When is a dementia sufferer ready for a long-term care facility?


By Micha Shalev

The mid-stage of Alzheimer’s or dementia requires 24-hour car may be the point when a caregiver should consider institutionalization. A caregiver should consider long-term care placement when they or their loved one’s physical and mental state begins to deteriorate.

When the caregiver can no longer cope with the physical and mental demands of caregiving, he or she should first consider support services. Alarm signs of the need for caregiver support are:

•Feeling very stressed, anxious, depressed, easily angered or irritable;

•Feeling exhausted or having sleep problems;

•Health begins to deteriorate;

•People say you are depressed or exhausted, but you deny it;

•You withdraw socially; and

•You can’t concentrate anymore.

Caregivers can try resolving these problems with help from a doctor, counselor or Alzheimer’s support group. Studies have shown that the more support and counseling caregivers get, the longer the sick elder stays out of an institution.

Some key behaviors or conditions in the sick elder that would cause a caregiver to consider a facility are:

•The person is so physically abusive that the caregiver doesn’t feel safe;

•The person wanders from home and jeopardizes his or her own safety; and

•The person required constant medical or mental supervision.

Before placing a loved one in a facility, the caregiver should try taking a break from caretaking duties by sending the dementia sufferer to adult day care. Time away from care responsibilities could help extend the caregiving role for a while; or the caregiver could use the break to think more clearly about moving the sick loved one to a facility.

The caregiver should not be surprised that they may also feel stress when they first move their loved one to a facility. On the other hand, a facility can offer a better setting for the dementia sufferer since it can alleviate the sense of isolation of home care by providing social stimulation and professional care.

Some facilities claim to specialize in treating sufferers of Alzheimer’s disease and other forms of dementia, but not all of them excel in this kind of care.

Those facilities that do excel tend to be very expensive. If the caregiver cannot afford such care, he or she should look for a place where he, she or others can visit frequently and assist with the loved one’s needs. Ideally the place chosen should meet the following criteria:

•Caregivers help residents get ample movement. If the resident can’t move on his or her own, caregivers help the person get out of bed. Otherwise, caregivers move the person in bed and around the facility, particularly outside.

•Caregivers appear to truly enjoy what they are doing. Look for the smile.

•Care is culturally and linguistically specific. In the later stages of Alzheimer’s disease, many sufferers revert to their native language. So, it is best to have caregivers who can interact with the resident in the resident’s own language. Look for cultural sensitivity in how personnel care for residents.

•Residents with dementia live together. Dementia residents should be cared for together in a group setting. Studies have shown that the social aspects of a group are beneficial to residents with Alzheimer’s or other dementias.

Micha Shalev, MHA, is the owner of Dodge Park Rest Home at 101 Randolph Road in Worcester. He can be reached at 508-853-8180 or by e-mail at m.shalev@dodgepark.com or view more information online at www.dodgepark.com. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com.