Making the Decision about Facility Care

by Jeff Hamm

The decision to move a loved one with Alzheimer’s or dementia into facility care can be a very difficult one to make for care partners and families. One longtime Alzheimer’s & Dementia Alliance of Wisconsin client and frequent volunteer shared that he remembers two dates vividly: the day he and his wife were married and the day he placed her in facility care. Caregivers frequently struggle with guilt, regret, anger, fear, and sadness throughout the process.

There’s no consistent or standard right time for a move. The timing depends on individual circumstances, and everyone’s story and situation is different. Sometimes family members who can’t imagine providing personal care for their loved one find themselves transitioning naturally into a caregiving role. Others who may have committed to keeping the person at home end up overwhelmed with unexpected care demands, safety concerns, and health issues. Moving a loved one to a care facility may be based upon one or multiple reasons.

Safety. The loved one forgets or refuses to use safety equipment, such as wheelchairs, walkers, and grab bars.

Frequently, spoiled food is found in the individual’s refrigerator, their stove burners are on, or they leave cigarettes unattended. Regular falls or wandering away from home are key reasons to consider a move.

Poor hygiene. A combination of urinary or fecal incontinence plus a refusal to bathe can lead to serious health problems.

Inadequate nutrition. The loved one is unable to prepare food, has problems eating and swallowing, or forgets to eat entirely.

Serious behavior problems.

Examples include wandering and regular verbal or physical aggression.

Increased need for care. When a caregiver is no longer able to provide the level of care needed, the individual requires additional assistance with daily living activities, such as toileting; bathing; dressing; eating; moving around the home; and transferring between bed, chair, and toilet. The individual requires 24/7 care and supervision.

Inability to balance care with

other responsibilities. A caregiver is unable to provide care while managing their own employment and family responsibilities.

Crisis. Situations, such as illness or injury, arise for the loved one or caretaker. It’s not unusual for persons with dementia to go from a hospital to a care facility.

Caregiver burnout. Caregivers can become physically, emotionally, and mentally exhausted. Unfortunately, they often don’t recognize the toll of the caretaking until they’ve broken down or the loved one has moved into a facility.

Optimally, the decision to move an individual to a facility is made in consultation with others, including the individual. Ask others to take on the caregiving role for a few days so fresh eyes can help evaluate the caregiving demands. Adult children often recognize the burden to one parent while caring for the other; their advice can be invaluable. Consider convening a family meeting that includes family, friends, neighbors, clergy, and others who are involved in supporting the individual.

Caregivers may be surprised to find that a move to a care facility improves the quality of life for their loved one. Increased social interactions, support of caring staff, a daily routine, regular meals, improved sleep, and engaging activities can lead to increased well-being and a more satisfying life. This possibility can often remain unconsidered.

While there may be no clear right time for placement, many professionals suggest it’s never too early to start planning. Thinking about a care facility location, size, quality indicators, and funding can bring peace of mind even if a loved one is able to remain at home. A solid plan protects the caregiver and loved one in the case of sudden crisis or rapid disease progression.

Jeff Hamm is the executive director of Alzheimer’s & Dementia Alliance of Wisconsin. alzwisc.org.

Alzheimer’s and Dementia Alliance of Wisconsin

6314 Odana Rd., Ste. 4 Madison, WI 53719 (608) 232-3400 alzwisc.org

(608) 251-6776 East (608) 709-5445 North (608) 284-7800 West willystreet.coop

PROGRAMS FOR INDIVIDUALS WITH DEMENTIA ISSUES

ALZHEIMER’S & DEMENTIA ALLIANCE OF WISCONSIN (608) 232-3400 or (888) 308-6251 alzwisc.org

Memory Cafés: A social gathering place for persons with memory loss, mild cognitive impairment, early Alzheimer’s, or other dementia and their family and friends offering an opportunity to visit, share common interests, and enjoy refreshments. Visit alzwisc.org for locations and times.

Crossing Bridges: Four-week educational support group for people who have mild memory loss, are in the early stages of Alzheimer’s disease or a related dementia, or are a primary care partner. Meeting Minds: A memory enhancement program for people with mild memory impairment, early Alzheimer’s, or other dementia that includes stimulating activities, intellectual exercises, and tai chibased exercise.

MY CHOICE WISCONSIN 1617 Sherman Ave., Madison 53704 (800) 963-0035 mychoicewi.org/JA

My Choice Wisconsin offers governmentfunded programs to frail seniors and adults with disabilities. We match members to the health and long-term care supports and services they need.

VISITING ANGELS 2001 W. Beltline Hwy., Ste. 110 Madison 53713 (608) 819-0665 infomadison@visitingangels.com visitingangels.com/madisonwi

Local family-owned business offering flexible hourly care, 24/7 care, and respite care for individuals with Alzheimer’s and dementia. Our services include bathing, dressing, walking assistance, grooming, medication reminders, errands, shopping, light housekeeping, meal preparation, friendly companionship, bed-bound care, and end-of-life care.

SUPPORT SYSTEMS & LOCAL RESOURCES

Visit the Safe & Healthy at Home section to find assistance and respite in your residence.

ALZHEIMER’S & DEMENTIA ALLIANCE OF WISCONSIN 3330 University Ave., Ste. 300 Madison 53705 (608) 232-3400 or (888) 308-6251 support@alzwisc.org alzwisc.org

The Alzheimer‘s & Dementia Alliance of Wisconsin provides hope for people facing Alzheimer’s or other dementias through education, support, and personalized guidance to understand the diseases, learn how to continue living a satisfying and rewarding life, and plan for the future. All donations stay local to support individuals and families in Wisconsin.

BRIGHTSTAR CARE® 3240 University Ave., Ste. 3A Madison 53705 (608) 441-8620 brightstarcare.com/madison

BrightStar Care is your solution for all stages of dementia care. Whether you need respite, overnights, or roundthe-clock care, our team of dementia specialists will work closely with you to create a customized plan of care for your loved one.

CROHN’S, COLITIS & IBD SUPPORT GROUP - STOUGHTON HEALTH

This group meets the third Wednesday at 5:30 p.m. Contact Marilyn (608) 8737928. Currently COVID-19 restrictions.

DIABETES SUPPORT GROUP - STOUGHTON HEALTH

This group meets the second Monday at 6:00 p.m. Contact Taylor at (608) 8773498. Currently COVID-19 restrictions.

VISITING ANGELS 2001 W. Beltline Hwy., Ste. 110 Madison 53713 (608) 819-0665 infomadison@visitingangels.com visitingangels.com/madisonwi

Local family-owned business offering flexible hourly care, 24/7 care, and respite care for individuals with Alzheimer’s and dementia. Our services include bathing, dressing, walking assistance, grooming, medication reminders, errands, shopping, light housekeeping, meal preparation, friendly companionship, bed-bound care, and end-of-life care.

WISCONSIN ALZHEIMER’S INSTITUTE

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