Dementia Care

Elderly woman with dementia appears confused While early signs of dementia vary from person to person, some common early signs include; reduced concentration, memory problems, difficulty remembering recent events, confusion, behavior changes, withdrawal or depression.  These symptoms may appear gradually over time or may present more suddenly.   Many of these symptoms or signs may go unnoticed for a long period of time, as many spouses or family caregivers unknowing compensate and take over in certain areas of life not realizing that the onset of dementia is occurring.   Caring for those with Dementia is very complex and can be very physically and emotionally draining for those who are responsible to care for loved ones who suffer with Dementia

Dementia Diagnosis

Doctor holding his dementia patients handOnce a person’s symptoms rise to a level that requires a loved one to devote their time and energy to managing and caring for their loved one, they may seek guidance from their doctor.  Many primary care doctors will do a simple test, like the Mini Mental Status Exam (MMSE) while other specialists may do more complex neuropsychological testing. In both cases, the tests typically just help the doctor have specific end points to follow the chronic illness.  Many people get caught up in the diagnosing, testing, labels and stages of the disease. While diagnosing & testing is important to establish baselines and monitor progression of the illness, doctors & loved ones often focus labels and stages and are often not aware what is required to develop the most effective treatment plan to treat the specific issues or behaviors. Labels & symptoms vary greatly from individual to individual.  Dealing with dementia and the increased stress & anxiety is difficult not only for the patient but also for a spouse or family caregiver.  Spouses and children of those with dementia are often the targets of the unintentional paranoia and psychotic thoughts a person with Dementia might express. For example, they might accuse the spouse of cheating with another person, poisoning them or wanting to steal their money.  Even if the family caregiver is aware that this is the dementia and not their true feelings, they are human, and these comments have a significant negative impact.  They are looking for solutions to help treat the paranoia, repetition, aggression, combativeness or other symptoms to help alleviate some of the stress and frustration. 

Unfortunately, help is not always easy to come by.  Many primary care physicians and even specialist do not have the advanced training and experience required to treat the behaviors associated with the illness.  Finding the right balance of behavioral therapy and medications therapy is the key and requires a great deal of input and communication between to the doctor, the patient and the family to effectively adjust all prongs of the treatment plan to achieve the best treated state.   Tender Loving Care Senior Residence is able to help and provides an experienced Geriatric Trained Physician who is directly involved and communicates frequently with the caregiver and the patient to develop and adjust the most effective care & treatment plan

Difficulties of Dementia Care

Caregiver helping an elderly woman walk on garden pathWhile many try to care for a person with dementia at home by themselves with some type of respite care or assistance from an outside caregiver it often is too much to handle; it becomes too physically, emotionally and financially draining.  While it is often difficult to make the decision to move a loved on to a specialized dementia or memory care facility, it usually is the right decision to make and can help preserve the physical and emotional health of the healthy spouse or family care giver. 

Many under estimate the physical and emotional costs of caring for a loved one at home, especially a loved one who suffers from dementia.  Unfortunately, the responsibility often gets dumped on one person in the family leaving them feeling unsupported and ultimately burned out.  Family caregivers are at a disadvantage because they often lack training and experience required to provide effective care to those with Dementia. 

Most Geriatric Medical doctors will tell you “behavioral therapy” should be the focus of a Alzheimer’s care plan but what does that involve?   Family members try to do their best and spend money hiring outside help that often does not have the advanced training needed to provide the behavioral therapy. Most agency caregivers have the skills needed to assist as a companion to provide respite care that allows the family caregiver to go out and do the shopping or go to their own medical appointments.   The home care assistant in most cases does not have the needed dementia training or clinical supervision.  That puts the additional stress on the family caregiver adding on more items to coordinate and supervise. 

Home care & respite care are short-term plans and typically are far less effective than moving into a Dementia Care Home that can offer more complete care and support, not only for the patient but the family caregiver as well.  Dementia Care homes have caregivers who have caregiver training and dementia training which includes complex behavioral therapy which helps both the caregiver and patient adjust to the day to day variation and the longer-term progression of the illness. 

Finding a reliable, well-coordinated and experienced dementia trained care team is difficult.  Preparing & planning early can save BOTH spouses in quality of life and financial outcomes.  Moving to a Memory Care Facility or Dementia Care Home in the early stages of Alzheimer’s Disease should be considered to avoid stress and negative outcomes down the road. Tender Loving Care Senior Residence is owned and operated by geriatrics trained MD & RN and can assist with all of these services

Dementia Care Costs

Costs of senior care can vary widely based on the amount of care needed.  Costs of Dementia care can vary as well but are typically more costly than other types of senior care.  Caring for someone at home with assistance from a Personal Care Agency care is the most expensive and provides lowest value of all Long-term care choices.  When looking for assistance for Dementia care it is important to understand not only the financial long-term costs but the physical and emotional costs that are often not mentioned. 

Financial Costs

Dementia care is the most expensive type of senior care because it typically requires 24 hr. monitoring & supervision.   Most people start with looking for Respite Care from an outside agency to come into the home for 4 hrs. – 8hrs per day at $25/per which equals $3,000 to $6,000 per month.  This is for only 8 hrs. a day & does not account for the rest of the hours in the day.  If one needs 24 hr. care the cost skyrockets to $18,000 per month. 

Many don’t consider the cost savings they could get by placing a loved one in a Dementia Endorsed Residential Care Home or Group Home where the total, inclusive costs for 24hr care ranges from $3,000 to $6,000. This is a significant cost savings compared to the 3- 6 thousand a month for only 4 to 8 hrs. per day.  

We direct all readers to read about Long Term Care Costs, Medicaid, Medicare on these links.  We encourage families to get assistance with Estate Planning to better plan and allocate funds for both spouses or parent’s long term care needs.   In addition, seeking the advice & assistance with planning from a Geriatric doctor who can provide Geriatric Case Management can help both spouses live better and more affordably.    Also See: cost comparison table

Emotional & Physical Costs

People often minimize the negative effects of being a “caregiver” has on the family caregiver.  Family caregivers often focus all their time and energy of the infirmed loved one, instead of taking the time needed to care for their own emotional and physical well-being.   This self-neglect leads to increased stress, anxiety and can cause or worsen the family caregivers own medical issues. 

Being the family caregiver and trying to utilize private in-home care as a long-term care solution, is not only extremely expensive but it can often cause more work and stress.  Another drawback to the high cost of private in-home care is the lack of clinical coordination and supervision of the caregiver.  The agency sends a caregiver with minimal caregiving training and likely no Dementia or Behavioral Therapy and the agency provides little to none oversite or on the job supervision of the caregiver leaving the task of supervising and instructing the caregiver up to the family. This often adds to the stress and frustrations that already exist for the family caregiver who is looking for some relief and respite and can be compounded when the agency frequently sends different caregivers adding to the worry and anxiety that is felt when a new person comes into the home.  Residential Care Homes provide many things that in-home care does not, for example; a cost effective, safe, supervised & monitored setting by a BELTCA licensed Administrator, consistency in staffing & back up if a caregiver gets sick or goes on vacation.   Caregivers receive Dementia training and medication management training and required to communicate with the patient’s doctor when and if needed.

Having a cost effective, supportive care team to assist in caring for a loved who has Dementia goes a long way to help relieve stress and reduce the caregiver burnout many family caregivers endure. 

We acknowledge that this is a difficult decision but having the information required to make the best long-term plan for the entire family can be useful now and for any future needs.

Tender Loving Care Senior Residence in owned and operated by geriatrics trained MD & Rn who have vast experience caring for those with & without Dementia. They provide is a high quality, cost effective care option that includes a high level of communication & coordination of care, supervision & advanced training for staff on Dementia & Behavioral therapies.  Contact us anytime for more information