Dementia Care Getting You Down?

If you have an aging loved one who suffers from Dementia, you may have been seeing changes in their behavior for years--and adapting along with it. Maybe your loved one was a little forgetful at first, but now it's gotten worse. Remember, dementia is usually a progressive disease; it's going to get worse no matter how hard you try to prevent that. Perhaps your loved one doesn't sleep well, hides the mail or other household items, or often becomes angry or frustrated with you. You may feel you can't leave them alone for very long, or not at all. You may worry about their safety if left unsupervised.

The stress of caring for a loved one with dementia can lead to the caregiver's own battle with depression, anxiety, and withdrawal from normal life. If this sounds like something you are going through, please keep reading. I have some suggestions that might help.

I have been working with dementia patients and their families for many years, and the one thing I can say is universal is that the family care giver keeps on giving long past a point that is healthy for the care giver, often to the detriment of his or her own health. There's a lot of guilt and sadness around the changes that the care giver is witnessing. It is never too early to get some help from the outside. So let go of the guilt, NOW!

There are many options for caring for a loved one with Dementia.

1. Hire someone to come into your home. This could be on a part or full-time basis. The part time option often works well if you just need someone to give you a temporary break, and if you can manage the care the rest of the day or week. The full time option is always going to be the most expensive caregiving choice you might make. Twenty-four hour in-home care runs about $8,000-$10,000 per month if you go through a licensed staffing agency. Some people try to save money and hire caregivers directly (off Craigslist or by the newspaper). Be prepared to become your own staffing agency; you will have no-shows, call-outs, and disciplinary problems. You will not have any of the benefits of hiring a staffing agency such as applicant screening and verification. Most people give the direct method a try and eventually give it up for the reasons I just mentioned.
2. If you're ready to consider out-placement you have a range of options. Outplacement can be live-in or for just part of the day.
3. Adult Day Care Programs are a great way to give your loved one some extra structure and stimulation. A good adult day program will have staff who put on fun, interesting activities targeted at seniors with dementia. There will also be staff available to help with hygiene, safety, medications, and (in some programs) toileting. A meal and snacks may be served. Day programs do not provide sleeping accomodations and cost $35 to $60 per day.
4. Personal Care Homes (PCH) are state-licensed homes for seniors who are private pay or Medicaid. These homes provide around-the-clock care to a senior who cannot live safely alone. The senior receives help with bathing, dressing, grooming, toileting, medications, laundry, and meals. PCH's range in size from 2 to 200 beds; the average size is about 6-8 beds. PCH's are usually private residential homes which are owner-operated and whose care giving team lives in with the residents. These homes often charge $1900 to $5500 per month, making them the most cost-effective residential option. Many seniors prefer the smaller care home environment which offers a smaller footprint and thus makes it easier for mobility-challenged seniors to keep walking. PCH's usually boast the best staffing ratios--often half the ratio of the larger "big box" facilities. This can mean more attention for your loved one. Consider your loved one's medical stability, chronic illnesses, and other needs while researching PCH's. PCH's can be hard to find, as they are often located in residential neighborhoods with no sign or advertising. You can find a complete list of all licensed PCH's on www.NewLifestyles.com or you can do an internet search through the State's department of community health.
5. Assisted Living Communities (ALC) are the newest type of facility licensed in Georgia and are only available to private pay seniors. These facilities must be 25 beds or larger (typically 100 beds or more) and meet stringent fire/building codes. They are usually easy to find--they are in commercial areas with signs and big advertising budgets, and their corporate management structure means more standardization than you might typically find in a smaller PCH, but not always worth the extra cost. ALC's usually run $2500--$10,000 per month (the most expensive residential option available).
6. Nursing Homes are the most restrictive and expensive option available for seniors whose needs cannot be met anywhere else. Unlike ALC's and PCH's, Medicare does pay for nursing homes, after the senior has "spent down" their own resources. Nursing homes are usually 100% occupied, and finding an available bed can be difficult.

So often, I hear people say they only have social security to live on. You won't be able to afford residential care of any type on social security alone. If that's the case, you should apply for Medicaid for public supplemental assistance for a loved one's care. There are state programs (this will have to be another blog subject!) which are available to people who lack sufficient private resources. War Veterans are eligible for the Veteran's Aid and Attendance benefit (google it) which can provide almost $2000 per month for a senior's in-home or residential care. Make sure your loved one doesn't have a Long Term Care Policy in place which would pay for placement in any of the above options.

Call me if you have questions or need advice! We're always here to answer questions and point you in the right direction at www.ProvidenceAL.com  or 404-824-1008.