Care Options for Alzheimer's Patients

Things to consider when it comes to providing care for the person with Alzheimer's disease.

As Alzheimer's progresses, people usually need more care and support. It is a good idea to consider all the options carefully before the situation reaches crisis point.

If a person with Alzheimer's is assessed as being in need of certain services, social services may be able to help provide these. Services vary from area to area but range from meals on wheels or day care, enabling the person to stay in their own home, to care in a nursing home. The views and preferences of the person receiving services should always be taken into account.

Even if it is concluded that the person's needs are not yet urgent enough to receive help from social services, an assessment will give everyone clearer information about the situation and the kinds of help available from other sources.

Local voluntary organizations, such as the Alzheimer's Association, are a source of further information, advice and practical help.

Thinking it through

Once everyone is aware of the services available, a decision can be made about whether the person can remain in their own home with additional support or whether they would prefer to move into sheltered housing or a nursing home, for example.

You may also want to consider the financial implications of the options available. Social services should be able to give you an idea of the costs of the various services that are arranged through them.

It is important not to rush into a decision. You might also want to talk to friends and relatives, other caregivers or your local Alzheimer's Association branch.

Alzheimer's and Help at home

If the person with Alzheimer's is staying in their own home, there are a number of points to consider:

• Benefits. Check that all benefits are being claimed. Extra benefits for the person with Alzheimer's or their caregiver can make a great difference.
• Equipment. Would equipment such as a raised toilet seat, a walking frame, a gas detector or a memory board make it easier for the person to stay in their own home?
• Adaptations or repairs. Adaptations such as a wheelchair ramp, a specially designed shower, improvements to the heating system or basic repairs might enable the person to remain at home.
• Practical help. Would meals on wheels, help with shopping, cooking or other domestic tasks, or assistance with bathing or dressing make a difference? Ask social services whether they can arrange these services or put you in touch with an appropriate organization. Speak to your doctor if nursing care is needed at home.
• Company and breaks for caregivers. Would a befriending scheme, home care service, day care or respite care be helpful? Again, ask social services whether they arrange these services.

If social services are unable to arrange appropriate help, find out what services other organizations can provide. Ask at your local library or the United Way or at a local Alzheimer's Association group.

The Alzheimer's Association publishes helpful information sheets about help at home and what to look for when making your own arrangements.

Social services may have a list of local private home care agencies.

Alzheimer's and Assisted living accommodations

You may wish to consider assisted living accommodations. This enables people to continue to live independently but with the reassurance that help is at hand. It may be suitable for some, but not all, people with Alzheimer's. However, any move to new surroundings is likely to increase confusion and most assisted living place do not offer the constant monitoring and support available in a nursing home. Talk through the pros and cons with professionals involved in Alzheimer's care as well as with family and friends.

There are many different types of assisted living accommodations, both to rent and to buy. The support offered ranges from just getting prepared meals to part-time nursing care.

No matter what you decide on it's important to carefully check the financial and legal implications before settling on an option.

It may be agreed that the best option is a move into a home providing residential or nursing care. Whether a person with Alzheimer's needs residential or nursing care depends on the degree of their Alzheimer's and on any other illnesses and disabilities.

Most community homes offering residential care are run privately or by voluntary organizations. Most nursing homes offering nursing care are also run privately or by voluntary organizations. Some homes are able to provide both residential and nursing care.

Residential care for Alzheimer's Patients

Most residential homes (group homes) provide personal care for the residents who need it. This might include help with dressing, washing, going to the toilet and taking medicine. If you are considering a residential home, find out whether suitable care can still be offered if the person with Alzheimer's becomes more confused and dependent. A move to another home can be very upsetting.

Nursing care for Alzheimer's Patients

Nursing homes always have a trained nurse on duty and can offer 24-hour nursing care in addition to personal care. Nursing care may need to be considered if the person with Alzheimer's is very confused and frail, has difficulties walking, has other illnesses or disabilities or is doubly incontinent, for example.

Sources:

• Early-Stage Alzheimer's Disease: Fact Sheet, Family Caregiver Alliance, Revised 1999.
• Making Hard Choices, Respecting Both Voices: Final Report, Feinberg, L.F., Whilatch, C.J. and Tucke, S. (2000). Family Caregiver Alliance, San Francisco, CA.
• Alzheimer's Society - UK, Information Sheet 465, March 2003.