A Guide to Choosing an Alzheimer Facility

As published in "Senior Life", an insert of the Statesman Journal in Salem, OR

Article provided by: Pacific Living Centers, Inc. "A Loving Home For the Memory Impaired"

One size does not fit all when choosing a care facility for a loved one with Alzheimer's. People with Alzheimer's need structure and routine so that they know what to expect. There are facilities that are better equipped to deal with the special problems that those with Alzheimer's or Dementia may face, such as anxiety, wandering, unpredictable behavior and the inability to perform every day tasks. The best facilities for a loved one with moderate to severe Alzheimer's disease focus on resident safety and comfort while providing opportunities for socialization and structured activity.

Care centers designed specifically for those with Alzheimer's and Dementia safeguard the resident, provide 24-hour supervision and care, offer a room and meals in a common dining area, assist with activities of daily living and offer personalized care designed to provide residents as much mental and memory stimulation as possible. These specialized care centers are State endorsed Alzheimer facilities that have gone through extensive training to care for such persons; their State endorsed Alzheimer status can be verified through the Senior and People with Disabilities office in Salem.

People with Alzheimer's disease often end up living in an assisted care facility, especially during the disease's advanced stages. However, many nursing homes don't have the same resources to handle an Alzheimer's resident as facilities that specialize in Alzheimer care do. As a result, finding the right home for a family member can be difficult.

In choosing a facility, often your five senses provide a good measure for quality of life and quality of care. Be aware of what you experience when you visit a facility; this may be the future home of your family member. You want to make the best choice you can and you want to know that your family member will be well taken care of especially since he or she will not be well prepared to advocate on his or her own behalf.

Selecting a care provider

Your loved one may be able to live independently and safely for some time on their own or with the help of a family member or hired caregiver. However, as Alzheimer's advances, there may come a time when your day-to-day care will require the skills of a full-time health care staff.

To make sure that your loved one's needs and preferences for care are understood, talk to them about the options that are available; the sooner you do this, the more likely you are to find those options with services you prefer. Care services tend to fall into three categories: respite care, residential care and hospice care.

Respite care

Respite care provides temporary relief to the caregiver from tasks associated with care giving. Your loved one benefits from opportunities to socialize with others and live in a community longer. Respite care is mainly offered through community organizations or residential facilities. The most common respite care programs are in-home care and adult day services and can provide assistance for a 24-hour time period.

In-home services offer a range of options, including companion services, personal care, household assistance and skilled care services to meet specific needs. In-home helpers can be employed privately, through an agency or as part of a government program. Adult day services provide your loved one with opportunities to interact with others, usually in a community center or facility. Staff lead various activities such as music programs and support groups. Transportation and meals are often provided.

Residential care facilities

The following are types of facilities that may meet your loved one's needs, depending on the level of care they require:

• Retirement housing generally provides each resident with an apartment or room that includes cooking facilities. This type of housing usually does not have round-the-clock staff on-site. Staff members may have little or no knowledge about dementia. This setting may be appropriate for persons in the early stage of Alzheimer's who can still care for themselves independently and live alone safely.
• Assisted living facilities (or board and care homes) bridge the gap between living independently and living in a nursing home. Facilities typically offer a combination of housing and meals; supportive, personalized assistance; and health care services.
• Alzheimer Care Unit (ACU) are State endorsed Alzheimer facilities. These facilities are typically much smaller then the average nursing home or assisted living facility. Their staff has gone (and continually receives) special training to deal with residents who suffer from Alzheimer and Dementia. These facilities are built with Alzheimer and Dementia residents in mind, providing secure outdoor areas, surveillance in common rooms, and special design features throughout the building that caters to their residents.
• Skilled nursing facilities (also known as nursing homes) provide round-the-clock care or ongoing medical treatment. Most nursing homes have services and staff to address issues such as nutrition, care planning, recreation, spirituality and medical care.
• Continuing care retirement communities (CCRC) provide all of the different types of options described above. In these facilities, a person may receive all of the different levels of care on one campus but may need to be moved between buildings to receive different services.

Hospice care

Hospice programs provide care to persons in the late stages of Alzheimer's disease. Hospice emphasizes a philosophy of comfort and care at the end of life without using drastic lifesaving measures. This service is available through local hospice organizations and some home care agencies, hospitals and nursing homes.

Choosing a care facility can be a very stressful undertaking. It's important to choose the right care provider as people who suffer from Alzheimer and Dementia need to feel secure and stable, and moving them to a different facility can be very traumatic. No matter which care you decide is appropriate for your loved one, there are very important questions to ask when deciding on a care provider:

Questions to ask in-home caregivers

• What is your training and experience in working with people with Alzheimer/Dementia?
• What times are you available?
• Who would substitute if you can't come?
• Whom can I talk to at the agency if I have a concern?

Concerns when choosing a residential care facility:

• Make sure the facility has been licensed to handle the special needs of Alzheimer's residents. (This can be verified with the Senior and People with Disabilities office).
• Ask the care provider if the staff is continually trained on dementia care issues, what kind of programs are offered for people with Alzheimer's, and how they address an increasing need for care.
• Make sure the premise is secure. This is vital for a place that cares for Alzheimer's residents.
• Observe how the environment promotes independence of the residents, provides safety and security, and reflects your own preferences for comfort.
• Check that the programs offered will keep your relative alert, interested and entertained.
• Ask the provider if residents and family members can participate in creating and reviewing care and service plans.
• Spend time in a variety of facilities observing what goes on and how residents are treated. Talk with residents and visitors about their opinions of the facility and staff. See if the residents look happy, comfortable, relaxed and involved in activities.
• Talk with staff working directly with residents to see if they are competent and content in their jobs. Also, meet with the administrator and directors of nursing and social services.
• See that the resident rooms are clean and spacious. And ask whether house rules allow rooms to be personalized with family photographs and mementos from home.
• Choose a facility that allows as much access to your relative as you need.
• Visit a facility more than once before making a decision.

These questions should be used to help you decide which facility is best suited for your loved one. Take these questions along with you when you tour a facility. Bear in mind that the staff's attitudes and philosophies about caring for residents with Alzheimer's/Dementia should be reflected throughout the facility, from architectural design to meal preparation and planned activities. Also, when touring a facility, talk to residents and their families to see how they like the environment and staff, and check to see if the residents look engaged, cared for, and mentally stimulated. Choosing a long-term care facility for a person with Alzheimer's disease is an important decision; you are evaluating the facility for its ability to offer acceptable quality of life and quality of care.

For more information, or to tour a local Alzheimer/Dementia resident care facility, contact a Pacific Living Centers location nearest you.