Your Guide on When to Move Your Loved One with Alzheimer’s to Inpatient Care

Here are five signs that your loved one with Alzheimer’s may need to transition to inpatient care:

Increased emotional instability

If your loved one experiences heightened anxiety, depression, or severe changes in mood that are difficult to manage at home, it may indicate the need for specialized care. These emotional changes can lead to distress and may require professional intervention to ensure their well-being.

Frequent disorientation or confusion

When your loved one frequently becomes disoriented or confused and fails to recognize familiar places or people, it can pose significant safety concerns. This level of cognitive decline often necessitates 24-hour supervision and a secure environment that inpatient care facilities provide.

Aggressive or agitated behaviors

If your loved one displays aggressive or agitated behaviors, such as physical outbursts or verbal hostility, it can endanger themselves and others. These behaviors can be challenging to manage in a home setting and typically require specialized support.

Difficulty with basic daily activities

When your loved one has trouble with essential daily activities like bathing, dressing, eating, or maintaining personal hygiene, it may signal the need for professional assistance. Inpatient care facilities have trained staff to help with these tasks and ensure your loved one receives proper care.

Lack of judgment or decision making

If your loved one exhibits a lack of judgment, such as forgetting to turn off appliances, wandering outside unsupervised, or making unsafe choices, it can lead to dangerous situations. Inpatient care facilities offer a structured environment that reduces these risks and provides continuous monitoring.

To evaluate whether your loved one can perform basic activities independently or needs assistance, you can follow these steps:

• Observation: Observe your loved one during daily activities such as dressing, eating, housekeeping, cooking, and using transportation. In early stages, they may still be able to carry out some of these tasks with varying degrees of independence. However, as the disease progresses, they may require more assistance.
• Conversation: Have open conversations with your loved one about how they feel while performing these activities. Do they express any difficulties, confusion, or frustration?
• Safety and risk assessment: Evaluate their safety during these activities. Are there any risks of falls, burns, or accidents due to forgetfulness or physical limitations?
• Physical and cognitive health: Consider their physical health and any cognitive decline they may be experiencing. Health conditions such as arthritis or dementia can impact their ability to perform tasks.
• Assessment tools: Use standardized assessment tools like the Katz Index of Independence in Activities of Daily Living (ADL). A 2015 study in Turkey found that the six-item Katz ADL is highly effective and reliable for assessing the ability status in basic activities of daily living among older adults.
• Professional evaluation: Seek input from healthcare professionals, such as doctors, occupational therapists, or social workers, who can provide a professional assessment of functional abilities.

When your loved one can no longer manage daily activities safely or effectively, moving to an inpatient facility can ensure they receive specialized care that supports their health, safety, and quality of life.

Approximately 80% of people with ADRD receive care at home. While caring for a loved one with Alzheimer’s is rewarding, it’s also incredibly challenging.

A majority (57%) of Alzheimer’s caregivers provide care for 4 years or more, and over 6 in 10 (63%) expect to continue caregiving for the next 5 years.

It’s important to assess your own capacity to continue providing care for your loved one with Alzheimer’s.

Consider the following factors:

• Evaluate your health: Research indicates that caregivers of individuals with Alzheimer’s often face substantial challenges to their overall well-being, including physical, mental, and social health. Consider how caregiving impacts your physical and mental well-being. Are you experiencing heightened stress, exhaustion, or health issues?
• Consider safety concerns: Evaluate the safety of your caregiving environment. Are there hazards or risks that could jeopardize your loved one’s well-being or your own?
• Review available resources: Look into support services such as home health aides, respite care, or community programs that can assist you. Do you have access to resources that could lighten your caregiving responsibilities?
• Monitor caregiver burnout signs: Watch for signs of caregiver burnout, including persistent fatigue, irritability, social withdrawal, and neglecting your needs.
• Consider time constraints: Evaluate whether your caregiving responsibilities allow you to balance other commitments, such as work, children, or personal obligations. Do you have enough time to provide the necessary care?

Considering your loved one’s quality of life involves several important factors when deciding on inpatient care:

• Social Interaction: Evaluate if your loved one is isolated at home and whether an inpatient care facility could offer more opportunities for social engagement with peers and caregivers.
• Access to medical care: Assess the current level of medical care your loved one receives at home versus what may be available in a specialized facility, including regular monitoring, medication management, and access to healthcare professionals.
• Daily activities: Consider if your loved one is able to participate in meaningful daily activities at home or if they would benefit from structured routines and activities provided by an inpatient facility.
• Safety and comfort: Reflect on whether your loved one’s home environment meets their safety needs and if they feel comfortable in their surroundings, especially as Alzheimer’s disease progresses.
• Caregiver capacity: Evaluate your own ability to provide consistent care and support, considering factors like your physical and emotional health, available support network, and potential impact on your daily life and responsibilities.

Exploring inpatient care options for a loved one with Alzheimer’s involves several key steps:

• Research Alzheimer’s facilities: Look for specialized facilities that offer specific Alzheimer’s care. Consider their location, cost, services provided, staff qualifications, safety measures, and reviews from other families.
• Consult with healthcare professionals: Seek advice from healthcare professionals such as your loved one’s doctor, geriatric specialist, or social worker. They can provide insights into suitable facilities and help you understand your loved one’s care needs.
• Visit and tour facilities: Schedule visits to potential facilities to observe their environment, activities, and interactions among residents and staff. This firsthand experience can help you assess the quality of care and comfort level.
• Involve your loved one (if possible): If you can, include your loved one in the decision making process. Their preferences and comfort are important factors in choosing a suitable facility where they may live.
• Consider financial and legal aspects: Evaluate the cost of care at different facilities and explore financial options such as insurance coverage, Medicaid, or other financial assistance programs. Review legal considerations such as contracts, policies, and resident rights.
• Evaluate staffing and support services: Inquire about the facility’s staffing ratios, training in Alzheimer’s care, availability of medical professionals, and additional support services like therapy or specialized dementia programs.

Considering different types of facilities

There are several types of facilities that may care for individuals with Alzheimer’s disease. These include:

• Memory care units: specifically designed for dementia and Alzheimer’s patients
• Assisted living facilities: provide support with daily activities while allowing some independence
• Nursing homes: provide 24/7 medical care and supervision
• Residential care homes: small, home-like settings that offer personal care and supervision
• Hospice care: end-of-life care focused on comfort and quality of life

Research indicates that nursing homes where over 90% of residents have ADRD tend to provide better care for individuals with Alzheimer’s.

Choosing a dementia-specific facility with a high percentage of dementia patients is beneficial because it can ensure care tailored to their needs. These environments are designed to minimize confusion, promote social interaction, and manage dementia-related behaviors effectively, thereby enhancing quality of life.

Deciding whether to transition a loved one with Alzheimer’s to an inpatient facility is a big step. While your loved one might be doing well at home, it doesn’t hurt to consider facilities to ensure they receive specialized care tailored to their needs.

Consulting with experts, considering your capacity as a caregiver, and utilizing available resources can provide clarity and help you make an informed choice for their care.