Dementia now requires more supervision than you can provide. What do you do? That is the question faced by thousands of caregivers every day. And there is no easy answer and no easy decision.
Understanding the Options- and the Journey Ahead
The best thing you can do is to try to understand options that may be available to you and your family. And to truly understand all of your options, it is important to know the possible cause of the signs of dementia, the expected progression of the disease and how your loved one can remain safe and cared for. In short – there is no easy answer but knowing your options can help you formulate a plan. And knowledge is power – even when we talk about dementia.
I’ve Rationalized Long Enough
There comes a time when an uncomfortable feeling that you have becomes a talking point in family conversations.
“I drove with Dad to the post office and he completely forgot where it was.” “I know, he did that with me when we went to Uncle Peter’s house.”
Or, “Mom just bought an extended car warranty – again!”
These interactions can be excused away for a time – but as the frequency of occurrence increases it becomes clear that a different level of care or supervision is needed.
It is important to understand the levels of dementia.
In this early stage of dementia, an individual can function rather independently, and often is still able to drive and maintain a social life. Symptoms may be attributed to the normal process of aging. There might be slight lapses in memory, such as misplacing eyeglasses or having difficulty finding the right word. Other difficulties may include issues with planning, organizing, concentrating on tasks, or accomplishing tasks at work. This early stage of dementia, on average, lasts between 2 and 4 years.
In this middle stage of dementia, often the longest stage of the disease, brain damage causes a person to have difficulty expressing thoughts and performing daily tasks. Memory issues are more severe than in the earlier stage. Someone in this stage might forget their address, be unable to recall personal history, and become confused about where they are. Communication becomes harder. The individual may lose track of thoughts, may be unable to follow conversations, and may have trouble understanding what others are saying. Mood and behavior changes—including aggressiveness, difficulty sleeping, depression, paranoia, repeating actions or words, hoarding, wandering, and incontinence—may be seen. This moderate stage of dementia, on average, lasts between 2 and 10 years.
In late-stage dementia, also known as advanced dementia, individuals have significant issues with communication. They may not verbally communicate at all. Memory also worsens, and individuals may not be able to remember what they had for lunch. They might forget family members’ names. It’s possible they may think they are in a different time period altogether and revert back to their childhood days. It may be too difficult to walk, and extensive help is needed for daily living activities, including personal hygiene and eating. At the end of this stage, the individual will most likely be bedridden. This severe stage of dementia lasts approximately 1 to 3 years.
Levels of Care
Deciding on the level of care that is right for your loved one is important. But it is important to remember that the progression of dementia has its own timeline based on many factors. The general health of the patient plays an enormous part in the progression of the disease, as does the type of dementia, prognosis, amount of mental and physical stimulation and living environment.
Finding the right “care fit” requires a certain flexibility and watchful eye on the patient’s needs at any given time. An individual might not require a specific care scenario in the early stages of dementia as “day” help and family oversight can frequently provide enough care and coverage to ensure safety and well-being for a period of time until symptoms worsen. However, as the progression of the disease advances, it is important to understand the appropriate options and levels of care available for your loved one.
Personal Care or Assisted Living in Early Stages
Assisted living residences combine room and board with medical and personal care, and are often sufficient for someone in the early stages of Alzheimer’s disease or related dementia. Full-time supervision means residents are safe, with living units like private studios or apartments so someone with mild dementia can still feel a sense of independence.
Services offered typically include meals, help with activities of daily living (ADLs), social activities, and transportation to and from doctor’s appointments. Before moving in, the residence will assess your loved one to make sure it’s a good fit.
Memory Care in Middle to Late Stages
Some residences offer Memory Care. Memory care is better for someone in the middle stages of dementia, when independence has become more difficult. Memory Care can be a wing or special section of assisted living, or there are stand-alone memory care homes. These are more appropriate for people past the earliest stages because staff is trained specifically to communicate with and care for people whose needs are particular to dementia. Speaking with someone who has dementia requires careful technique. Similarly, activities for people with dementia are more considerate of the participants’ ability (or inability) to function and understand.
Memory Care residences have physical designs that are appropriate for people with dementia. Residents are encouraged to decorate their “homes” or apartments in close approximation to the home that they left. Creating a familiar layout and placing loved pictures and objects in their new living situation helps to make for a smooth transition. Memory Care residences offer a safe environment. Because people with dementia are prone to wander, memory care residences have increased security and supervision.
Doing Your Homework Early
No one likes to think of what “might” happen. Our eternally optimistic selves like to focus on “beating the odds” or creating the best outcome by ourselves. But when it comes to the health of our loved ones, knowing what may lie ahead – just in case – is the smart thing to do. In fact, studies show us that transitioning to Memory Care during the moderate stage of dementia leads to easier adjustments for both the resident and family.
The Memory Care team at Chandler Hall has devoted years and thousands of hours of expertise to helping folks with memory needs transition from a challenging life at home to a secure and fulfilling life of Person-Centered Care.