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An initiative of the Massachusetts Councils on Aging

Residential and Specialty Care

by | Jun 4, 2019

Residential and healthcare decisions can be some of the most complex decisions a person can make later in life.

Aging in Place

Many adults idealize their golden years living at home.  This option of aging in place, particularly for those diagnosed with dementia, is possible but only with advance financial, legal, and healthcare planning, and with the help from people in the community. Age- and dementia-friendly house modifications can introduce changes to the home that support life through changing physical and cognitive conditions.  As cognitive decline occurs and greater help is required to address daily tasks, in-home care can be introduced to support routine care. As people with dementia struggle to maintain their existing relationships because cognitive change, they may begin to isolate themselves, making participation in community and social events vital to that person’s wellbeing.  Geriatric Care Managers can identify a person’s changing needs and recommend services or activities to enhance their quality of life.

Staying Active in the Community

To age in place, maintaining relationships with friends, families, and the community contributes to a person’s social and emotional health.  Access to dementia-friendly transportation, businesses, and public areas allow people with cognitive change to continue to navigate in their community independently.  People with mild cognitive impairment can continue to work or volunteer, promoting a sense of purpose. Adult Health Day Care programs and Memory Cafes are opportunities for adults to live at home but interact with peers in the community.  Learn more about programs and services that support people with dementia in the community.

Care Partner Services

Being a care partner for a person with dementia is a complex role.  Each person reacts differently when faced with the care responsibility with emotions ranging from guilt, satisfaction, fear, burden, and more.  There is no “right way” to identify as a care partner. Like professionals in many care industries, burnout is a real outcome for someone in a supportive role, especially over a long period of time.  Attending caregiver support groups can provide opportunities to bond with other care partners and create a community of people with similar responsibilities.  Respite care or adult day health programs are beneficial for people with dementia as they can engage with peers in a stimulating social environment but also provide care partners a period of time to be independent of their loved one.  The Savvy Caregiver training is a free service that teaches care partners practical skills in caregiving.  Help is available to care partners but sometimes other care or residential options may be considered for the wellbeing of all parties involved.

Confused about what to expect as a care partner?  Consider visiting our YouTube channel for some insight or explore our collection of toolkits for care inspiration.

When to Consider Placement

Determining if or when to move a person with dementia to a care facility is a difficult and emotional decision.  Some people may have access to services that provide the necessary level of care in the home. However, symptoms of dementia may progress to the point where care partners may be overwhelmed by their caregiving responsibilities or may face the reality that the individual is no longer safe in the home setting.  Falls, unsafe wandering behaviors, and isolation may also be factors in choosing to relocate to a residential care facility. There are several residential placement options to consider but ultimately, the decision is shared amongst the person with dementia and those in their support network.

Residential Placement Options

Care facilities are designed to meet the individual needs of older adults.  When a person with dementia is considering residential options, they should identify facilities that offer specialized memory care.  Memory care facilities employ staff that are specially trained to identify and support the needs of people with dementia. These care facilities have different staffing requirements than standard care facilities so more individualized attention is offered.

While some people with mild cognitive impairment would live successfully in independent living centers, they may not have access to the care they need in the future.  Continuous retirement care communities may place an individual in an independent care unit and transition the resident to a more appropriate part of the community when the person requires a greater level of care.  Assisted living facilities with memory care allows people with dementia to live as independently as possible, providing assistance in Activities in Daily Living (including hygiene routines). Nuursing home settings are suitable for adults who require greater care such as requiring multi-person lifts or assistance with administering medication.

Dementia Friendly Home Modification

Alzheimer’s Association Home Safety Checklist

Alzheimer’s Society, UK- Making Your Home Dementia-Friendly

Alzheimer’s Society of Manitoba, Canada- Reducing Risk of Falls for People with Dementia (PDF Download)

Canada Mortgage and Housing Corporation- At Home with Alzheimer’s Disease (PDF Download)

Home Modification and Repair Resources

Home Safety and Alzheimer’s Disease

Making Your Home Dementia Friendly

In-home Care

Alzheimer’s Association- In-Home Care

Care Dimensions

Caregiving Questions- Senior Housing and Home care

Connected Home Care

Disaster Planning Tips for Older Adults and Their Families

Home Instead

Massachusetts Home Care Services

Visiting Angels

Care Partner Services

Alzheimer’s Association- Caregiver Stress Checklist (PDF Download)

Alzheimer’s Association- Find a Support Group

Healthy Living 4 Me Training Programs

Massachusetts Caregiver Support Program

Resources for Patients & Caregivers

Residential Care

Alzheimer’s Association- Residential Care

Alzheimers.net- Massachusetts Dementia Care Resources and Facilities

Assisted Living Directory

Checklist for Deciding Residential Care

Find Memory Care in Massachusetts

How to Move a Parent with Dementia to Assisted Living

Nursing Home Search Page

Paying for Senior Care

Prevent Elder Transfer Trauma

Senior Housing Options for Clients with Dementia

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