Ways to Keep Loved Ones with Dementia at Home - When to Consider Facility Care

Alzheimer's and dementia continue to be a growing concern worldwide as populations get older. Dementia is the leading cause of dependency and disability among older people. The dependency places substantial burdens on family members who often become caregivers for their loved one.

Dementia is a big deal with big numbers, so it's not something to ignore. Every three seconds worldwide, someone develops dementia. Over 50 million people live with dementia, and that number should double every 20 years.

How will the family address the problem when your parent or spouse starts showing signs of dementia? Understand your loved one may notice the signs before the family detects anything. Many people ignore it, are embarrassed, or are just afraid of it and attempt to hide it from loved ones. 

Early Signs of Dementia

An individual's friends and family will start to see changes in their loved one's memory, behavior, or abilities. Here are a few of the early signs of cognitive decline according to the CDC:

1. Memory Loss that Disrupts Daily Life

When someone starts to forget important events, they keep repeating themselves or rely on more aids (like sticky notes) to help remember; these are some of the signs a person has problems with their memory. 

2. Challenges with Problem-Solving 

Most people take the skills they had learned when they were young and perform all the time for granted. When a person starts having problems with routine things like paying bills, this is an indication there may be a decline in cognitive ability. 

3. Challenges Completing Daily Tasks

Most of us take for granted the ability to do everyday tasks like cooking, driving, using the phone, or shopping. There is a problem when a person starts to have challenges doing these things. For example, if your mother starts forgetting how to bake your favorite cake and makes significant mistakes doing so, this is not a normal part of aging. If they get lost driving to the grocery store, that is also not normal.

Many other signs indicate a decline in cognitive ability, like poor judgment, inability to choose the right word, withdrawal from social activities, and mood and personality changes.

Get Medical Evaluation

There are other medical reasons to have these cognitive symptoms. For example, some medications can cause memory problems. Once the medication is removed, the person returns to normal cognitive function. If a family member exhibits these signs, be sure they see a doctor for evaluation.

The Mayo Clinic says diagnosing dementia can be challenging. Recently, biomarkers have become available to make a more accurate diagnosis of Alzheimer's disease. 

The doctor will review medications, order lab work, brain scans, and complete cognitive and neuropsychological testing. 

Caring for a Loved One with Dementia

There is no question most people feel more comfortable at home, and families may prefer that mom or dad remain in their home. Health insurance, including Medicare and supplements, will not pay for this care. So, unless the person has a Long-Term Care Insurance policy, family members will provide the care, or professional care will be brought in to help.

Family caregivers often get overwhelmed with the responsibilities of being a caregiver. Whether family members or professionals provide the care, technology can help the care recipient stay at home longer.

Technology Helps People Stay Home Longer

"Modern technology gives families some options when faced with the challenge of keeping a senior loved one with growing cognitive impairment safe at home," says Dwight Smith, owner and operator of Amada Senior Care in Toledo, OH.

Smith says that several brands of user-friendly, 24-hour electronic monitoring devices can summon assistance when a care recipient falls, or some other emergency happens. 

Smith notes that automated medication dispensers are another safety device that keeps a care recipient's medications secure and dispenses the correct dose at the right time. 

"This prevents medication confusion that can lead to a senior's loss of independence or a hospital admission," Smith said.

There are tracking and monitoring devices that help supervise a dementia patient. These devices can monitor medications, bathroom habits, and movement. The caregiver and other family members get appropriately notified to take action if required.  

Some voice-activated assistants can be programmed to provide reminders, play favorite music, read audiobooks, tell jokes, play games, and answer questions any time, day or night. 

These devices can control the thermostat and turn lights on and off. The caregiver or family member can program these settings. Plus, the care recipient can ask the device simple questions like, "What is the weather today?" and "What day is it?" The device doesn't care how often it gets asked the same question.

Amada's Dwight Smith says that hands-on support by trained, certified caregivers can give families the respite they need along with the peace of mind knowing their loved one's health and safety are ensured. 

"Many seniors prefer to live in familiar surroundings and enjoy the comforts of home. Families are encouraged to seek out adult day care or 12-to 24-hour care by professional caregivers," Smith said. 

As Dementia Progresses, a Facility May Become the Best Option

No matter if you have professional paid care, family caregivers, or a combination of both, at some point, the care recipient may need to transition to a facility. 

There are memory sections in many assisted living facilities that can easily handle mild to moderate dementia and help the person with daily living activities. All this is a less institutional setting. 

Transitioning a loved one to a memory care community should be considered when the care recipient needs more help and support than in-home care. Changes in their personality and safety concerns should also be considered. 

"There are many variables to consider, but this emotional decision comes down to the dementia patient's safety. If they are a danger to themselves or others in the household, the family will benefit greatly from seeking guidance from their family physician and the senior care advisors of their home care agency," Smith explained.

When the care recipient's dementia progresses, they may need more attention than a family caregiver or professional in-home caregiver can physically or mentally provide at home. The safest place for some dementia patients will be in a long-term care facility as residents are closely monitored, and the staff is skilled at dealing with dementia patients.

Finding Quality Care Options

LTC NEWS offers these guides which can help the family members find appropriate care options - 

• Finding Quality In-Home Care | LTC News
• Adult Day Care Centers (ADCCs) | LTC News
• Finding a Quality Nursing Home | LTC News
• Assisted Living and Memory Care Facilities | LTC News

Smith says that family conversations should take place once their loved one's dementia has progressed that in-home care is no longer appropriate. Remember, at this point, the care recipient can no longer make sound decisions on their behalf. They may object to moving from their home - there is fear of the unfamiliarity of leaving one of the few things they are comfortable with. 

"We had been providing in-home caregiving services to an individual who had granted permission for his son to make health care decisions for him. But when it came time for them to transition to memory care, he couldn't remember doing that," Smith said.

Advance planning is always best, but it can be challenging once the problem is real. 

Long-Term Health Care Costs Rising Sharply

Many families are concerned with the costs of the proper long-term health care their loved one - or they, in the future - will require. Funding quality care can be financially devastating even for those with larger estates. 

Depending on where you live, today's costs can reach and surpass $100,000 a year for a nursing home. Even assisted living facilities that provide dementia care can be very expensive. In-home care and adult day care are less expensive but not cheap. 

The LTC NEWS Cost of Care Calculator shows you the current and future costs of care where you, or a loved one, lives - Cost of Care Calculator - Choose Your State | LTC News.

The costs are going up sharply due to the increasing demand for long-term health care, labor shortages in some areas, and higher labor costs overall. Your older parent may not have many options, but those in their 40s or 50s who are now planning for their future retirements should consider declining health and aging as part of their planning. 

Long-Term Care Insurance is Funding Quality Care Options

Long-Term Care Insurance is already helping families nationwide by providing guaranteed tax-free resources to pay for their choice of quality care options, including in-home care and memory care.

In 2021 the top companies paid over $12.3 Billion in benefits from Long-Term Care Insurance. With growing long-term health care costs, the need for Long-Term Care Insurance is growing.

There are several types of policies available, including those that combine life insurance or annuities with long-term health care benefits. All these plans are custom designed and affordable, especially if you are in good health. You must have reasonably good health since Long-Term Care Insurance is medically underwritten. 

Underwriting criteria and premiums vary dramatically between insurance companies to seek the help of a qualified Long-Term Care Insurance specialist to guide you in the process. 

It can be depressing thinking about your parent's decline in health, much less your own. Aging happens and being prepared will make it easier for everyone.