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Alzheimer's: when to move to a nursing home

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The symptoms of Alzheimer’s disease progress in three general stages: mild, moderate and severe.

As a caregiver, you will be able to provide support to your loved one up to a point, but the time will come when it becomes too much for you to manage on your own.

This is when the person with Alzheimer’s disease may be better cared for in a nursing home.

The ties that bind
A decision about the right time to move a loved one with Alzheimer's disease to a care facility is always challenging, especially if you promised to never place them in a nursing home.

The transition from homecare to an assisted-living community is, unfortunately, an inevitable one. A nursing home can provide the care that you aren’t trained to give.

So, while the thought of “strangers” caring for your mom, dad or partner may be unsettling, you would do well to remember that the move is in the best interest of your loved one.

Planning ahead
Start planning from the mild/early stage of the disease, when your loved one is still fully coherent. At this stage, they can be a part of the decision-making process and the selection of a care facility.

At this early stage, you can still provide home-care service yourself, which you can do with the help of one of the following three options:
• Respite care. This will involve family, friends and/or neighbours staying with your loved one when you need a break. You could also consider respite-care services from community organisations.
• Adult day centres. These centres focus on socialisation and activities, some of which are specifically designed for people with Alzheimer’s disease.
• Home health services. These services are centred on eating, bathing, dressing, grooming and assisting the patient in using a toilet. You could also enlist the help of an organisation that helps with meal preparation and household chores.

Stage-appropriate care
As time goes by, and your loved one starts to develop more prominent symptoms, you should consider your options. Note, however, that the disease affects each person differently. This is why you need to assess, together with your doctor, which type of assisted care is appropriate for your loved one.

Your options are as follows:
• Assisted living (also known as “board and care”, “adult living” or “supported care”). These facilities are ideal if your loved one needs support with personal care and daily activities, such as meal preparation, but doesn't need skilled medical care.
• Specialised dementia care facilities. These facilities offer highly specialised activity-based programming that would be great for a sufferer who needs memory care assisted living.
• Nursing home. This is your best option should your loved one need skilled medical care. They provide room and board and round-the-clock medical care and supervision with a special focus on people with Alzheimer's disease.

REMEMBER: Relocation to a care facility can be traumatic for the person with Alzheimer’s, especially in the severe stages of dementia, so place special focus on the transition. Meet ahead of time with the facility staff to discuss the best way to ease the patient into the transition. And, most importantly, be prepared for the call that the bed is available for your loved one. There usually is a long waiting list, and you wouldn’t want to miss the opportunity.
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