When to consider care outside the home

One of the most difficult experiences for family caregivers of a person with Alzheimer’s disease or a related disorder is deciding when to consider placement outside the home.

Caregivers should ask themselves the following questions to evaluate their situation:

1. Is constant care required beyond my physical capability? 
2. Is the person with memory loss becoming unsafe in their home
3. Am I becoming impatient or irritable toward the person for whom I am caring?
4. Am I becoming impatient or irritable toward the person for whom I am caring?
5. Would structured activities and increased social interaction benefit the person I care for?
6. Am I neglecting my family, my job or myself in order to provide care?
7. Would placement outside the home result in more enjoyable visits and outings with the person I care for?

1.  
   1. Your answers to those questions can help you determine if placement outside the home is the best decision.

1. What to look for when visiting care facilities:
2.  
3. Environment

License:  Ask to see the facility’s valid California State License, issued by the State of California, Dept. of Social Services Community Care Licensing Division.

Atmosphere: When you walk in do you “feel” the nurturing, loving, and supportive environment your loved one needs and deserves?

Living space: Is there indoor and outdoor space? Are their safe walking paths or secured access to fresh air and outdoor activities?

1. Visiting hours: Does the visitation policy meet your needs? Visit unannounced at different times to see the staff interact with residents.

2. Structure:Is the facility designed and constructed with the abilities, comfort, and freedom of the resident in mind?

Staff:  Has the staff been screened and properly trained? Residents with memory loss present unique challenges to staff, requiring ongoing training.

Administrator:  Does the Administrator seem knowledgeable about dementia and the special care required?

Physical contact:  Is there positive physical contact between staff and residents – a warm touch, an arm around the shoulders?

Humor: Do staff and residents interact joyfully and set a tone of lightheartedness? Verbal cues: How do staff redirect a resident? Do they command or encourage?

Personal care:  Is care (bathing, toileting, etc.) done with respect and dignity for the resident?

Resident behavior: Are some residents sitting quietly or sleeping? Are some residents moving around freely? These are normal behaviors and should be allowed in a safe environment.

Personal belongings:  Are residents allowed to bring in furniture, bedding, and photos that are familiar to them? This helps them to feel “at home” and gives them a sense of belonging and not being lost.

Level of function:  Ask what happens when the person needs a higher level of care. Can the facility accommodate residents with a wide range of abilities?

Home life: Can the residents participate in meaningful activities such as setting the table, washing dishes, folding the laundry, etc.?

Programming:  What does the structured activity program look like? Are projects interesting and success-oriented? Are activities planned with the dementia resident in mind?