Placement in a memory care facility: Damned if you do – damned if you don’t


By Micha Shalev

Micha Shalev

Life expectancy has been on an upward trajectory for over 100 years. According to the most recent report released by the AARP, the age group 65 and above will increase 89 percent over the next 20 years, and the 85 and older population will grow 74 percent during the same period.

Based on the Alzheimer’s Association’s recent report, the number of Americans living with Alzheimer’s disease is growing — and growing fast. An estimated 5.4 million Americans of all ages have Alzheimer’s disease in 2016. Of those people, an estimated 5.2 million people are age 65 and older, and approximately 200,000 individuals are under age 65 (younger-onset Alzheimer’s). One in nine people age 65 and older has Alzheimer’s disease. By mid-century, someone in the United States will develop the disease every 33 seconds.

These numbers will escalate rapidly in coming years, as the baby boomer generation has begun to reach age 65 and beyond, the age range of greatest risk of  . By 2050, the number of people age 65 and older with Alzheimer’s disease may nearly triple, from 5.2 million to a projected 13.8 million, barring the development of medical breakthroughs to prevent or cure the disease. Previous estimates based on high range projections of population growth provided by the U.S. Census suggest that this number may be as high as 16 million.

Several factors simultaneously prompt and mitigate against a decision to place a relative in a care home. The existence of multiple stressors, such as incontinence and wandering behavior, combined with reduced caregiver resources and greater feelings of burden, have all been associated with placement while other studies suggest that living apart from the relative, and the need to balance care-giving with paid employment, are better predictors of care-home placement than functional ability.

Virtually no one wants to place a loved one in a “facility”. But what if you have to work full-time and can’t provide the required 24/7 care?  What if you can’t afford an in-home care service around the clock that could help you out? Or what can you do if your loved one becomes too combative to manage?

You and your loved one aren’t the only people in the equation. Family members may argue strenuously against any decision you make. They may try to make you feel guilty enough to give up any plans for institutionalization.

Sometimes a placement is the best (or even only) solution for your benefit as well as the  benefit of the person you’re caring for. But many people feel like institutionalizing their loved one is a cop out – virtually a crime.

If you do it you may feel terribly guilty. But if the person really needs to be in a facility for his or her own safety and well-being you may end up feeling even guiltier if you don’t do it. If something happens to your loved one – such as wandering off or sustaining an injury from a fire or other hazard – you’ll never forgive yourself.

Ask yourself two questions:

1) Would being in a facility provide your loved one with better care, more personal attention, more opportunities for socialization and – especially – greater safety?

2) Is taking care of the person at home wrecking your own physical and mental health?

If you answered “yes” to either one of these questions it may be time to start looking for a good facility.

People with Alzheimer’s that are placed in a long-term setting typically adjust over time and often later forget they were even moved in the first place. The facility will become their new “home” away from home.

If you decide not to do it, just remember that Alzheimer’s is progressive. You may need to revisit the issue later on.

    Micha Shalev MHA CDP CDCM CADDCT is the owner of The Oasis at Dodge Park, Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 and 102 Randolph Road in Worcester. He is a graduate of the National Council of Certified Dementia Practitioners program, and well-known speaker covering Alzheimer’s and dementia training topics. He can be reached at 508-853-8180 or by email at For more information visit