Sometimes a parent living with dementia can age in place with extra support. Other times, for the well-being of the whole family, it may be necessary to help put a parent with dementia in a skilled nursing care community.
Signs It’s Time for Skilled Nursing Care
First things first: skilled nursing care is not your only option. Before starting the process for nursing home placement, decide as a family if nursing home care (skilled nursing care) or another level of care is more appropriate.
About Assisted Living Options
Assisted living communities, also known as assisted living facilities or ALFs, are a lower level of senior care than memory care and skilled nursing care are. They offer residents assistance with activities of daily living (ADLs) like toileting, bathing, and dressing while still encouraging independence where possible. These communities are ideal for someone in the early stages of dementia.
Signs that it may be time for assisted living include:
- Difficulties with ADLs, like trouble bathing
- Slight memory loss or cognitive decline
About Memory Care Options
Memory care communities, also known as memory care facilities and dementia care communities, are a higher level of care than assisted living communities are but less than skilled nursing communities are. They are designed for people living with Alzheimer’s disease or another form of dementia who need assistance with ADLs and some instrumental activities of daily living (IADLs) like meal preparation and medication management. Communities have simple layouts to reduce confusion for residents and have full calendars of events to encourage mental stimulation, physical activity, and social engagement.
Signs that it may be time for memory care include:
- Moderate to severe cognitive impairment
- Memory loss that interferes with daily life
- Difficulty with ADLs
- Difficulty with IADLs
- A tendency to wander or get lost
About Family Caregiver Support Options
For families that want to help their aging family member live in their own home for as long as possible, in-home care services or other caregiver support options may delay the need to move to a long-term care facility as well as reduce caregiver burnout.
In-home care options include elderly sitting (companion care), adult day care (watching older adults while the primary caregiver is at work), and respite care services (short-term stays in residential care communities).
Signs that a family can benefit from these senior care options include:
- The person with dementia does not want to move to a senior living community just yet
- The family is able and willing to assume caregiving responsibilities
- The family can mostly support the elderly parent with a little extra help
About Skilled Nursing Options
Skilled nursing care communities are known by many names, including nursing homes, skilled nursing facilities, SNFs, and skilled nursing communities. They are a higher level of care than memory care and assisted living options are. They are staffed with full-time caregivers, nurses, and other professionals who know how to care for individuals with advanced care needs.
Signs that it may be time for skilled nursing care include:
- Extreme cognitive decline or memory issues
- Complete or nearly complete inability to perform ADLs
- Complete or nearly complete inability to perform IADLs
- Intense medical care needs
- Increased safety concerns like frequent falls or wandering
Prepare for the Transition
If your family decides that skilled nursing care is the right type of care for your aging parent, it’s time to plan for the move.
Preparing for the transition to skilled nursing care looks different for each family, although the following actions often make the process easier long term:
- Have a sit-down conversation as a family. Let everyone, especially the parent in question, voice their concerns and wishes for the future as well as vent any pent-up negative emotions. This “conversation” may actually be several important conversations; don’t feel as if everything needs to be solved in a single sitting.
- Establish durable power of attorney to make decisions for the person with dementia in the event that they can no longer do so. This step is crucial to navigate complex issues like filing taxes for your aging parent once they can no longer do so themselves.
- Have the person with dementia create a living will/advance directive to outline their wishes for medical and personal care decisions. This way, your elderly parent gets a direct say in how and when they want to receive certain health or elder care services as well as what their wishes for end-of-life care are.
- Discuss payment plans. Paying for senior living can be a major concern for many families. Ease that worry by planning ahead. Discuss long-term care insurance and ask communities your family is interested in what types of payment they accept; not all communities accept Medicaid, and Medicare typically only covers short-term stays in skilled nursing communities.
Choose the Right Community
Your next steps as a family are to make a list of potential skilled nursing care communities and schedule tours with them.
Important questions to ask during this time include:
- What qualifications or certifications does this community and its staff have?
- Does the community offer opportunities for social, mental, physical, and spiritual engagement?
- Is this community the right size?
- Will the community accept our preferred payment option?
- Is the community nearby?
- Does the community feel like a place my aging parent could call home?
Once you’ve toured your top choices, sit down as a family and discuss which option offers the best perks, is in your budget, and will make your loved one feel most comfortable.
Make the Move to Skilled Nursing
Moving to a skilled nursing care community can be a challenging and emotional experience for the whole family. Prioritizing the parent’s needs and feelings and involving them in the decision-making process can help ease this transition.
Your family can work with a social worker or care team at the community to develop a plan that ensures a smooth transition and minimizes disruption. Be sure to bring plenty of personal items to help your parent feel more at home and make the transition easier.
After the Move
Putting a parent with dementia in a nursing home can be a stressful experience for adult children. Your parent will also likely feel apprehensive about the process too. In fact, many older adults feel anxiety and stress about moving to skilled nursing communities because they fear they will be left behind and forgotten.
Prove to your loved one that this fear is simply not the case for them! Set up regular in-person visits or video chats (if you live far away) to remind your parent that they are loved and still an important part of the family.
Disclaimer: Each person’s situation is unique. This article is for general informational purposes only and is not intended to take the place of medical, financial, tax or legal advice.