If your loved one is showing signs of dementia or Alzheimer’s, you might be wondering what’s next: How long can your parent safely keep living alone? How long can your mom care for your dad? The truth is there are no easy answers: age-related changes in memory affect everyone differently. Renowned expert Dr. Heather Palmer, National Director of Cognitive Well-Being for Amica, offers these guidelines to help families decide what’s right for them.
Safety
“I’d be evaluating if the parent is able to go about daily life in their environment in a way that’s not going to cause any harm or injury,” says Dr. Palmer. For example, can Mom manage the stove? If not, what safety precautions have been put in place to enable her to freely come and go from the kitchen and play a role in the cooking, but not be in danger? Safety factors in every room should be considered when evaluating when is it time for Mom to move,” says Dr. Palmer.
Wandering
Is Mom waking at 3 a.m. and going out? It is common for people with dementia to confuse day and night, so it is possible that at 3 a.m. Mom thinks it is 3 p.m. and she feels a need to pick up children from school. “We often see this type of wandering and exit-seeking in our residences, so it is likely occurring in the home environment as well,” says Dr. Palmer. “When a resident is feeling anxious because he believes he is late for work, our team members know how to offer support by safely redirecting and reassuring.
Eating
Is your parent getting proper nutrition? Families often prepare meals for their parent but is anyone checking to if see Dad can safely heat the food, is actually eating it or can tell if it has gone bad? “Eating habits in someone with dementia can change quickly,” says Dr. Palmer. That may include not feeling hunger, forgetting to eat or changing taste preferences. Others may require ongoing prompting because of confusion around how to use utensils. Since dining at a memory care residence happens in a nice dining room with other people for company and a variety of delicious foods prepared by chefs and served by friendly staff, don’t be surprised if your loved one starts eating twice as much!
Socializing
When someone is very comfortable in their home there is a greater tendency for them to “not bother” going out. If that is the case, how are social opportunities being maintained? Is someone visiting every day? Is the person getting out with friends or are they waking up and staying home with very little interaction? Research consistently points to the importance of social interaction in terms of slowing cognitive decline. It’s tough to compete with a premium senior living residence, which caters to the needs of seniors with a variety of life enrichment activities.
Hygiene
Is your loved one able to brush their teeth, comb their hair, bathe, etc.? If they’re living with a spouse, is the spouse able to help? “If not, then a residence is staffed with people who are skilled at helping with those tasks,” says Dr. Palmer. Not only that, but at Amica, staff help according to the wishes of the resident and family, not according to a random schedule of when we want residents to wake, dress, bathe, etc. If a resident likes to sleep until noon or relax in a bath before dinner, we will happily make those preferences happen.
Caregiving Services
If there’s not a capable spouse at home, does your parent have a caregiver coming in, whether privately or government-funded? Perhaps you’ve progressed to six hours a day of help with shopping, cleaning, cooking and other tasks. Are you comfortable with Mom alone for 18 hours a day? “If you’re looking at bringing in someone 24/7,” says Dr. Palmer, “the benefit is you’re keeping your parent in a familiar setting, but you need to evaluate if quality of life is being sacrificed. You’d need a very special, very skilled caregiver to compare with the level of expertise in wellness, life enrichment, fitness and dining that your parent would experience in a premium memory care residence.”
Family
One of the biggest signals it’s time to move is the impact on family. Is supporting and caring for your mom or dad becoming a significant challenge to your personal life and your family? Are you struggling to manage everything? As a result, is the quality of your relationship with your parent negatively affected? “At a residence, we take care of those everyday chores so the time you spend with your parent is happy and enjoyable,” says Dr. Palmer. If moving would benefit the parent with dementia, it will also benefit a spouse who may be working overtime as a primary caregiver.
Diagnosis
"I personally think it’s time to explore moving and dropping the idea into conversations when you know there’s a diagnosis or a likelihood that the person is in decline,” says Dr. Palmer. “Too many people wait until they’re in crisis before moving to memory care. Having your parent cognitively involved in the process is always going to be better. Not only does this allow them to play a part in the decision-making, it increases the likelihood they will have the cognitive resources to learn about their new environment and adapt to it.”
Dr. Heather Palmer is a cognitive aging and dementia specialist with more than 30 years of clinical and scientific experience. She focuses on helping individuals improve the way they think, feel and function. As Amica’s National Director of Cognitive Well-Being, she develops cognitive well-being programs for Amica with a heightened focus on memory care and assisted living.
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