When and Where to Turn for Help
Read through the following situations to see which circumstances you can relate to best. Then read on for recommendations and practical solutions. Remember that each individual family is different, and there is no magical solution or standard answer for when to get help. This quiz will serve merely as a guide for your decision process.
1) Which best describes your loved one?
• A. He or she is occasionally forgetful and confused, and often has difficulty with daily tasks that were once routine.
• B. He or she is often disoriented, has difficultly following simple directions, and may not recognize familiar people.
• C. He or she is unable to communicate clearly, often displays paranoia and delusions, and has extremely poor recent and long-term memory.
2) What describes the level of care your loved one requires?
• A. He or she requires supervision in new environments (such as in a new and different grocery store), prompting for word finding, and assistance in making decisions and finding objects (such as the wastebasket, which has been in the same place for 5 years).
• B. He or she requires a watchful eye because of a tendency to wander, demonstrations of how to do simple tasks, such as eating, dressing, or sweeping the floor, and constant supervision because of blurred judgment (some examples of impaired judgment include turning on burners under empty pans and leaving the kitchen, climbing onto an unsafe chair to reach a high place, or crossing the street without checking for traffic).
• C. He or she is unable to take care of his/her personal needs, requires 24-hour care, and is unable to communicate clearly, if at all.
3) What describes your loved one's emotional state?
• A. He or she has a difficult time showing their feelings, does not handle frustration well, and a previously mild-mannered person may now have angry outbursts.
• B. He or she has a noticeable decrease in warmth and affection, exhibits an extreme over-reaction to negative information, and can be aggressive or insulting towards caregivers.
• C. He or she is apathetic and listless.
4) Some abnormal behavior that you have seen your loved one exhibit may include:
• A. Getting lost on a familiar route (such as to the post office), confusing daily routines (such as putting clothes on out of order, or using a toothbrush to comb hair??), or hoarding household items (such as sugar packets).
• B. Repeating the same action over and over (such as washing a coffee mug), laziness, changes in sleep patterns, wandering, difficultly completing self-care activities successfully or undoing progress (such as undressing after being assisted to dress completely, or applying make-up in an incorrect manner).
• C. An inability to complete simple tasks, extreme distrust or paranoia, or very limited functioning.
5) Which of the following situations would best meet your, your family's and your loved one's needs?
• A. A trained individual comes into your home on a scheduled or as needed basis. This person would help your loved one with personal needs, such as eating and grooming, as well as household assistance. He or she would also provide companionship, a watchful eye, and help your loved one to participate in interesting activities.
• B. Your loved one attends a "day program" on a daily/ bi-weekly basis. This day program would be open weekdays, during business hours and would provide a safe environment, staffed by trained professionals. He or she would be one of a group of individuals with Alzheimer's/dementia, and would spend his or her day participating in group activities like arts and crafts, watching movies, baking, singing, and dancing. The noon meal and transportation would be provided.
• C. Your loved one moves from your home or their own home into a housing facility that bridges the gap between living independently and living in a nursing home. Your loved one would have their own private or semi-private room, along with shared living and kitchen areas. The staff in this situation may be trained to work with individuals in the early stages of Alzheimer's or dementia and will assist residents with personal care, meal preparation, and housekeeping duties. There would be scheduled recreational activities and periodic visits by skilled medical professionals (such as nurses or nurse practitioners).
• D. The care for your loved one may have exceeded your abilities and he or she moves into a skilled nursing facility. This facility may have a special unit or section dedicated to Alzheimer's care. The staff in this facility would provide round-the-clock skilled care (24 hour care provided by a licensed nurse) and medical treatment, as well as nutrition and dietary planning, recreation, care planning, and religious services. If the facility has an Alzheimer's unit, care and activities would be structured around the special needs of those with Alzheimer's.
• E. Your loved one is in the advanced stages of Alzheimer's disease and your family's wishes are that he or she can spend his last days in comfort, without drastic measures in place to prolong life. The focus of this facility would be to provide care in a soothing, serene environment, while still attending to your loved one's medical needs.
Where to turn for Help: What your answers mean
♦ If you answered A's for all five questions:
Your family and your loved one may best benefit from Respite Care or Home Health Care which is appropriate for individuals in the early stages of Alzheimer's Disease. Respite Care provides your loved one with a skilled companion to assist with personal care and other activities. Home Health Care may be able to provide a nurse to help with at-home medical care. Respite Care also gives, you, the caregiver, time for yourself. Respite Care and Home Health Care are typically offered by community organizations, private agencies, or governmental organizations. Respite care and home health workers can be employed privately, through an agency, or through a governmental program.
♦ If you answered all A's or a combination of A's and B's for questions 1-4, and B for question 5
Your family and your loved one may benefit from another type of respite care, called Adult Day Services or Elder Day Hab, which is appropriate for individuals in the early stages of Alzheimer's. Adult Day Services are an opportunity for your loved one to get out of the house and participate in recreational activities with other individuals with Alzheimer's disease. The staff is typically trained in the special needs of those with Alzheimer's, and meals and transportation are usually provided. Adult day services may be provided by local elder agencies, councils on aging, local chapters of the Alzheimer's Association, or other social service organizations.
♦ If you answered mostly A's for questions 1-4, and C for question 5:
Your family and your loved one may benefit from placing him or her in an Assisted Living Facility, which is appropriate for someone in early to early-mid stage Alzheimer's disease. Assisted Living Facilities provide assistance with personal care, housekeeping and meals, as well as organize social and recreational activities. Residents often have private or semi-private living quarters. Staff may or may not be trained to deal with Alzheimer's disease, and families should inquire about staff capabilities at each facility. Assisted Living Facilities DO NOT provide 24-hour skilled care. Assisted Living Facilities can be found using www.ElderCare.gov.
♦ If you answered B's and/or C's for questions 1-4, and D for question 5:
Your family and your loved one may benefit from placing him or her in a Skilled Nursing Facility, which is appropriate for someone in mid or late stage Alzheimer's disease. Skilled Nursing Facilities provide 24- hour skilled care as well as dietary, housekeeping, personal care, and social services. Many Skilled Nursing Facilities have Alzheimer's units, where staff are specially trained the needs of Alzheimer's disease and activities and care are based on those needs. Skilled Nursing facilities can be found using www.ElderCare.gov.
♦ If you answered all C's for questions 1-4, and E for question 5:
You and your family may want to consider Hospice Care for your loved one. Hospice care provides an environment that focuses on comfort and quality of life, without a focus on drastic life sustaining measures. This is appropriate for those in the late stages of Alzheimer's disease. Hospice Care is available through hospitals, home care agencies, and some nursing home, or try www.ElderCare.gov.
