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Introduction
You may be able to live independently and safely for some
time on your own or with the help of a family member or hired
caregiver. As Alzheimer’s advances, there may come a
time when your day-to-day care will require the skills of
a full-time health care staff.
To make sure that your needs and preferences for care are
understood, talk about the options available to you with a
family member or trusted friend. The sooner you do this, the
more likely you are to find those options with services you
prefer.
Care services tend to fall into three categories: respite
care, residential care, and hospice care. The cost for each
type of care differs by service and community. Financial assistance
may be available through state or federal programs (e.g.,
Medicaid or the Veterans Administration).
Selecting a care
provider
There are important questions to ask when deciding on care
providers.
Questions to ask in-home caregivers:
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What is your training and experience in working with
people with dementia?
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What times are you available?
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Who would substitute if you can’t come?
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Whom can I talk to at the agency if I have a concern?
Concerns when choosing a residential care facility:
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Observe how the environment promotes independence of
the residents, provides safety and security, and reflects
your own preferences for comfort.
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Ask the care provider if the staff is continually trained
on dementia care issues, what kind of programs are offered
for people with Alzheimer’s, and how they address
an increasing need for care.
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Ask the provider if residents and family members can
participate in creating and reviewing care and service
plans.
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Spend time in a variety of facilities observing what
goes on and how people are treated. Talk with residents
and visitors about their opinions of the facility and
staff. See if the residents look happy, comfortable, relaxed,
and involved in activities.
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Talk with staff working directly with residents to see
if they are competent and content in their jobs. Also,
meet with the administrator and directors of nursing and
social services
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Visit a facility more than once before making a decision.
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Respite care
Respite care provides your caregiver temporary relief from
tasks associated with caregiving. You benefit from opportunities
to socialize with others and live in the community longer.
Respite care is mainly offered through community organizations
or residential facilities. The most common respite care programs
are in-home care and adult day services.
In-home services offer a range of options, including companion
services, personal care, household assistance, and skilled
care services to meet specific needs. In-home helpers can
be employed privately, through an agency, or as part of a
government program.
Adult day services provide you with opportunities to interact
with others, usually in a community center or facility. Staff
lead various activities such as music programs and support
groups. Transportation and meals are often provided.
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Residential care
facilities
The following are types of facilities that may meet your
needs, depending on the level of care you require:
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Retirement housing generally provides each resident
with an apartment or room that includes cooking facilities.
This type of housing usually does not have round-the-clock
staff on-site. Staff members may have little or no knowledge
about dementia. This setting may be appropriate for persons
in the early stage of Alzheimer’s who can still care
for themselves independently and live alone safely.
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Assisted living facilities (or board and care homes)
bridge the gap between living independently and living
in a nursing home. Facilities typically offer a combination
of housing and meals; supportive, personalized assistance;
and health care services.
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Skilled nursing facilities (also known as nursing homes)
may be the best choice when a person needs round-the-clock
care or ongoing medical treatment. Most nursing homes
have services and staff to address issues such as nutrition,
care planning, recreation, spirituality, and medical care.
Many facilities have special care units designed to meet
the unique needs of people with dementia.
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Continuing care retirement communities (CCRC) provide
all of the different types of options described above.
In these facilities, a person may receive all of the different
levels of care on one campus but may need to be moved
between buildings to receive different services.
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Hospice care
Hospice programs provide care to persons in the late stages
of Alzheimer’s disease. Hospice emphasizes a philosophy
of comfort and care at the end of life without using drastic
lifesaving measures. This service is available through local
hospice organizations and some home care agencies, hospitals,
and nursing homes.
Related resources
For more information on choosing a care facility, see Planning
Ahead.
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