Kinds of Long Term Care

About a year ago this blog discussed way to make your home Lewy friendly (4-5 and 12, 2013). However, even with an accessible home, you will eventually need help. Caregiving, and especially dementia caregiving, is NOT a job that can be done safely alone. More recent blogs have discussed the red flags that warn of the need for help of some kind (4-25-14). If this is an subject you avoid, you aren’t alone. The 4-14-14 blog discussed common resistances that keep caregivers from asking for help.

For most caregivers, the time will eventually come when they will have to consider placement in a long term care facility. The 9-15-12 blog lays out the main reasons for this, adds some warnings and makes some suggestions about choices. Read this blog sooner than later. This week, the blog is about types of long term facilities available and how to choose the right one.

Residential facilities come in several levels of care:

Independent living. This is like having your own apartment, except that it is within a facility that can quickly provide assistance if needed. These apartments are usually in a multi-level of care facility. People often chose this option so that they can migrate to higher levels of care without leaving the friends they’ve made in the facility. Unless you choose to move here as a couple, your loved one would seldom qualify for independent living.

Assisted living. This is the level of care that many LB loved ones would fit into. The units are usually a small suite, with a mini-kitchen, a private bathroom and a bed-livingroom. Although assistance is readily available as needed, a person must be safe to leave alone and able to cope without fulltime help. Wheelchair-bound people will probably qualify, but only if they are still fairly functional. Some facilities encourage spouses to in with the loved one—often at little extra cost. Then, the couple must be able to cope without full-time help.

Memory care. The level of care may be similar to assisted living, but this is usually a locked unit, due to the wandering that many people with dementia tend to do. Loved ones with LBD may not need to be in a locked unit because wandering is not a common LBD symptom. (However, LBD and AD are often mixed and then, all bets are off.) Memory care units may also be equipped to care for people with more advanced dementia, where heavier nursing care is needed.

Skilled nursing care. The level of care is high, essentially round the clock nursing. A loved one who has become bed-ridden would qualify for this level of nursing, as would one who had become so helpless that they could not assist in transferring.

Adult Family Homes. These are usually smaller facilities and each is different. They are often family run with few staff changes, and much less activity than occurs in a larger facility. They may or may not have patients requiring several levels of treatment. These are all things you would need to explore when researching such homes. However, LB loved ones tend to do well in these smaller facilities that have fewer changes and less stimuli—if the home is well run and the staff are caring.

Future blogs will discuss more about when to place and how to make it work once a person has been placed.

For more information, read A Caregiver's Guide to Lewy Body Dementia, available on LBDtools.com