What They Are
Alzheimer's care facilities are live-in facilities that provide care for individuals with dementia who cannot live independently. Both nursing homes and assisted living facilities can provide residential care for Alzheimer's patients; however, the term Alzheimer's care facility typically is used to describe assisted living residences.
Sometimes Alzheimer's care facilities are a part of a larger assisted living community which also serves seniors who do not have dementia, but require some type of personal care or help. These types of facilities tend to have a separate dementia unit although dementia patients may socialize and interact with other residents during activities. Some assisted living facilities provide only for mild dementia care and require residents to move should their dementia become more pronounced. Make sure your loved one is thoroughly assessed before looking into Alzheimer's care units so you know exactly what kind of care your loved one needs now-and what level of care they will most likely require in the future. Ensure that your loved one isn't forced to move out of community by asking questions as to what kind of care is available and under what circumstances a person would be asked to leave the community.
What to Expect
Alzheimer's care facilities provide room and board, some housekeeping, social activities, supervision and assistance with basic activities like personal hygiene, dressing, eating and walking. A facility that specializes in Alzheimer's or dementia care should also have safety precautions in place to prevent wandering, such as personal monitoring systems or locked dementia units. Caregivers should be trained in handling behaviors associated with dementia, such as Sundowner's syndrome or combativeness.
Facility staff either provides or arranges transportation for residents. Most facilities offer three meals per day, as well as snacks in between meals.
These facilities are considered nonmedical facilities and are not required to have nurses, certified nursing assistants or doctors on staff, although many facilities do have medical staff either onsite or on call. Medications are usually stored and distributed to residents so that the dosage and timing is monitored.
How to Find the Facility That is Right for You
Facilities should be evaluated to ensure that the needs of the patient and family are met and exceeded. It is often vital for all parties involved to have the facility located near family members in order to allow for regular visits. Before making any decisions, prospective facilities should be toured and evaluated for:
* Care Capabilities. Figure out if the facility can manage your loved one's condition both now and in the future.
* Safety. Rooms and bathrooms should have emergency call systems. Staff should perform in-room checks on a regular basis. To prevent wandering, Wanderguard or other personal monitoring systems should be used or the dementia area should be secured.
* Cleanliness. Take a look at residents to determine the level of personal attention and care they are receiving-are they well-groomed and clean?
* Staff Attentiveness and Expertise. Make certain staff has specialized dementia training on top of being good care providers. This means caregivers understand the disease and how to communicate with individuals who are not always able to express themselves. They should know how to manage combativeness, recognize signs of pain and be able to create solutions for the challenges often associated with eating, bathing or toileting in dementia patients.
* Plans of Treatment. Ask management how often care plans are re-assessed. It should be on an as-needed basis and every few months.
* Activities. Check not only the amount of available activities, but also how appropriate they are for your loved one's cognitive abilities. Usually dementia programming mimics everyday activities, such as having a dementia-safe kitchen for cooking activities, has time set aside for art projects or reminiscence and incorporates some basic exercising.
* Menu Options. Keep in mind nutritional needs and also your loved one's personal preferences, which may become more limited in moderate to later stages of Alzheimer's.
* Planned Schedule. Individuals with dementia do better with a regulated schedule as such ask the administration about what the everyday routine is.
* Common Areas. Common areas should be free from clutter as dementia patients often have trouble seeing low-lying objects, such as coffee tables, or distinguishing objects from one another. Many good Alzheimer's care facilities have special areas, such as one for reminiscence, a quiet room or sometimes even a Snoezelen. A reminiscence area may have childhood toys or dolls, sports memorabilia or other items that help bring up memories and can aid in helping dementia patients talk about their lives, especially with visiting family members. Quiet rooms are places that often have low lighting and virtually no stimuli and can aid agitated dementia patients. A Snoezelen is a room with specialized lighting, tactile surfaces, calming music and sometimes pleasant odors; it works to stimulate the five sense and can be soothing for some dementia patients.
* Decor. Lighting should be bright, even and warm. Carpeting, drapery and furnishings should not have busy patterns as it can be mistaken for insects or other objects. Resident's rooms should be clearly marked and it is a good sign when the resident's artwork and family photos adorn the walls to personalize each room. Kitchens should not have microwaves or access to anything with which a person might hurt themselves such as knives, scissors or exposed burners. All taps should have well-marked hot water handles so that individuals do not accidentally burn themselves.
* Secure Outdoors Areas. Individuals with Alzheimer's often benefit from spending time outdoors; however, any patio or garden areas must be secured or fenced so as to keep residents safe. Some facilities even have special gardening areas or greenhouses which can be a very rewarding activity.
A facility's licenses and insurance documentation should be up to date and accurate. Check references from families who have had loved ones with similar diagnoses as your family member in order to measure actual experiences. Review the patient's and their families' rights to determine how any concerns that may arise will be handled.
Try to determine the overall "feel" of the facility and notice if it is generally calm and organized. The best facilities encourage family participation and strive to maintain the dignity and safety of those entrusted to their care. You should also take note of what the average cognitive levels of the population is and what the protocol is in place for patients should their dementia becoming progressively worse. Find Alzheimer's care facilities in your area and also check out our Assisted Living & Alzheimer's Care Facilities Learning Center to learn more about finding dementia care in your area.
Paying for Alzheimer's Care Facilities
Medicare, Medigap and Managed Care do not cover care in Alzheimer's care facilities. In some states, Medicaid will pay for Alzheimer's facilities; however, very few facilities accept Medicaid as reimbursement. Long-term care insurance policies (LTCI) and Veterans Benefits sometimes can cover the cost of Alzheimer's care facilities. Most Alzheimer's care facilities are private pay. Read a detailed description of all types of reimbursements.
LTCI
What It Covers
Facility Only and Comprehensive policies pay benefits in an Alzheimer's care facility, but the amount of coverage depends on the individual policy. For information on how to determine what kind of LTCI policy suits your needs, visit Duane Lipham's Expert Column on LTCI.
Veterans Benefits
What It Covers
Veterans Benefits refers to care in an Alzheimer's facility as Community Residential Care. The program provides health care supervision to eligible veterans who are unable to live independently and do not have anyone to provide the required supervision and care. The veteran must be able to function with minimal assistance.
Conditions and Limitations
* Veteran must meet eligibility criteria for VA benefits, and
* Demonstrate need for this type of care
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