Choosing an assisted living facility for your loved one with dementia is not simply a matter of finding a facility that's closest to you or that you can afford. Facilities differ greatly in their skills and abilities to manage residents with dementia, and there are several key factors that will help you decide which facility may be the best for you and your loved one.
Once you've determined that assisted living is the right setting for your loved one, you need to decide what factors are important in deciding on one or another. (To see the options in your area, check out the Assisted Living Federation of America.)
Expertise With and Awareness of Alzheimer's Disease
Even though the Alzheimer's Association notes that at least half of assisted living residents age 65 and older have Alzheimer's disease or other type of dementia, many facilities don't seem to appreciate how much it is within their midst. They may have no experience with or plans to deal with wandering, agitation, aggression, sundowning, or other behaviors that require structure, distraction and redirection.While activities and social opportunities for residents are important, they won't help much if your loved one is unable to make heads or tails of the daily schedule of events. Even though the facility may have a "secure dementia unit" within the building, it doesn't necessarily imply that that unit is properly staffed with educated professionals who understand how to work with residents with dementia to maximize their quality of life.
Medication and Medical Needs
The more your loved one has medical problems and takes medications, the more you need to be convinced the facility can meet her needs. In some states, the laws are vague regarding which staff may administer medications, and even the requirement for nurses being available in the building at all times varies by state and by facility. Since most assisted living facilities were conceived and are still marketed as social environments geared toward wellness, they are often ill-suited to residents with dementia. Cocktail hours, swimming pools and resident council meetings may seem impressive at first glance, but they may be there only to benefit the residents without dementia.
Depending on your situation, it may be important that the facility have a relationship with a mental health or dementia care provider to see individual residents or help the facility with dementia education. Similarly, some facilities have a designated primary care physician who provides on-site medical visits at a specified time each week.
Individualized Care and Flexibility of Facility
No facility or staff member is perfect, but there really are major differences in how accommodating and flexible they are in meeting your needs and those of your loved one. Rigid thinking by the staff and a chaotic, unrelaxed environment are red flags, as they are not usually conducive to the changing and unpredictable needs of a person with dementia. Some questions to ask: If a resident would benefit from a companion that you hired privately for a few hours a day, would the facility be okay with that? If your mother wanders out of the building, will a comprehensive assessment be done to determine the reason and to implement a plan with better safety precautions?
Five Questions To Ask In Your Search for an Assisted Living Facility
- What specific training do the staff receive in dementia care?
- What are the activities available and are they supervised?
- What is the availability of cognitive and psychiatric assessments in your facility?
- What is your facility's policy/culture about transfer to a nursing home as my loved one's dementia worsens?
- Which staff will administer medications, and how do you handle medical problems when they arise?
