Alzheimer’s Caregiving: Finding Long-Term Care

Different types of long-term care facilities

Long-term care facilities are not one-size-fits-all. Facility-based long-term care services include assisted living facilities, group homes, and nursing homes. Some facilities offer only housing and housekeeping, but many also provide personal care and medical services. Many facilities offer special programs for people with Alzheimer’s or other types of dementia.

Learn about the different types of places to determine where the person with Alzheimer’s will feel most comfortable.

• Assisted living facilities. Assisted living facilities have rooms or apartments. They’re for people who may need some help with daily tasks but do not need around-the-clock care. Some assisted living facilities have special Alzheimer’s units with staff who check on and care for people with dementia. You must pay for the cost of the room or apartment, and you may need to pay extra for any special care. Some assisted living facilities are part of a larger organization that also offers other levels of care. For example, continuing care retirement communities offer independent living and skilled nursing care.
• Group homes. A group home is a home for people who can no longer care for themselves. Several people receiving care live in the home. At least one caregiver is on site at all times. The staff takes care of the people living there by making meals, helping with grooming and medication, and providing for other needs. These homes may not be inspected or regulated but may still provide high-quality care.
• Nursing homes. Nursing homes are for people who can't care for themselves anymore and may need ongoing medical care. Some nursing homes have special Alzheimer’s care units. These units are often in separate sections of the building where staff members have special training to care for people with dementia. Some units are designed with the goal of making the person feel more like they are at home. They provide special activities, meals, and medical care. Nursing homes are inspected and regulated by state governments.

Visiting facilities

Once you decide what kind of long-term care facility works for your loved one’s needs, choose a few places to visit. Talk with friends, relatives, social workers, or your religious community to find out what places they suggest. Check with health care providers about which nursing homes they feel provide good care. Call the facilities to learn more and to schedule visits.

Visit at different times of day and meet with the facility’s leaders to get a full understanding of how the facility works and treats the people who stay there.

Ask yourself:

• How does the staff care for the residents?
• Is the staff friendly?
• Does the place feel comfortable?
• How do the people who live there look? Are they clean and well cared for?
• Are mealtimes comfortable for people living there?
• Is the facility well-maintained? Does it look and smell clean?
• Do staff members speak to residents with patience and respect?

Ask the staff:

• What activities are planned for residents?
• How many staff members are at the facility? And how many of them are trained to provide medical
• care if needed?
• How many residents in the facility have Alzheimer’s?
• Does the facility have a special unit for people with Alzheimer’s? If so, what kinds of services does it provide? Are the costs for this unit different than those for the rest of the facility?
• Is there a doctor who checks on residents on a regular basis? How often?
• What is a typical day like for the person with Alzheimer’s?
• Is there a safe place for the person to go outside?
• What is included in the fee? What services or options would cost extra?
• How would my loved one get to medical appointments?

Talk with other caregivers who have a loved one at the facility. Find out what they think about the place. Ask about the total costs of care. Each facility is different, so you want to find out if long-term care insurance, Medicaid, or Medicare will pay for any of the costs.

If you're asked to sign a contract, ensure you understand what you are agreeing to.

Making moving day easier

Moving a person with Alzheimer’s to an assisted living facility, group home, or nursing home is a big change for both the person and their caregiver. You may feel many emotions, from a sense of loss and sadness to guilt or even relief. It is okay to have all these feelings. A social worker or someone from a private service may be able to help you plan for and adjust to this big change. It's important to have support during this difficult step.

Here are some things that may help:

• Know that the moving day can be very stressful.
• Talk to a social worker about your feelings about moving the person into a new place. Find out how to help the person with Alzheimer’s adjust.
• Get to know the staff before the person moves into a facility. Talk with them about ways to make the transition go smoothly.
• Be an advocate for the needs and preferences of the person with Alzheimer’s.
• Be supportive and listen to any concerns, but don't argue with the person with Alzheimer’s about why they need to be there.

Once the person has moved to their new home, check in regularly to see how they are doing. As the caregiver, you probably know the person best. Look for signs that they may need more attention, are taking too much or not enough medication, or may not be getting the care they need. Build a relationship with staff so that you work together as care partners.

You may also be interested in

• Learning more about long-term care
• Reading about ways to pay for long-term care
• Getting tips for how to take care of yourself as an Alzheimer’s caregiver