When Should an Alzheimer’s Patient Go into Assisted Living?

Alzheimer’s disease is a degenerative disease. Research shows that it can often begin as many as 2years before the most common noticeable symptoms arise. These first “red flags” are known as the preclinical stage of Alzheimer’s. The most common early symptoms (known as MCI, or mild cognitive impairment) include the familiar signs of memory loss and speech or language problems. As time progresses and the disease moves from mild to severe symptoms. Depending on age, general health and other factors, everyday activities and such basic body functions as walking and swallowing may set in within just a few years or not for up to a decade.

Due to the degenerative nature of Alzheimer’s, the sufferer’s partner and family are often put in the uncomfortable position of deciding when their loved one should go into an assisted living facility. Understandably, the top priority is finding a community which can provide a secure, nurturing environment. This is never an easy decision to make and it often stirs up deep seated emotions and can trigger “second guessing” on the part of family members. Therefore, it is somewhat reassuring to know the common signs to watch for which are useful in gauging when it is in the best interests of the family member to be transitioned from their home or caregiver’s home into a safe and comfortable assisted living facility:

Watch for caregiver stress

Partners, family members, and friends provide a stunning $240 billion dollars annually in unpaid care to people with Alzheimer’s. However, a much deeper cost comes in the form of caregiver overwork and exhaustion and the impact this has on the primary caregiver’s health emotional wellness. According to studies conducted by the Alzheimer’s Association over the past year, almost 60% of caregivers rate the stress of caregiving as “high” or “very high”. Between 30% to 40% report extended depression or anxiety. Fully 74% report that they are “somewhat” to “very concerned” about their own physical health, much of which can be directly traced to severe, long-term sleep disruption. Even more troubling, 35% of caregivers said their overall health has “worsened” due to the responsibilities associated with their caregiver role.

There comes a time when caring for an Alzheimer’s patient is simply too much. At this point, transition into an assisted-living facility should be given serious and immediate consideration.

Is care becoming a more demanding responsibility?

As Alzheimer’s progresses, the daily time commitment grows to become an around the clock endeavor. Ultimately, family members must be present or at least “on call” to assist with virtually all aspects of life. A common list of responsibilities might include:

• Basic household chores like shopping and meal preparation, transportation, and managing personal finances

• Medication and treatment management to ensure the patient keeps to the schedule provided by doctors. This often includes managing other health conditions which worsen with ageing (arthritis or diabetes).

• Assisting with personal care and hygiene, including bathing, dressing, and using the toilet

• Managing behavioral symptoms which often include increasingly disturbing emotional or physical aggression, wandering, repetitive behaviors, and irregular or disturbed sleep patterns.

As demands on the caregiver increase, so too do stress levels. Monitoring core care needs and associated emotional support requirements should be used as a baseline to inform the decision-making process to determine when at-home care becomes impractical.

Note if safety at home is diminishing

Over time, Alzheimer’s patients become less able to make their way safely around their own home. There are many steps that can be taken to make their home a safe place, including:

• Removing dangerous items, including prescription drugs, household cleaners, alcohol, and firearms, power tools, etc.

• Putting safety knobs on kitchen appliances (especially the stove); using child-proof plugs on electrical outlets, and installing latches on cabinets and drawers

• Installing extra smoke and carbon monoxide detectors in the kitchen and bedroom

• Get rid of clutter, remove tripping hazards (rugs are common), and ensure that all stairs have handrails.

However, even these precautions can only go so far. If you see signs of increasing confusion or stress, difficulty moving about their home, or indications of disorientation (cannot find the bathroom without help), it might be time to ensure their safety through a well-planned move.

Are they wandering?

As Alzheimer’s symptoms worsen so, too, does the chance that your loved one will wander. In fact, 60% of Alzheimer’s patients wander, often away from the home and far beyond anything resembling a predetermined “safety zone”. These spontaneous walks trigger disorientation and confusion. Given that many patients also forget their own names or long-time addresses, the risks associated with wandering adds another level of concern for family members. If wandering episodes become more frequent, a move might be the safest and most thoughtful option available.

Makes plans early

As the baby boom demographic transitions from middle age to retirement, the percentage of the population in need of memory care will continue to grow. It is important that families educate themselves on the living options available so they can make informed and thoughtful choices. Transitioning a loved one to assisted living is a milestone in life which requires compassion and planning. We’re here to help regardless of your current stage of the decision-making process.