Nursing Homes for Dementia and Alzheimer’s

Nursing Homes for Dementia and Alzheimer’s Patients by Jennifer Adams, LMSW, CDP.

According to the Alzheimer’s Association, one in three seniors are diagnosed with some form of dementia, with the majority of those being Alzheimer’s Disease. What do you do when a loved one has been diagnosed with Dementia or Alzheimer’s? It is a diagnosis that causes fear, stress, and concern for the person diagnosed, and their family members. Also, with the diagnosis of dementia or Alzheimer’s disease comes a recognition that life is going to change drastically as the disease progresses. Dementia and Alzheimer’s can be devastating physically, emotionally, and financially for the one diagnosed, their family, and friends. With the looming changes ahead, the first thing to do is take step back for a moment and take a deep breath. Remind yourself that you are not alone, you will get through this, and so will your family. The next thing to think about are the many options available to families as they face this diagnosis. One of the most prominent options, to assist with the care of a loved one with dementia or Alzheimer’s disease, is a nursing home or retirement facility. When making the decision to place your loved one in a nursing facility for dementia or Alzheimer’s care, there are some things to contemplate. How do you know when it is time for a nursing home? What type of care will be provided at an Alzheimer’s care community? What are the benefits of memory care facilities? What are the negatives of placing a loved one with dementia in a nursing facility? What are the costs, and how can those costs be satisfied?

Is it time to consider a nursing home for dementia or Alzheimer’s?

It is never an easy decision to place your loved one in a nursing facility due to dementia or Alzheimer’s disease. The very thought of doing so can cause stress and anxiety, and often anger at the situation. Unfortunately, there comes a time when the care that can be offered privately no longer covers the needs of someone with dementia or Alzheimer’s. How do you decide when it is time? Taking an assessment of the situation will help determine when it is time. If you, as a caretaker, are struggling with stress, anxiety, or meeting the physical, emotional, and safety needs of your loved one, it may be time to consider seeking a safe place that can ensure your loved one with dementia or Alzheimer’s disease can receive the care they need. Common reasons for making the decision to move a family member to a memory care facility include:

1. Your loved one needs a higher level of medical care than is currently available.
2. Current caregiver is suffering emotionally, financially, or physically.
3. Your loved one with dementia or Alzheimer’s disease can no longer participate in physical or social activities safely.
4. Your loved one is exhibiting aggression physically or sexually toward others.
5. Your loved one is trying to harm themselves out of frustration, depression or confusion.
6. Your loved one can no longer be kept safe at home due to fall risks, paranoia or wandering.

This is an abbreviated list of reason to determine whether it is time to consider a facility for your loved one with a diagnosis of dementia or Alzheimer’s. The many reasons considered are as varied as the families that must reflect on the decision.

Types of dementia & Alzheimer’s care available

There are three types of care offered at most nursing facilities: Custodial, Intermediate and Skilled. Custodial care is the lowest level of care available. It consists of basic personal care managing normal daily activities such as bathing, dressing, and eating. This level of care is designed for older adults in the beginning stages of dementia or Alzheimer’s, or those in the beginning stages of early onset of dementia or Alzheimer’s disease. Intermediate care offers the same assistance for basic care, as well as periodic medical monitoring of blood pressure and glucose levels. This level of care can also include reminders to take medicines or medicine distribution. The intermediate care level offers the care your loved one needs when the dementia or Alzheimer’s disease begins to progress but hasn’t yet made them completely dependent on assistance. The final level is skilled care. This is specialized care provided by medical professionals trained to provide 24-hour medical care and supervision. Skilled care is the level of care a dementia or Alzheimer’s patient needs in the later stages of the disease. Trained doctors, nurses and nurse’s aides provide complete care at this point. It is important to note that nursing facilities are able and prepared to care for those with early onset of dementia as well. Age is not a factor in most memory care facilities.

Benefits of nursing homes for dementia sufferers

There are a multitude of benefits to placing your loved one with dementia or Alzheimer’s disease in a retirement home, and they should definitely be part of the decision-making process. Nursing homes offer 24-hour supervised care by specially trained staff that can provide the level of care necessary to each individual.  Every dementia patient is provided room and board in a private or semi-private room at a safe, secure premises. Depending on the nursing home, some offer a lock down unit, known as an Alzheimer’s special care unit, to ensure that your loved one with dementia cannot wander off.  Your loved one will get to participate in social and physical activities in a safe and monitored environment. Some facilities even offer “field trip” activities for the residents of their center, although those with later stages of dementia or Alzheimer’s disease may not be allowed to participate for safety reasons. Customized care, nutrition, medical, and spiritual planning are available to care for the needs of each patient, with many activities and programs specifically designed for older adults with Alzheimer’s or dementia. Many nursing homes also offer therapy for individual needs. These therapies can consist of cognitive, physical, music, art, and pet therapies. These necessities and amenities are available and are provided to ensure that your loved one is getting the level of care they need, while maintaining their quality of life.

Reasons against choosing a nursing home for Alzheimer’s patients

It would be irresponsible to make a decision without considering the potential negative aspects of placing your loved one in a nursing facility. One of the biggest cons of a nursing facility is the cost. The costs associated with long-term care for those with dementia and Alzheimer’s can be staggering and increase as the disease progresses and additional levels of care are needed. In addition to cost, level of care can be a concern for dementia and Alzheimer’s patients. Depending on the facility and its staffing situation, some residents may be subjected to substandard care. No one will be as motivated to care for someone as a family member. Unlike residents without this disease, residents with dementia or Alzheimer’s disease may not have the mental constitution to hold staff members accountable for actions. That, combined with low staffing levels has, in the past, contributed to some of the horror stories presented on news channels nationwide. A loved one placed in a nursing home will experience some loss of freedom and independence. This can lead to emotional fallout for the resident. The adjustment to being placed in a nursing home can cause feelings of loneliness, depression, and abandonment. This may be amplified for those with dementia or Alzheimer’s disease, as they may not have a full understanding of what is happening or why. It is very important to keep an eye on the emotional well-being of your loved one in the first few months after placement. Finally, the declining emotional welfare can cause faster cognitive deterioration for dementia and Alzheimer’s patients. If you notice any signs of depression or emotional changes, talk to the medical staff and work towards developing a plan to minimize the adjustment period and the effects that come with it. 

How much do nursing homes for dementia and Alzheimer’s patients cost?

One of the most heavily considered elements of the decision-making process in regards to placing a loved one with dementia or Alzheimer’s disease in a nursing home is the cost. Providing 24-hour care at any level is expensive, and the more care a dementia patient needs, the more expensive that care is. The costs for care can vary based on level of care needed, the facility and location. Typical costs fall between $2,525 and $5,745 monthly with an average nationwide cost of $3600 per month. The price of care is 81% more for those with dementia and Alzheimer’s than for those in need of care at a facility without these diseases.

It is estimated that 2018 will see nearly $277 billion dollars spent on long term care for those diagnosed with dementia and Alzheimer’s disease. Of that $277 billion, $186 billion will be covered by Medicare and Medicaid, while $60 billion will be covered by out-of-pocket payments. The final $30 billion will be covered by private insurance, state programs, and VA programs.

With these staggering prices, how can the costs be covered for the care a dementia or Alzheimer patient needs? There are several ways to cover the costs, but not all options work for all families. The most common way of covering the costs associated with dementia care is to use Medicaid. Nearly 50% of dementia and Alzheimer patients use Medicaid to cover all or part of the expenses of long term care at nursing facilities. It is important to note that eligibility for Medicaid varies from state to state. Medicare will cover partial costs for up to 100 days following an eligible hospitalization, but will not cover all costs, and will not cover long-term care. Long-term care insurance is also an option to cover Alzheimer’s care at a nursing home for those who have planned ahead. This type of insurance provides the most coverage when it has been purchased well in advance of need. There are some long-term care insurance plans that will even transfer to a life insurance policy if not needed for their intended purpose. For members of the armed services, VA benefits or the FLTCIP will assist with the exorbitant price of long-term care for those with dementia or Alzheimer’s disease. The Federal Long-Term Care Insurance Program is designed to assist members of the armed services that meet the eligibility and enrollment requirements. The FLTCIP will provide coverage for care not linked to injury in action as well. Some private insurances will cover partial costs of the care needed, however, it is important to pay attention to listed lifetime limits and exclusions in the insurance agreements. Private pay is also an option for some families of dementia and Alzheimer’s disease patients. Family members and friends can assist in covering the costs by donating money, selling assets, and borrowing from retirement plans. Several states offer additional programs and grants to assist in paying the costs of long-term care for dementia and Alzheimer’s disease. These are typically made available to families and individuals with low incomes.

According to the Alzheimer’s Association, one in three seniors are diagnosed with some form of dementia. That means 33% of the population will be required to face this disease and its various forms, and make the difficult decisions that come with it. It is a progressive and devastating ailment with no cure, and the needs of the person diagnosed will change as the dementia or Alzheimer’s advances. Many families afflicted by it will have to consider care in a nursing home or memory care facility at some point during the progression of the illness. It is important to remember that you are not alone. You have options. Research all of your options before making a decision; there isn’t a single decision that will be right for everyone faced with dementia or Alzheimer’s disease. Make the one that is right for you and your family. There are multiple long-term care options including nursing homes and retirement facilities that can provide a safe, secure environment with complete care and assist in maintaining a quality of life for your loved one with Alzheimer’s or dementia.

About the author:

Jennifer Adams received a Master’s Degree in Social Work from the University of Denver and currently lives in Boulder, Colorado. Jennifer frequently contributes to online blogs and publications on topics that relate to dementia, Alzheimer’s disease and caregiving. As part of her on-going quest for learning, Jennifer also received a Certified Dementia Practitioner certification by NCCDP as well as EssentiALZ certification by the Alzheimer’s Association.