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Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care


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Decision Point

Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

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Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?

Get the facts

Your options

  • Care for your relative at home. Some caregivers also may want to think about part-time care at home with a health aide or a nurse or in an adult day care.
  • Move your relative into a nursing home or other long-term care.

Key points to remember

  • People with Alzheimer's or other dementia need a safe, structured environment. You may be able to provide this at home. In other cases, long-term care in a center is a better choice.
  • People with dementia usually need more and more care as time goes by. At some point, your relative will most likely have to be moved to a long-term care center.
  • A care center may offer your loved one some people to talk to plus activities and outings. These social contacts may keep him or her active for as long as possible.
  • Caring at home for someone who has dementia takes a lot of time and work. It also costs money if you hire part-time help. Caring for a loved one at home also may take time away from other areas of your life. Every family has different needs and limits to think about.
  • By using adult day-care programs and part-time help-whether hired or through family and friends-you may be able to keep your loved one at home longer.
  • Remember that your own health, both physical and emotional, is as important as that of the person you're caring for.
  • Deciding to move your relative into long-term care is not a sign of failure in your role as caregiver.
FAQs

What happens as Alzheimer's disease or other dementia gets worse?

The care a person needs increases as the disease gets worse.

  • Basic activities such as eating, dressing, bathing, using the bathroom, and simply moving around become harder or impossible without help.
  • Safety is a concern. Your loved one may be more likely to have an accident or to wander from home.

Taking care of the person at home often becomes too hard on your body and your emotions. Your loved one's behavior can be frustrating or dangerous. He or she may get angry or abusive. These behaviors are often the biggest challenge for caregivers.

What kinds of long-term care are available?

"Nursing home" is commonly used to refer to any long-term care, but there are several kinds of centers. Each provides different levels of medical care, help with daily living, programs, and support. The quality and costs of care and services vary widely. Your community may not have all of these choices.

  • Assisted-living centers usually provide private, apartment-style housing and offer a range of services. These services may include meals, cleaning and laundry services, and help with personal needs such as bathing, grooming, and dressing. Assisted-living centers do not provide medical care. This type of housing may be a good choice for people who have early, mild Alzheimer's disease or another dementia and can't live alone but who can still do many daily tasks on their own.
  • Residential care-which includes board-and-care homes, retirement homes, and foster-care homes-usually provides a greater level of supervision than assisted living. These centers offer community-style housing, meals, laundry and cleaning services, and help with other personal needs. They do not provide daily medical care. This kind of care may work well for a person with mild to moderate Alzheimer's disease or other dementia who needs daily help and supervision but doesn't need daily nursing care. These centers don't cost as much as nursing homes.
  • Nursing homes provide skilled nursing care up to 24 hours a day. They offer medical care; medicines; housing; meals; laundry; help with dressing, bathing, and using the toilet; and other support. This is the most costly type of care in a center. But it may be the best choice for many people who have advanced dementia.
  • Special care units (SCUs) are offered at some residential care centers and nursing homes. They focus on the needs of people with dementia. They have staff trained to work with people who have dementia. Studies haven't yet shown that these units are better than regular centers. Also, they can cost more than other types of care.
  • Continuing-care communities offer several levels of care. They offer assisted living up to full nursing care in the same place. These centers cost a lot. But they may be a good choice, because they can meet the person's changing needs.

You also could provide around-the-clock home care with health professionals. This option costs more than a nursing home. You would have to hire, supervise, and work with a team of caregivers.

What are the choices for part-time care?

Some people find that part-time help allows them to keep their relative at home for a longer time. Part-time care may take place either at home or in an adult day care.

As in long-term care centers, home care can provide whatever help a person needs. For example, a home health aide can help the person bathe and wash clothes and linens. A nurse can give medical care and help with behavior issues.

Adult day care and respite services take care of the person so that the regular caregiver can take a break. This may relieve some of the stress of caregiving.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Move your loved one into long-term care Move your loved one into long-term care
  • Your loved one lives in a care center. You can visit as much as you want.
  • The type of care you choose depends on whether your loved one can still take care of his or her daily needs and on what the family can afford.
  • Your relative has personal care, meals, and other needs met.
  • In a nursing home, your relative also can get medical care.
  • A care center may have activities and social outlets to keep your loved one involved and happy.
  • Staff members are trained to help people keep up their mental skills as much as possible.
  • You may be able to focus on your relationship with your loved one, not on his or her daily care.
  • You may feel guilty if you think that you should be caring for your loved one.
  • You won't know how he or she is doing at every moment of the day or be able to make sure that he or she is treated well.
  • Care at a nursing home or other center can cost a lot.
Care for your loved one at home Care for your loved one at home
  • You take care of your loved one's needs at home. This may mean helping with cooking, eating, going to the toilet, bathing, and dressing.
  • You need to be able to make sure your loved one is safe from accidents and can't wander from your home.
  • You may be able to get part-time help with a home health aide, adult day care, or respite care.
  • You can be sure that your relative is okay at all times.
  • You can spend more time with your relative.
  • Care at home costs less than at a center.
  • You may feel that your loved one will be happier at home.
  • Caregiving can be very hard on your body and your emotions.
  • You may have little time for yourself.
  • Your loved one may not be safe if you can't provide constant supervision.
  • Your loved one may have other health problems that need more care than you can give.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Read More
close

Personal stories about moving a relative with Alzheimer's or other dementia into long-term care

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I had always told myself that I would never place my husband George in a nursing home, and I kept him at home as long as I possibly could. But he started getting aggressive, throwing things and threatening me and other people who came to visit. His doctor gave us some medicine, but it didn't seem to help much. In the end, it just seemed too dangerous to keep George at home. I was afraid he would hurt himself or maybe hurt me, even though I know he didn't know what he was doing.

Louise, age 66

My husband and I thought about putting my mom in a care center, but we've decided to keep her here with us for now. We visited several different facilities, but we couldn't find one nearby that we felt comfortable with. If my mom were in a nursing home, I would probably spend so much more time worrying about her that it just wouldn't be worth it. Fortunately, we can afford to hire some part-time help so that we have time for work and other activities. I'm not sure we could keep doing this without that help.

Elizabeth, age 51

My dad was diagnosed with Alzheimer's disease several years ago. For most of the time since then, he's been living with my wife and me and our kids. Taking care of him is a lot of work, and we don't have any other family nearby who can help out. And with our jobs and the kids and other responsibilities, we just can't give him the level of attention he needs. I think he'll get better care in a facility than we can give him here.

Jeff, age 49

As long as Howard doesn't get violent, I plan to keep him at home with me. Some days it's really hard, and I think to myself, "Am I really making a difference here? Would he even realize it if he were living somewhere else?" He's still my husband, though, and I know he would do the same thing for me if the shoe were on the other foot. I just wouldn't feel right letting other people take care of him.

Marianna, age 65

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to move your loved one into long-term care

Reasons to care for your loved one at home

My relative has several health problems that need care.

My loved one has mild Alzheimer's but no other health problems.

More important
Equally important
More important

I can't give my loved one constant supervision.

I am able to give my loved one constant supervision.

More important
Equally important
More important

I don't mind having other people care for my loved one.

I don't feel right about other people taking care of my loved one.

More important
Equally important
More important

My loved one and my family can afford a care center.

My loved one and my family can't afford a care center.

More important
Equally important
More important

My own health and family life are suffering because of caregiving.

I'm able to take care of my needs and my family's needs.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

A care center

Home care

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Do all people with Alzheimer's or other dementia need to move to a care center?

  • YesSorry, that's not right. People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.
  • NoThat's right. People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.
  • I'm not sureIt may help to go back and read "Key points to remember." People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.
2.

Do care centers offer different types of care with varying quality and costs?

  • YesThat's right. Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.
  • NoNo, that's not right. Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.
  • I'm not sureIt may help to go back and read "Get the Facts." Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.
3.

Can part-time help or respite care help you keep your loved one at home longer?

  • YesThat's right. Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.
  • NoSorry, that's not right. Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.
  • I'm not sureIt may help to go back and read "Get the Facts." Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Credits

Credits
CreditsHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerPeter J. Whitehouse, MD - Neurology
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the facts

Your options

  • Care for your relative at home. Some caregivers also may want to think about part-time care at home with a health aide or a nurse or in an adult day care.
  • Move your relative into a nursing home or other long-term care.

Key points to remember

  • People with Alzheimer's or other dementia need a safe, structured environment. You may be able to provide this at home. In other cases, long-term care in a center is a better choice.
  • People with dementia usually need more and more care as time goes by. At some point, your relative will most likely have to be moved to a long-term care center.
  • A care center may offer your loved one some people to talk to plus activities and outings. These social contacts may keep him or her active for as long as possible.
  • Caring at home for someone who has dementia takes a lot of time and work. It also costs money if you hire part-time help. Caring for a loved one at home also may take time away from other areas of your life. Every family has different needs and limits to think about.
  • By using adult day-care programs and part-time help-whether hired or through family and friends-you may be able to keep your loved one at home longer.
  • Remember that your own health, both physical and emotional, is as important as that of the person you're caring for.
  • Deciding to move your relative into long-term care is not a sign of failure in your role as caregiver.
FAQs

What happens as Alzheimer's disease or other dementia gets worse?

The care a person needs increases as the disease gets worse.

  • Basic activities such as eating, dressing, bathing, using the bathroom, and simply moving around become harder or impossible without help.
  • Safety is a concern. Your loved one may be more likely to have an accident or to wander from home.

Taking care of the person at home often becomes too hard on your body and your emotions. Your loved one's behavior can be frustrating or dangerous. He or she may get angry or abusive. These behaviors are often the biggest challenge for caregivers.

What kinds of long-term care are available?

"Nursing home" is commonly used to refer to any long-term care, but there are several kinds of centers. Each provides different levels of medical care, help with daily living, programs, and support. The quality and costs of care and services vary widely. Your community may not have all of these choices.

  • Assisted-living centers usually provide private, apartment-style housing and offer a range of services. These services may include meals, cleaning and laundry services, and help with personal needs such as bathing, grooming, and dressing. Assisted-living centers do not provide medical care. This type of housing may be a good choice for people who have early, mild Alzheimer's disease or another dementia and can't live alone but who can still do many daily tasks on their own.
  • Residential care-which includes board-and-care homes, retirement homes, and foster-care homes-usually provides a greater level of supervision than assisted living. These centers offer community-style housing, meals, laundry and cleaning services, and help with other personal needs. They do not provide daily medical care. This kind of care may work well for a person with mild to moderate Alzheimer's disease or other dementia who needs daily help and supervision but doesn't need daily nursing care. These centers don't cost as much as nursing homes.
  • Nursing homes provide skilled nursing care up to 24 hours a day. They offer medical care; medicines; housing; meals; laundry; help with dressing, bathing, and using the toilet; and other support. This is the most costly type of care in a center. But it may be the best choice for many people who have advanced dementia.
  • Special care units (SCUs) are offered at some residential care centers and nursing homes. They focus on the needs of people with dementia. They have staff trained to work with people who have dementia. Studies haven't yet shown that these units are better than regular centers. Also, they can cost more than other types of care.
  • Continuing-care communities offer several levels of care. They offer assisted living up to full nursing care in the same place. These centers cost a lot. But they may be a good choice, because they can meet the person's changing needs.

You also could provide around-the-clock home care with health professionals. This option costs more than a nursing home. You would have to hire, supervise, and work with a team of caregivers.

What are the choices for part-time care?

Some people find that part-time help allows them to keep their relative at home for a longer time. Part-time care may take place either at home or in an adult day care.

As in long-term care centers, home care can provide whatever help a person needs. For example, a home health aide can help the person bathe and wash clothes and linens. A nurse can give medical care and help with behavior issues.

Adult day care and respite services take care of the person so that the regular caregiver can take a break. This may relieve some of the stress of caregiving.

2. Compare your options

Move your loved one into long-term care Care for your loved one at home
What is usually involved?
  • Your loved one lives in a care center. You can visit as much as you want.
  • The type of care you choose depends on whether your loved one can still take care of his or her daily needs and on what the family can afford.
  • You take care of your loved one's needs at home. This may mean helping with cooking, eating, going to the toilet, bathing, and dressing.
  • You need to be able to make sure your loved one is safe from accidents and can't wander from your home.
  • You may be able to get part-time help with a home health aide, adult day care, or respite care.
What are the benefits?
  • Your relative has personal care, meals, and other needs met.
  • In a nursing home, your relative also can get medical care.
  • A care center may have activities and social outlets to keep your loved one involved and happy.
  • Staff members are trained to help people keep up their mental skills as much as possible.
  • You may be able to focus on your relationship with your loved one, not on his or her daily care.
  • You can be sure that your relative is okay at all times.
  • You can spend more time with your relative.
  • Care at home costs less than at a center.
  • You may feel that your loved one will be happier at home.
What are the risks and side effects?
  • You may feel guilty if you think that you should be caring for your loved one.
  • You won't know how he or she is doing at every moment of the day or be able to make sure that he or she is treated well.
  • Care at a nursing home or other center can cost a lot.
  • Caregiving can be very hard on your body and your emotions.
  • You may have little time for yourself.
  • Your loved one may not be safe if you can't provide constant supervision.
  • Your loved one may have other health problems that need more care than you can give.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about moving a relative with Alzheimer's or other dementia into long-term care

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I had always told myself that I would never place my husband George in a nursing home, and I kept him at home as long as I possibly could. But he started getting aggressive, throwing things and threatening me and other people who came to visit. His doctor gave us some medicine, but it didn't seem to help much. In the end, it just seemed too dangerous to keep George at home. I was afraid he would hurt himself or maybe hurt me, even though I know he didn't know what he was doing."

— Louise, age 66

"My husband and I thought about putting my mom in a care center, but we've decided to keep her here with us for now. We visited several different facilities, but we couldn't find one nearby that we felt comfortable with. If my mom were in a nursing home, I would probably spend so much more time worrying about her that it just wouldn't be worth it. Fortunately, we can afford to hire some part-time help so that we have time for work and other activities. I'm not sure we could keep doing this without that help."

— Elizabeth, age 51

"My dad was diagnosed with Alzheimer's disease several years ago. For most of the time since then, he's been living with my wife and me and our kids. Taking care of him is a lot of work, and we don't have any other family nearby who can help out. And with our jobs and the kids and other responsibilities, we just can't give him the level of attention he needs. I think he'll get better care in a facility than we can give him here."

— Jeff, age 49

"As long as Howard doesn't get violent, I plan to keep him at home with me. Some days it's really hard, and I think to myself, "Am I really making a difference here? Would he even realize it if he were living somewhere else?" He's still my husband, though, and I know he would do the same thing for me if the shoe were on the other foot. I just wouldn't feel right letting other people take care of him."

— Marianna, age 65

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to move your loved one into long-term care

Reasons to care for your loved one at home

My relative has several health problems that need care.

My loved one has mild Alzheimer's but no other health problems.

More important
Equally important
More important

I can't give my loved one constant supervision.

I am able to give my loved one constant supervision.

More important
Equally important
More important

I don't mind having other people care for my loved one.

I don't feel right about other people taking care of my loved one.

More important
Equally important
More important

My loved one and my family can afford a care center.

My loved one and my family can't afford a care center.

More important
Equally important
More important

My own health and family life are suffering because of caregiving.

I'm able to take care of my needs and my family's needs.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

A care center

Home care

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Do all people with Alzheimer's or other dementia need to move to a care center?

  • Yes
  • No
  • I'm not sure
That's right. People who have dementia need a safe place. You may be able to provide this at home, especially early in the illness. In other cases, a care center is a better choice.

2. Do care centers offer different types of care with varying quality and costs?

  • Yes
  • No
  • I'm not sure
That's right. Care centers provide different levels of medical care, help with daily living, programs, and support. The quality and costs of care vary widely.

3. Can part-time help or respite care help you keep your loved one at home longer?

  • Yes
  • No
  • I'm not sure
That's right. Part-time help may help you keep your relative at home longer. You may use respite care or part-time care at home or in an adult day care.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerPeter J. Whitehouse, MD - Neurology
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Last Revised: November 9, 2010

Author: Healthwise Staff

Medical Review: Anne C. Poinier, MD - Internal Medicine & Peter J. Whitehouse, MD - Neurology


eMedicineHealth Medical Reference from Healthwise

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