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Choosing the Right Care Facility for an Elder with Alzheimer's

by Matt Kudish, Alzheimer's & Dementia Expert
November 17, 2011

Question: What factors should I take into consideration while evaluating if a facility is right for my grandfather suffering from Alzheimer’s?

Answer: Placing a relative with dementia in a nursing home can be one of the more challenging aspects of caregiving. It is important to remember that while remaining in the community throughout the spectrum of the disease may be possible for some, in many cases people with dementia cannot be managed safely in the home. Co-existing health conditions of the person with dementia and the caregiver’s not having the necessary support to effectively manage care while also balancing their own needs are two contributing factors to nursing home placement. If the person with dementia’s needs exceed what can be managed at home, or if the primary caregiver is unable to effectively manage the person’s care, nursing home placement should be considered. Remember too that few know the person as well as you do and few in turn will be able to provide care in the same way you would, or in the same way you would like it to be provided. 

Nursing home staff often do the best they can, despite having their own obstacles to contend with. With this in mind, it’s important to consider what will be relevant to the prospective resident and not to the caregiver.  In other words, try not to be wooed by the art on the walls or the beautifully maintained acres of land. People with dementia will likely not be interacting with the art and in many cases won’t be able to go out walking without a private aide to assist them. Good indications of the quality of a facility include how current residents are doing.Look at the people who reside in a home—are they dressed and well-groomed or in hospital gowns and unkempt?  Are they engaged in meaningful activities or are their wheelchairs parked in the hall without anyone to interact with?  Are they expected to follow a strict schedule, such as when they wake up, eat, bathe and go to sleep or are they given choice and flexibility in these decisions?  When taking a tour, be sure to visit the dementia floor or unit and not just the floor where more independent residents reside. Think about the kinds of things that are important to your grandfather, as well as his health and safety needs, and ask questions to ascertain if all of his needs can be appropriately met in each facility you visit. 

Remember, even after a relative has moved to a nursing home, you still need to be an active caregiver. Regular visits and a keen eye should help maintain the quality of his care. He will need you to advocate on his behalf and ensure his needs continue to be met in the best possible, least restrictive manner. If you encounter challenges or just need to process what you’re experiencing, the Alzheimer’s Association, NYC Chapter is available around the clock on our 24-hour Helpline: 800-272-3900.

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Matt Kudish, LMSW, is Vice President, Director of Education, Outreach and Caregiver Services at the Alzheimer’s Association, New York City Chapter. In this role, Matt oversees the Chapter’s 24-hour Helpline and Care Consultation programs, as well as comprehensive education and training initiatives throughout the five boroughs.

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