What to know about care homes for people with dementia

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A 2020 analysis suggests that people with moderate or severe dementia may require care within a nursing facility if their symptoms become severe or if a caregiver is facing burnout.

Signs that may indicate someone with dementia requires a care home or additional support include:

• hygiene issues, which may include not bathing or a decline in grooming or personal hygiene
• leaving appliances on unattended, such as a stove
• forgetting to take any medications
• refusal to seek medical help for significant health issues
• forgetting to eat or drink
• unable to dress themselves properly or wear clothing appropriate for the weather
• unable to keep up with everyday tasks, such as housekeeping
• wandering or getting lost
• confusion

The Alzheimer’s Association recommends that people consider whether the health and safety of the person with dementia is at risk.

Additionally, if someone with dementia is feeling isolated, a care home may provide a more social setting for them, with regular structure and interactions with staff or other residents.

Consider the caregiver

It is important to consider the primary caregiver’s needs. It may be time to consider additional support, such as a care home, if a caregiver can no longer cope with the demands of care or if they feel:

• exhausted
• resentful
• consistently stressed by the necessary level of care

If a person with dementia cannot decide about their care themselves, it may fall to family members or caregivers.

The National Institute on Aging recommends people talk with the person with dementia and try to accommodate their preferences as much as possible.

Individuals with dementia will need to name a power of attorney for healthcare and finances. This allows the assigned person to make decisions on their behalf around medical care and financial issues.

Care homes are long-term care facilities where people with dementia can live and receive support services. Types of residential care for those with dementia may include:

• Assisted living facilities: These may be suitable for people with early stage dementia. They generally offer housing, meals, healthcare, and support services.
• Nursing homes: A nursing home will provide 24/7 care and long-term support, including medical care, nutrition, and recreation.
• Memory care units: These specialize in providing dementia care and may form part of residential care communities.
• Life plan communities: These facilities offer varying levels of care, ranging from assisted living to nursing home care, allowing a person to transition to different levels of care if their requirements change.

According to the Alzheimer’s Association, the cost of live-in care facilities may differ. However, they provide the following national averages for long-term care:

• Assisted living, basic services: $57,289 per year
• Nursing home, semi-private room: $100,679 per year
• Nursing home, private room: $115,007 per year

In most cases, families will cover the cost of long-term care themselves, although some people may be eligible for long-term care insurance, Veterans benefits, or Medicaid.

Medicare covers short-term care following a stay in the hospital but does not include the costs of residential care.

Alzheimers.gov provides information on schemes that may help people find and receive financial support for dementia care services.

People with early stage dementia may be able to continue looking after themselves at home if they can still carry out their everyday activities.

In-home care may be suitable for those who require extra help with activities of daily living, such as bathing, using the toilet, eating, and mobility, such as moving from a bed to a chair. In-home care services can also provide medical care and companionship.

The average cost of home care may be around $28.64 per hour for a nonmedical health aide or $1,145 per week for 40 hours of care. Adult day services may cost around $83 per day.

One of the key differences between a care home and in-home care is that a care home can provide 24-hour supervision and care.

In the middle and advanced stages of dementia, people may require around-the-clock care to keep them safe and provide more intensive care.

Tips for supporting the transition into a care home include:

• telling the person about the move close to or on the day of the move to reduce anticipation anxiety
• telling the individual this is a short-term move until they become more familiar with their new home
• coordinating with care home staff to provide the same messages and reassurance
• talking with a doctor about using anxiety medication to ease the move
• decorating their new space with familiar, comforting objects, such as photos or books
• waiting a few days before visiting to allow the person to settle in

It is important that caregivers take the time to look after their own mental and physical health when supporting someone with dementia.

This may involve taking time out of the regular care routine to rest and relax, such as exercising and spending time outdoors or with friends.

Support is also available for the practical side of deciding to help someone transition to a care home. The following resources may be helpful:

• finding dementia care and local services
• planning for care costs
• find a respite provider

If a person with dementia is having difficulties taking care of themselves and requires a higher level of care than in-home care, a care home may be necessary.

Care homes may include assisted living, memory care units, or nursing homes. They can provide ongoing support, including meals, help with medication, and recreational activities.

Caregivers may be able to encourage a smooth transition by coordinating with care staff to ensure consistent messages, speaking with a doctor about anxiety medication, or decorating the person’s care home space with familiar items.