Karen McPhail, RN, MSN
Choosing a Facility: Memory Care Versus General Assisted Living
Some point to consider.....
Does my family member need memory care or general assisted living? When is it time? How will I know? How is this going to be paid for? These are questions that are commonly asked by family members of those with cognitive impairments. This can be a stressful process for many and a variety of aspects need to be considered when looking into facilities and planning a move for a loved one:
1. The move needs to be for the long term. Ensure that you meet with an Elder Care Attorney to review finances and choose facilities that can meet both health and financial needs for your loved one. Planning is critical! Some financial situations will limit or narrow your choices slightly for the long term. If needing financial assistance down the road, consider facilities that can perhaps accommodate an auxillary grant / medicaid conversion. In addition, ensure that you are clear on the specifics of any long term care policies and facility contracts.
2. When is the right time to move? This depends upon the individual, home, and family situation.
A move to general assisted living may want to be considered for the following reasons:
- Primary caregiver health issues or burn out.
- Frequent falls or hospital re-admissions.
- Increasing custodial care that is not easily handled at home.
- Access to appropriate socialization and support opportunities.
- Issues with balance and frequent falls.
- Forgetfulness and mild memory loss.
- Health situations that require closer or more frequent monitoring
Key indicators that a timely move to memory care needs to be considered:
- Primary caregiver with (physical or mental) health issues and / or having burn out over care needs.
- Frequent turnover among private duty caregivers due to care needs or behavioral issues.
- Safety issues at home for those who are an abatement risk, etc.
- The inability to provide adequate care or attend to hygiene properly while at home due to behavioral issues or home situations that cannot be modified.
- Difficulty in managing frequent or worsening, behavioral issues.
3. Facility differences:
All assisted living facilities are a little different in terms of services and philosophy. However, In general assisted living, residents are provided with care assistance at a variety of levels in a more home like residential environment. Access to outings, social groups, exercise and art related activities and more can be of great benefit to those who have mild impairments. Some facilities will also internally offer memory care if needed later.
A memory care facility is a secure and safe environment for those with dementia and other cognitive impairments. In memory care the staff are extensively trained in dementia care and communication. They are well versed in how to manage, communicate, and redirect issues as they arise. Daily programming and routine will help to also provide security and comfort for your loved one. Care can be individualized to meet their needs long term especially if choosing a smaller memory care environment.
3. Should memory care be considered early on? This is a frequently asked question and the answer depends upon the individual and situation. I am someone who feels that earlier memory care placement for those with dementia can often times be beneficial for many clients and families. The reason for this is that the potential resident and family members begin to have a strong support system, set and effective care routines, and socialization and direct support early on. Many dementia clients and family members begin to withdraw socially when cognitive issues emerge. Even when offered supportive programs, many clients and families fail to access them. This is detrimental not only for the clients, but also for the family. Overtime the isolation and withdrawal distances them from normal life, routines, and those who once were available as a support. Dysfunctional patterns can sometimes emerge due to a lack of understanding of care needs on the part of caregivers. These patterns can then be difficult to modify or change. With earlier placement in a memory care center, effective patterns can be set in terms of resident care. Often times behavioral issues can be avoided or limited. I frequently see with early placement, a quicker adjustment, less behavioral issues and less anxiety emerging overtime. In addition, many of the frequently seen issues such as resistance to bathing, dressing, etc are navigated past successfully due to knowledgeable staff intervening and setting effective patterns and modifications to care plans. In addition, family members express more enjoyment in terms of time with their loved one as they are given access to support and socialization, and taken out of direct care earlier, before fatigue and other issues emerge.
4. When looking at facilities think about the following:
What type of direct care does your loved one need? They may only need assisted living at this point, but may have more intensive care needs later. Choose a facility that can adjust and meet their needs as they change over time. Ask about rehab, end of life care and aging in place when considering a facility. Ask about how care levels are adjusted and also accommodated in staffing. If financial issues are a concern, consider those with access to assistance through a local program or through an auxillary grant/ Medicaid. Ask directly about the facility process for accessing assistance if needed.
5. If having difficulties navigating the system consult a Geriatric Care Manager or Care Advisor to assist in guiding you through the process and recommending facilities that may best meet your care and financial needs. Most long term care policies cover services for care managers / advisors.