings, board and card games, music therapy, reminiscence discussions, exercise programs, cooking or baking, volunteer projects and more. As if that weren’t enough, the social opportunities made available through these facilities encourage seniors with dementia to be more outgoing and boosts self-worth and awareness.
Respite Care Services
Often referred to as companion care, respite care allows for family members and/or caregivers to have a day off, should they need a break or have other obligations. Additionally, it offers the person with Alzheimer’s disease the appropriate level of care and supervision, as well as the opportunity for meaningful social interaction. Respite care can be provided by family members or friends whom you trust to watch after and keep company with your loved one, or you can use respite services from your local community organization. Simply contact them and set up a day and time, as well as the level of care your senior will need, and they will be able to provide you with details in regards to price and activities they offer, etc.
Geriatric Care
Geriatric care managers usually consist of trained medical professionals, like a nurse or social worker with the proper background and training. They can offer services and support in-home care and care planning for seniors both with or without Alzheimer’s disease and other forms of dementia. A geriatric care manager may:
- Evaluate the in-home care needs of a patient
- Recommend services, or coordinate care services for a patient
- Assist in helping families with short- and long-term care planning
- Offer support and help address difficult topics related to care and care planning
It’s worth mentioning, there are some local government agencies, as well as community charities, who offer geriatric care consulting services for free, or for a sliding-scale fee. Contact your local community center for more details.
Assisted Living Facilities
Assisted living facilities (also called adult living, supported care, or board and care), are built to reflect a residential living community program that provides various levels of care and services to those who can live with some 
degree of independence but may require a bit of additional support to complete certain tasks. Services at an assisted living facility may include:
- A single room, or an individual apartment/suite or a shared living quarters
- Meal preparation or meals provided
- Housekeeping services
- Medication management
- Both recreational exercise and social programs
Assisted living is a good option for patients in the early stage of Alzheimer’s disease or any other form of dementia that are experiencing memory loss. Patients will have access to staff members and at least one on-site registered nurse 24-7. A major benefit of assisted living is its ability to provide seniors with plenty of opportunities to socialize and share experiences with one another – something many seniors would benefit from, but do not have access to.
Specialized Memory Care
If your aging senior needs more support, care or supervision than what’s being provided through an assisted living facility, he or she may benefit from “memory care” assisted living. These facilities are similar to assisted living but primarily focus on the care and support of Alzheimer’s and dementia patients. You can expect to find the following at specialized dementia care facilities:
- Specially trained staff who have a better understanding of memory care, including Alzheimer’s disease and other forms of dementia
- Plenty of engaging activities that stimulate both the mind and body, based on each individual’s preferences and strengths
- Visual cues, signs and/or pictures on the walls to support independence of the residents
- Added safety measures such as enhanced locks and/or secured exits
Nursing Homes
As most people know, nursing homes are for the elderly and they provide around-the-clock care, supervision, and medical assistance – nursing homes are the highest level of long-term care. Each member of the staff in a nursing home has a varied level of medical training, but most are certified to assist with administering medications, injections, IVs, wound care and other medical tasks that are typically unavailable in other senior living facilities, such as independent living.
Dementia patients are generally transitioned into a nursing home environment once they’ve reached late-stage Alzheimer’s unless they have another serious medical issue that would cause them to have to make that transition sooner. Many patients are incontinent, a fall risk, and may not be able to walk safely, if at all, during the late stages of Alzheimer’s disease. The ability to communicate, feed themselves, and perform other activities of daily living (ADLs) may become virtually impossible at this stage. Nursing homes are equipped to handle these high-levels of intensive care and supervision.
Continuing Care Retirement Communities
Also known as CCRC’s, continuing care retirement communities are a “one-stop shop” for progressing levels of care throughout the retirement years. What’s unique about continuing care communities, is that they provide different levels of care over extended periods of time to all of their residents. For example, as Alzheimer’s progresses, the level of care required will increase. At continuing care retirement communities, care levels increase so that residents don’t need to move around to more hands-on facilities as their disease progresses. They’re able to stay in the same community, but receive a higher level of supervision and support there. 
Continuing care communities are an excellent choice for seniors who feel isolated – these communities allow aging adults to be in more social situations with people of a similar age. As Alzheimer’s disease progresses, the level of medical needs change. With continuing care, nursing services increase proportionally in response to these changes. We’ve gathered a list of services commonly offered through continuing care retirement communities across the U.S.:
- Safe and secure private apartments/suites, open common area amenities
- Meals cooked and provided for all residents
- Dressing, bathing, and hygiene services
- Transportation services
- Lawn care and gardening
- Garbage and snow removal
- Repairs within each apartment are covered
- Housekeeping and laundry services
- Engaging social activities and outings
- Medical health monitoring services, medication administration, and management
- 24/7 emergency call monitoring
Hospice Care
Once your loved one reaches the late stages of Alzheimer’s disease, you may be able to consider the possibility of hospice care. Hospice care is an aging care approach that focuses on both comfort and dignity at the end of life. It involves support and care services aimed to greatly benefit people who are in the final stages of Alzheimer’s and other dementias, as well as providing peace of mind to their families.
Hospice offers a unique approach in the way of caring for terminally ill individuals. The primary purpose of hospice care is to manage pain levels and alleviate other symptoms during the last six months of a person’s life, where the focus shifts from trying to cure an underlying disease to offering comfort during one’s last days.
Hospice care is provided by a team of specialized medical providers, including nurses, doctors, home health aids, social workers, counselors, volunteers, and even clergy. Hospice allows family members to be involved in providing care for their elderly loved ones, as well. This care is generally provided at home when possible, or at a nursing facility. In some parts of the country, hospice care may be provided in a hospital.
It’s worth mentioning that hospice care and services are usually covered under Medicare, as well as many Medicaid and private insurance plans. Medicare is especially useful, as they require no deductible and only limited coinsurance payments for hospice care services. In cases where a senior does not have the means to cover the cost of hospice, community donations make receiving services possible for them.
Choosing a Type of Care
Check out the National Association of Area Agencies on Aging in order to locate the local resources in your area. When you’re determining which type of care would best suit your family member, consider both their current and future needs, such as the following:
- Dietary needs and/or restrictions and meal preparation
- Assistance with dressing and personal hygiene
- Medication management and reminders
- Management of any other illnesses such as diabetes, heart disease, or another chronic condition
- Whether they need supervision and what level of supervision they may need
- Costs associated with each type of care you are considering, and what payment options are available (as well as financial assistance)
- Discussing your family’s care philosophies and institutions, and what goals for care you have
- If there is a family caregiver involved, what are their abilities and needs both currently and in the future
- The topic of transportation, and how you and your family plan on getting your aging loved one to family functions and events
Planning Ahead
Although rewarding, there are both physical and emotional burdens associated with caregiving. That said, you can help ease the weight on your shoulders if you choose to consider long-term care options and make a plan ahead of time. By planning early, you can have additional time to do more research and take advantage of any local resources that may be available to you or your loved one. In addition, the earlier you plan, the safer you are with making adjustments to that plan, should the need come. There are many ways to receive financial assistance for seniors who need the extra support, planning ahead allows you to apply for any grants or other forms of assistance beforehand. Last but not least, by developing a care plan ahead of time, your loved one will be able to give their opinion and input with a clear mind, as to what their long-term care wishes are.
