Tuesday, October 9, 2012

Should You Consider Nursing Home for your Alzheimer’s Patient?

Why Nursing Home?

According to the Alzheimer's Association, nearly 15 million Americans are taking care for people with Alzheimer's. At the certain stage of the disease development, these patients may require around the clock care and monitoring, which is exhausting to the caregiver, and may be simply impossible to carry on in the personal and family circumstances. Also, it is quite challenging for you to be there for your loved one and provide high quality of care if you are physically fatigued and emotionally burned out all the time. It's also possible you'll spend so much time caregiving and worrying that you won't be able to enjoy spending time with the person.

In addition, it is quite common for caregivers to ignore their own health and wellbeing, which can have serious negative consequences. In its most recent report, the Alzheimer's Association states:

Caregivers not only suffer emotionally but also physically. Because of the toll of caregiving on their own health, Alzheimer's and dementia caregivers had $7.9 billion in additional health care costs in 2010. More than 60 percent of family caregivers report high levels of stress because of the prolonged duration of caregiving, and 33 percent report symptoms of depression.

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According to the National Family Caregivers Association, family caregivers experiencing extreme stress have been shown to age prematurely. This level of stress can take as much as 10 years off a family caregiver's life. The Alzheimer's Association report states that caregiving may also have a negative impact on the employment, income and financial security of caregivers.

Many families who have loved ones with Alzheimer's disease or other dementias are extremely reluctant to place them in a long-term care facility. The vast majority of the caregivers don't want to do it, and many refuse to even think about it. Some feel it's the most cruel, shameful thing they could possibly do to their loved one, even if they have access to a high-quality facility nearby.

Standing back and looking at the situation more objectively, however, it becomes clear that in certain cases, nursing home placement is the most loving course of action for the patient because caring for the person at home may actually deprive them of the amount, quality and level of care and safety they need.

Nursing home placement should be of special consideration for patients in the late stages of the disease. These patients desperately need so much more care than a single person or family unit -- even with some paid help coming in -- can provide.

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Types of Care Nursing Homes Provide

There are two types of care provided in nursing homes:
  • Skilled Care (also known as "sub-acute" or "Medicare occupancy")
  • Long-Term Care (also known as "Intermediate Care")

Skilled Care entails services that can be rendered only by a doctor, licensed nurse, physical therapist, occupational therapist, speech and language therapist, social worker or respiratory therapist. It usually follows a hospital visit involving a short-term stay, during which the patient receives nursing care and/or therapy until he or she is stable enough to return home. Due to the skilled nature of the care, it is covered by Medicare and secondary insurance for up to 100 days. Beyond that length of time, it must be paid for privately.

Long-Term Care is appropriate for the individual who can no longer take care of him or herself and will continue to require a high level of care for the remainder of his or her lifetime. Such care may include help with any "activity of daily living," such as bathing, dressing, transferring (moving from one place to another), toileting, eating and walking. Medicare does not cover this type of care. However, when the individual's financial resources are exhausted, the state-funded source (Medicaid) will supplement the cost. If the nursing home does not accept state funding, you must find another long-term care facility that will. Unfortunately, most nursing homes have waiting lists for people entering the facility under state funding. Planning ahead with an appropriate strategy may help the patient and family avoid these conflicts.

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Services Nursing Homes Offer

The services nursing homes offer vary from facility to facility. Services often include:
  • Room and board.
  • Monitoring of medication.
  • Personal care like dressing, bathing, and toileting assistance.
  • 24-hour emergency care.
  • Social and recreational activities.

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Key Points in Making your Decision

The decision to put a relative with Alzheimer's disease in a nursing home is often a difficult one. Caring for someone with Alzheimer's disease at home requires significant social, financial, and personal sacrifices. Every family has different needs, preferences, and constraints to think about.

Consider the following when making your decision:
·         People with Alzheimer's disease need a safe, healthy, structured environment. Some families are able to provide this at home; in other cases, nursing home placement is a better choice.
·         People with Alzheimer's disease usually need an increasing level of care and assistance as time goes by. Many of those cared for at home eventually have to be moved to a long-term care facility.
·         Adult daycare programs and part-time help, whether hired or offered by other family members and friends, are options for some caregivers.
·         Your physical and emotional health is as important as that of the person you're caring for.
·         Deciding to put your relative in a nursing home is not a sign of failure in your role as caregiver.

Reasons to consider putting your relative in a nursing home:
·         Relative's behavior has become dangerous or disruptive to you and your household.
·         Your own health is at risk.
·         Burden of caregiving is too great and you have no one to help you.
·         Nursing home may offer a safer, more controlled situation for your relative.
·         Relative has other medical problems that require skilled nursing care
Reasons to consider keeping your relative at home:
·         Risk of rapid decline in nursing home.
·         Less individual attention for your relative in nursing home.
·         Risk that your relative may receive poor care in the nursing home.
·         You will feel too much guilt or anxiety about relative in nursing home.
·         Nursing home costs much more than caring for your relative at home.
·         Facility may have a waiting list if you have not planned ahead.

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Sources and Additional Information:
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