Alzheimer's and other dementias: Long-term care options

If you're caring for a family member with Alzheimer's disease or a related dementia, it's important to understand long-term care options and carefully evaluate them. The type of care needed will likely change over time as the disease progresses. Find out about the spectrum of services.

Home health services

These services provided in your home may include:

• Personal care, such as eating, bathing, dressing, grooming and toileting
• Meal preparation and household chores
• Basic nursing care, such as help with medications, wound care and medical equipment
• Physical or occupational therapy

Respite care services

Respite care, or companion care, provides time for a family caregiver to take a break. It provides the person with Alzheimer's disease appropriate supervision and an opportunity for meaningful social interaction. Respite care might be an informal arrangement with family or friends, but you also may use respite services from a community organization.

Adult care centers

Adult care centers enable participants to attend supervised activities outside the home for a few hours a week. Some adult care centers are designed specifically for people living with dementia. Services may include:

• Social programming
• Art and music
• Exercise programs
• Limited health services
• Support groups
• Transportation
• Meals

Geriatric care managers

A geriatric care manager, usually a nurse or social worker, can provide services to support in-home care and care planning. The manager may:

• Evaluate in-home care needs
• Recommend or coordinate care services
• Assist with short- and long-term care planning
• Provide support or recommendations for addressing difficult care issues

Some local government agencies and charities offer geriatric care consulting services for free or for a sliding-scale fee.

Assisted living

An assisted living facility is a residential program that provides services for people who can live with some degree of independence but require additional support. Services may include:

• An individual apartment or suite or a shared living space
• Meal preparation
• Housekeeping
• Medication management
• Recreational and social programming

Specialized dementia care

If your family member needs more supervision or help than what's available through a traditional assisted living facility, he or she might benefit from "memory care" assisted living. These facilities may offer:

• Specialized staff training in memory care
• Meaningful engagement and activities based on the individual's preferences and strengths
• Visual cues, such as signs or pictures, to support independence
• Enhanced safety measures such as secured exits

Nursing home

Nursing homes provide round-the-clock supervision and medical care. Some nursing homes may have special accommodations, activities and care services tailored to the needs of people with dementia.

Continuing care retirement communities

Continuing care communities provide different levels of care over time. A person with dementia may, for example, begin in an assisted living environment and move to skilled nursing care in the same community as the disease progresses and care needs change. Some continuing care communities include memory care facilities.

Choosing the type of care

To locate resources in your area, check the National Association of Area Agencies on Aging. When trying to determine which type of care is best for your family member, consider current and likely future needs, such as the following issues:

• Dietary needs and meal preparation
• Assistance with personal hygiene and dressing
• Medication management
• Management of heart disease, diabetes or other chronic medical conditions
• Need for supervision
• Costs and your ability to pay
• Care philosophies of institutions and your family's goals for care
• Abilities and needs of the family caregiver

Planning ahead is best

Seeking help can ease the physical and emotional burdens of caregiving — and the earlier you consider the options, the better. If you make plans early, you can take time to study the resources in your community and learn about costs. Early planning may also enable the person with dementia to express personal preferences for future care.