If an elder family member has been diagnosed with Alzheimer’s or another form of dementia, you probably did your best to keep their lives as regular and independent as possible, but now they need more help. Caring for a loved one with dementia is a recurring process of noticing changes in their abilities, accepting those changes, and making tough decisions to adapt how you help them navigate life. Dementia patients inevitably reach a point where they can’t safely live independently and will need professional care in their home or in a long-term eldercare facility (aka, an assisted living, nursing home, or memory care facility).
Does your family member with dementia need more at-home care or is it time to transition to a nursing home? Considering the following factors will help you keep them safe while also making arrangements that support you and the rest of your caregiving family.
Compare the costs
As with most caregiving and healthcare decisions in the United States, we often have to consider costs ahead of the best interests of the person needing care. Womp womp. Might as well be practical about it.
First, don’t assume you know how the cost of home-care services compares to living in a nursing home. The level of care your family member needs will depend on the progression of their dementia. Would an aide visiting a few times a week cover gaps in your schedule? Or do they have other medical conditions that warrant around-the-clock nursing?
Start by talking to home-care agencies and nursing homes about your family’s needs and how their services line up. The main factors determining cost will be how many hours of care you need per week and how independent your family member is with daily activities.
For the sake of comparison, the national average monthly cost of in-home care (40 hours per week) is about $4,500; assisted living is also about $4,500 per month; a private nursing home room is more like $9,000 per month.
Understand their stage of cognitive decline
Whether you need to hire a home caregiver or move Mom to a nursing home depends largely on how much your family member can still do on their own and how their abilities are expected to change. Get familiar with the stages of dementia and where your loved one is on that spectrum. Resist the (very common) denial you and other family members might be feeling about dementia so you can get an honest picture of what your needs are.
Assess your support system
How much professional care a person with dementia needs is also dependent on how much care is available from family members. Ditch any shame you may feel about not living close enough or being overwhelmed and burned out by caregiving. Consider the needs not just of your aging family member but the entire family support system. Needing professional help is a real factor in eldercare and not a family failure.
Who in your family and community is available and able to help on a regular basis while still maintaining their own well-being? Where are there gaps in your family member’s days when they need more help or can’t safely be left alone?
At-home care vs. a memory care community
Let’s look at exactly what services you can expect from at-home care compared to a memory-care home or nursing home.
Home-care services can range from occasional companionship to constant medical supervision. Home-care workers are not usually nurses, but instead can provide the following services as needed or on a regular daily or weekly schedule:
Companionship
Transportation
Help with bathing, dressing, using the toilet
Medication reminders
Meal preparation
Housekeeping and laundry
Filling in when a family member needs a break
Healthcare providers like nurses and physical therapists can also visit the home as needed.
The benefits of home care are staying in familiar surroundings, additional support for family caregivers, scheduling flexibility, and one-on-one attention.
On the other hand, a memory care community can provide housekeeping, meal prep, and personal-care services, along with medication management, security and safety features, trained full-time staff, organized activities and social opportunities.
In the later stages of dementia or Alzheimer’s, a person may lose the ability to walk or feed themselves, or they may be more vulnerable to secondary infections and illness.
By knowing your budget, the cost and availability of different services, and your family’s ability to support your loved one with dementia, you can better decide when to transition to more care services as their needs change.