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

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.

"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.
• Skilled nursing facilities 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), such as memory care, 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.

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 can 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.