Picking a facility for dementia care shouldn't be trial and error

  • Updated: September 1, 2014 - 2:00 PM

Different residents need different approaches for dementia care.

Doing your homework before deciding on a care facility for a loved one will make things easier for both of you.

It took three tries before Leslie Reid-Green found a suitable nursing home for her 88-year-old mother, Bella Solomon, who has advanced dementia.

The first home her mother moved into “was dreary and gray, in an old hospital,” Reid-Green said. “The staff wasn’t very nice; my mother hated it, and it was far from where I live.”

The second home was “a newer and much nicer facility, though still more like a hospital than a home.” But the staff was unable to deal with her mother’s aggressive behavior.

After multiple hospitalizations and 18 months on a waiting list, a spot became available at a facility closer to Reid-Green’s home in New Jersey. Despite costing significantly less, it offered “a homier atmosphere, an attentive and pleasant staff and a more serene environment,” she said.

“The take-home message: More expensive is not necessarily better,” she said.

Her experience and similar ones reported by other families emphasize the importance of thorough footwork well in advance of the need to place a loved one in a nursing home.

(While the term “nursing home” has a specific meaning within the industry and for Medicaid, it typically is used by the public as a generic reference for several forms of senior housing that offer varying levels of care options, not all of which technically qualify as nursing homes.)

Nearly half of the residents in nursing homes are there because their dementia, primarily Alzheimer’s disease, has reached a point where caring for them at home has become unsustainable. They may wander from home, not knowing how to return or even who they are, or awaken many times a night, causing mayhem and exhausting their caregivers. Falls, fires, poisonings, self-injuries and physical aggression often are ever-present dangers.

It’s not a sign of weakness to move a loved one with advancing dementia to a nursing home, counselors insist. But it isn’t easy to find a place that offers the services and environment that the patient needs.

Study the programs

Simply having a specialized dementia unit is not enough: The quality and extent of services may vary widely.

“There are different levels of dementia, and people with it have different needs,” said Joanna Leefer, author of “Almost Like Home,” a guide to choosing a nursing home.

She recommends looking for a place with different levels of care. As dementia progresses, a resident’s needs will change. The facility must be able to adapt to those changes.

Different residents need different approaches, too. Some people with dementia benefit from stimulation, but overstimulation, such as a noisy environment, can make others agitated and aggressive.

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