The number of residential care settings that provide Alzheimer's care-including assisted living, adult foster homes, group homes, and special care units within skilled nursing facilities-has exploded during the past five to 10 years. If you or your loved one has Alzheimer's disease, the following information can help guide you through the maze of care options to find the facility that best meets your needs.
Plan Now for Care Later
When considering residential care options, planning ahead is key. It's best to become familiar with available care options in your community long before an admission is needed. Too often, people don't want to think about a possible need for residential care in the future, so the admission takes place in a crisis, without the time and knowledge to evaluate available options.
Today, with increased awareness of Alzheimer's disease, more people are diagnosed earlier, allowing them to plan for the future, including their financial, legal, and residential care needs. For example, a person with an early diagnosis of Alzheimer's disease can talk about his or her preferences and visit local residential care facilities. He can make his decision and share with others where he wants to live should the time come when he can no longer live alone.
For families researching the many options available, a helpful tool is the free Alzheimer's Association brochure, Residential Care: A Guide for Choosing a New Home. This brochure covers six areas people with Alzheimer's and their families should study when evaluating a residence, including Commitment to Alzheimer/Dementia Care, Assessment and Care/Service Plans, Ongoing Care, Activities, Staffing, and the Environment.
A Commitment to Alzheimer/Dementia Care
This area focuses on the philosophy and mission of a care setting. Staff should be able to discuss and describe their residence's philosophy of care. Does the philosophy and mission address the unique needs of persons with dementia? Do you see the needs of current residents being met as you walk through the community?
Ask about admission and discharge criteria. Request specific examples of situations that would result in a resident's discharge from the setting or unit. Be cautious if staff members are unable or unwilling to share examples or specific discharge criteria.
Assessment and Care/Service Plan
A good residential care provider will spend a significant amount of time getting to know the person with Alzheimer's disease and his or her family and friends. The staff should ask many questions about the person's past and present including interests, family relations, likes and dislikes, hobbies, communication styles, daily routine, etc.
As you walk around a care setting, watch to see whether staff are interacting with residents on a personal level and appear to know personal things about each resident.
More than anything else, you'll want to be confident that the person with dementia will receive the best care possible. All staff must recognize residents with Alzheimer's as unique people and treat them with dignity and respect.
Watch how staff members approach residents. Are they talking to residents or talking to each other? Do residents seem alert and active, or are they lethargic and sleeping? Are residents freely moving around the area or are they restrained? These are important things to look for when touring each setting.
Find a care provider that believes activities are much more than just structured group functions. Activities should be defined as everything a person does throughout the day. Staff should be skilled in creating meaning out of each task a resident undertakes. However, other more structured activities that are individualized to each resident should be available every day as well. What are residents doing in the evening and on the weekends? Do residents appear to be stimulated and engaged in their surroundings?
The most important component to quality care is a committed, dedicated, and knowledgeable staff. Ask the staff about the training they receive. Do the interactions you see between staff and residents appear genuine? Are staff members addressing residents by name? Do staff members appear happy and content or do they seem stressed and upset?
You'll also want to know adequate staff is available to meet everyone's needs. Ask how many residents each direct-care staff member is responsible for in the unit. As you walk around, do you see residents with unmet needs or not receiving needed attention?
The physical building and interior decorating offer the first impressions when you walk into a building. But quality of care is so much more than the furniture or wallpaper. Care providers have made significant advances, however, in incorporating the environment into the total care offered to residents.
Safety is the first concern for most people. Ask the staff what measures are in place to provide a safe and secure environment. As you walk through the residence, do you spot potential hazards? Examples might include cluttered hallways that increase the risk of falls, poor lighting, confusing hallways, and loud and frequent overhead paging systems. Check to see whether the residence encourages registration in the Alzheimer's Association's Safe Return program (nationwide identification, support, and registration program).
Another important environmental feature is the availability of outdoor space. Residents should have easy and independent access to a secured outdoor space. Do you see residents using the available outdoor space?
As you consider care environments, be sure to keep this resource handy to help you make an informed decision.
To receive more information on Safe Return (key elements of dementia care), or to receive a copy of Residential Care: A Guide for Choosing a New Home, contact your local Alzheimer's Association chapter or call (800) 272-3900.
Contents based on the original article published in Assisted Living Today, "Adding Alzheimer's to the Picture," by Marlene Mahn, MSSW.
At a Glance
- You should be comfortable with the care philosophy of the residence you choose. Do the philosophy and the mission address the unique needs of persons with dementia? Expect the staff to take time to get to know each resident.
- Activities are a key element of Alzheimer's care. Activities should be defined as everything a person does throughout the day. And, structured activities should be individualized to each resident.
- A committed, dedicated, knowledgeable, and well-trained staff is the most critical component of quality Alzheimer's care.