When Is It Time for My Parents, Who Both Have Dementia, to Go to Assisted Living?

1 answer | Last updated: Oct 12, 2016
A fellow caregiver asked...

Mom has had Alzheimer's for a while, officially diagnosed about two years ago. Dad also has dementia (non-Alzheimer's), diagnosed at the same time as Mom. We hired part-time homecare until Mom took a fall and broke a hip a few months ago. They now have 24/7 homecare from an agency. Mom is moderate/severe now; is a fall risk yet hates people in her house. She is starting to say mean things to the caregivers. She has balance issues and needs a walker. She thinks the caregivers are saying that to "contain" her and insists that she is fine. Dad has moments of clarity sometimes, but mostly just sits quietly in his chair with his own thoughts. At what point do we move them to assisted living? Both are OK today, but I know it will get worse. What do I do?

Expert Answers

As Founder and Director of Circles of Care, Ann Cason provides caregiving, consulting, and training services to individuals and public and private organizations involved in eldercare. She is the author of Circles of Care: How to Set Up Quality Home Care for Our Elders.

Deciding to send parents to assisted living, especially with dementia, tugs at the heart strings and does not always work.

Here are some suggestions to help them stay at home as long as possible. The time to move is when it is not working; you will know.

First look at the care. What time of day did your mother break her hip? Are there times of the day when she is relatively safe? Could your parents have some time alone? 24/7 care can be hard to receive, especially for couples. Could they be alone in the evening or the afternoon? Consult with your agency to see if something creative could be worked out.

Often, people suffering from dementia have abandonment issues. Sometimes having one caregiver, inadvertently promotes fear and dependency. It helps to have a care team. Care goes beyond trusting a person to trusting that someone will be there for you. A care team with good communication among the members and the family often creates a healing circle of care for both helpers and helped.

Sometimes, women who are territorial with women can be helped with a male caregiver.

Does your town have adult day care? If so, even if your dear mother does not want to go, try to enroll her. Many elders suffering from dementia are helped with activities appropriate for their needs. How wonderful it is to come home in the evening, after a busy day, to a meal and a familiar bed.

Make sure that your father's needs are being met.

Many elderly people who suffer from dementia are soothed by being driven around in the car. Take your mother to the doctor, go for a longish drive on the way home, then stop for an ice cream sundae. Enjoy!

Consult with a geriatric psychiatrist. Alzheimer's cannot be cured, but sometimes proper medication, will help a person through a difficult stage of the illness. Sometimes, after a wild and cranky time, the elder settles down. Then it is important to make sure the medication is evaluated to see if it is still needed. Sometimes older people take medication for too many years, long after the usefulness has ended.

Finally, visit assisted living facilities. Take tours, have lunch, investigate what is offered for memory care. Listen to suggestions, get new ideas, and create good communication. Knowledge will help you act from strength rather than panic when the time comes to decide.