Many people with early-stage dementia can live independently or with some in-home help, while some who have more significant cognitive decline may need assistance from trained professionals in memory care communities. But how do you determine when it’s time to seek extra help?
Many dementia symptoms vary by the day or even moment, making it difficult to know when your loved one requires the kind of support provided by these communities. Sometimes, you, the caregiver, need that extra support. It can be hard to determine when it’s time to ask for it — especially if that means moving your loved one into a memory care community.
Here are four questions to consider when trying to decide whether or not memory care is the next step for your loved one’s care plan:
Is your loved one showing signs of struggling with daily living activities, or are there behaviors or incidents that indicate their safety is at risk?
Caregivers should look for various signs that someone may be struggling with activities of daily living, particularly in the context of dementia. Ellen Finney, LMSW, Director of Memory Care at Inspīr Carnegie Hill, outlines some of those signs:
- Difficulty with personal hygiene, such as bathing, grooming, or changing clothes
- Forgetfulness related to taking medications or managing prescriptions
- Challenges with meal preparation, including forgetting to eat, overeating, or under-eating
- Confusion about the time, day, or location making it hard to plan or initiate daily activities
- Trouble with mobility, balance, or walking, increasing the risk of falls
“Ensuring the safety of individuals with dementia is paramount,” Finney adds. Some signs that a person’s safety may be at risk due to dementia include:
- Wandering or getting lost, even in familiar environments
- Leaving appliances or stove burners on without realizing it
- Misplacing items, such as keys or medications, leading to potential hazards
- Inappropriate or erratic behaviors, including aggression or agitation
- Neglecting personal safety, like wandering outside without proper clothing in extreme weather
What kinds of signs do doctors note when performing a mental status exam that could help determine if your loved one’s dementia is advanced enough to require memory care?
Gerontologist Dr. Macie P. Smith is a licensed gerontology social worker at SYNERGY HomeCare who focuses on helping families support their aging loved ones through long-term care. Specifically, Dr. Smith educates caregivers on how to care for seniors with dementia. She is an advocate for specialized care and assists others in finding a way to provide a better quality of life for individuals with Alzheimer’s or dementia.
Dr. Smith has dedicated over 22 years of her life to working in gerontology and assisting families in finding personalized solutions for dementia care. She explains how doctors can help families determine if their memory care could help a loved one.
“Dementia is marked by a persistent, disabling decline in two or more intellectual abilities such as memory, language, judgment, and abstract thinking,” she explains. “While Alzheimer’s is the main cause of dementia, there are still several other underlying factors that could be causing mental decline.”
Some of the other most prevalent causes of decline are strokes, which are the second leading cause of dementia, thyroid disorders, vitamin deficiencies, urinary tract infections, stress and anxiety, medication interactions, and more. Dementia is also prevalent in people living with Parkinson’s or diabetes.
Many medical causes of dementia are treatable, such as a urinary tract infection, a vitamin B12 deficiency, a thyroid imbalance, diabetes, medication interaction or side effects, depression, or even a traumatic event like a death in the family.
Doctors perform mental status exams to assess cognitive function and detect signs of cognitive impairment. Finney outlines some of the key signs they may note during such an exam:
- Memory problems, such as difficulty recalling recent events or information
- Disorientation to time, place, or person, indicating impaired spatial and temporal awareness
- Language difficulties, including word-finding problems or trouble understanding and expressing ideas
- Impaired judgment, reasoning, and problem-solving skills
- Changes in mood or behavior, such as emotional lability, apathy, or agitation
“These observations are crucial in diagnosing and managing dementia and ensuring that individuals with memory impairment receive appropriate care and support,” says Finney. “It’s essential for caregivers and healthcare professionals to work collaboratively to provide the best possible care for individuals with dementia.”
“Should the doctor suspect that your loved one has dementia, they may refer them to a neurologist for confirmation of that diagnosis,” Dr. Smith says. “A neurologist should be able to provide formal validation of the type of dementia your loved one might have. Be sure to ask for information and resources to help you gain a better understanding of the disease and its progression.”
What are some signs that caregivers are hitting burnout and could benefit from the caregiving support of memory care?
Caring for a loved one with memory-related issues can be both physically and emotionally exhausting. Dementia patients often need regular, hands-on assistance with activities of daily living like bathing and dressing and some form of basic supervision to ensure their safety once the disease progresses. In addition, caregivers for loved ones with dementia often need to display incredible levels of patience when dealing with many of the challenging behaviors that are typical of the disease.
“Caregiving can also be an isolating experience,” says Dr. Smith. “Family caregivers often sacrifice their own social lives, hobbies, and sometimes even their careers to maintain proper care for their loved one. By giving up these social outlets, a caregiver’s stress and depression can be amplified.”
All of these responsibilities create intense pressure on a family caregiver, as their loved one’s well-being often comes at the price of stress, anxiety, depression, sleep deprivation, and other health-related issues.
Dr. Smith says caregivers may be experiencing burnout if they are experiencing any of the following:
- Feel overwhelmed, pressured, or constantly worried
- Unable to focus
- Often feel tired
- Disruptions in eating/sleeping habits
- Become easily irritated or angry
- Lost interest in activities you used to enjoy
- Feel sad
- Have frequent headaches, bodily pain, or other physical problems
- Abusing alcohol or drugs, including prescription medication
“If you notice any of these signs, it may be time to consider respite care,” she says. “[Memory care] companies like SYNERGY HomeCare can provide help and a much-needed break. Our team of specially trained, professional caregivers provides compassionate care to clients across the country.”
If a caregiver or a family member does decide that memory care is the best option for a loved one, how can they make the adjustment easier?
Weighing the pros and cons can help you take the first steps toward making the right decision. You’ll want to consider the costs of a facility versus the expenses of adding safety and accessibility modifications to a home — as well as the increasing amount of time you’ll be dedicating to your loved one’s care as the disease progresses. A third option is to hire a professional in-home caregiver, which can also be expensive.
This article examines the upsides and downsides of each possibility so you can make an informed decision that will give your loved one an optimal quality of life.
Making the decision to move your loved one into assisted living is challenging enough — not knowing what comes next can make it feel even more overwhelming.
With a plan in place, you can make the transition as smooth as possible and
welcome this next step of the journey. Read this article, which provides a checklist of “next steps” for helping your loved one move to their new assisted living community.
Dr. Smith offers advice to help make any transition smoother for your loved one:
- Find a facility that focuses on person-centered care and takes cues from the person living with Alzheimer’s and develop a care plan that aligns with their interests.
- Minimize change in routine and people who interact with your loved one.
- Keep the environment simple and calming.
- Establish a predictable routine with them and stick to the routine so they know what to do next and won’t have to ask you over and over again. Allow your loved one to do familiar things.
- Give them appropriate choices and try not to control their decisions. Making decisions helps to promote independence.
Dr. Smith reminds families and caregivers that remaining in the home is a viable option for most people living with Alzheimer’s disease, provided there is caregiving support. “I think people would be surprised to know that many people living with Alzheimer’s do very well staying in their own home,” she says.
Families will need to be supportive and, at some point, will likely need professional assistance, whether assisting with ADLs (Activities of Daily Living) or simply providing family members with a break, otherwise known as respite care.
“Thankfully, we have learned so much more about these diseases and therapies have emerged to help. We use reminiscing, music therapy, robotic companion pets, and subscriptions to brain games,” she says.
