Moving to a Memory Care Home - Successfully That Is.
CAREtrends
Family members of those affected with degenerative brain diseases, such as Alzheimer’s, know that there may come a time when caring for their loved ones in their own homes may no longer be possible. Although family caregivers may spend ever longer hours in caring through the years, worsening health conditions can end up requiring more intensive levels of care and supervision.
Behavioral and Psychiatric Symptoms of Dementia (BPSD) in advanced dementia patients are the number one reason why people move to a memory care community. There are also reasons that include concerns with safety in the home, elopement risk, repeated falls, concurrent health issues—such as diabetes and heart disease—and the high cost of in-home care. Caregiver fatigue, although often overlooked, is another frequently cited reason for placement.
Regardless of what has prompted the need to move a patient into memory care, there is a common and pervasive feeling of dread that affects caregivers contemplating this difficult decision. Many conflicting questions arise: Will he adapt? Will she hate me for leaving her there? How will they treat her? Will the move make the disease progress even faster? How can I break my promise of keeping him home?
Although all these are valid questions, there is a single factor that will influence every other facet of the moving outcome: Is this the right memory care home for them?
Selecting the Right Home
The success of a move to memory care is greatly contingent on the pairing of the resident’s care needs and personality with the care abilities and social outlets of the selected home.
Each patient with dementia has unique care needs, ranging from light supervision to attention to dietary requirements, to complex medication management and symptom monitoring. Individual care needs are also expected to change in intensity and diversity as the underlying conditions and age continue to advance. The experience and training of the home administration and staff must be commensurate with the care needs of the residents, current and future, as well as with their ability to work with additional multidisciplinary medical providers, such as home health and hospice teams. Selecting a home that can attend to the resident’s current health needs and provide increased levels of care as their needs change can help ensure a successful transition to memory care for the long run.
But no matter how experienced and reliable the care team is, a successful placement must also consider the personable features of the home. Does it provide outlets for your loved one’s unique social, emotional, and spiritual needs?
Memory care homes are as different as people living with dementia, the difference being not only in the features of their physical buildings and their established routines, but also in the programs they provide. Some homes accommodate only a handful of residents, some house dozens. Some offer plenty of outdoor spaces where residents are safe and welcome to explore, others keep their residents mostly indoors under staff’s supervision. They may offer a variety of activities, some more physical, such as walks and yoga, others more cognitive enhancing, such as those involving music and reminiscing. Some observe their residents’ likes and dislikes, or their wants, in addition to their needs, and go through great lengths in facilitating related activities. They may collaborate with outside organizations to provide additional programs such as outings, entertainers, companionship, spiritual support, and pet visits. They may offer flexibility in scheduling activities of daily living, sometimes referred to as person-centered care, or they may operate in a more regimental schedule. These and other features are part of the care home “personality”.
You know your loved one’s personality well. Is it compatible with the selected home’s personality? A person is much more than a list of medical conditions and symptoms. We must make sure that their soul, or spirit, or emotional being—however you name it—is also being addressed and provided outlets for expression, movement, and interpersonal connections. The closest compatibility between the resident-person and the care home-person, the better the chances for a successful transition to memory care.
Add Your Own Special Personal Touches
Again, you know your loved one’s personality well. In addition to selecting the facility that can best attend to their medical needs as well as to their personal needs, you can greatly increase their chances of adapting to the new surroundings by bringing personal touches to their room. Here are five areas where your attention to detail can make a huge difference:
1. Use familiar furniture. Selecting a few pieces of furniture that are familiar to your loved one can create a feeling of being at home. Moving to memory care is not the time to buy new furniture, but stick to the old pieces, however frayed or stained they are. An old, comfortable chair, the same Chester drawer that’s been in their room for ages, the same lamp that’s been by the bed forever. A favorite pillow and blankets will add to the feeling of familiarity. Those are the pieces you want to set up in their new room prior to moving in. Try to place them in the same disposition in relation to the door and access to the bathroom as they were in the previous home. This will help minimize confusion, particularly when waking up in the middle of the night.
2. Decorate the walls with mementos. Pictures can serve as windows to memories of younger days. Place those of happy sentimental value on the walls: a first car, the wedding day, family and friends. These and other mementos are helpful reminders of who we are and what is valued in our lives. Prefer copies of the originals, so not to risk these precious memories being lost or damaged. In memory care, all items are subject to being shared, borrowed, or placed in “safe” locations by the legitimate owner or other residents: Do not bring in anything of value or that you don’t want to risk losing (jewelry and original documents included).
3. Observe lighting preferences. Some like their rooms darker, others like plenty of natural light. Use lamps, curtains, and window treatments to ensure that the light in the room is pleasant for the resident and compatible with their own preferences. Motion-activated night lights can greatly reduce the risk of falls and help a resident be better oriented in the middle of the night.
4. Bring their favorite clothing. They do not need their entire wardrobe, only the pieces that they enjoy wearing in the most recent years. Too many clothing options can cause confusion and become overwhelming. As a general guideline, bring in clothing sufficient for a week’s stay without laundry. You can always bring in more items if needed or requested. Place clothing in drawers in the same orders as they were in the previous home.
5. Leave a handwritten reassuring note. During the first few days after the move, a certain level of confusion is expected. You may have found the most perfect memory care home for your loved one, but it is still a new place, with new faces, new routines, away from the loved ones who have been their anchor for so long. A handwritten note from you can be greatly reassuring for the new resident. When confused, the staff can present them with the note that says: Dad, you are safe here; These people will be assisting you while I’m away; or I love you and I will come by to see soon. These supportive messages are wonderful in helping new residents relax while they are becoming acquainted with the new residence care staff.
The biggest concerns surrounding a move to memory care are those related to adaptation during the very few first days after moving in. Selecting the right home wisely and staging the room in a way that honors the resident’s legacy and personal preferences are important steps in ensuring a successful transition.
Transitional Medication
If BPSD is among the reasons why a move to memory care has become necessary, consider talking to the doctor about using medication to help alleviate the likely enhanced anxiety and confusion associated with moving to a new home.
Typically, a change in settings and care team triggers a higher level of anxiety, which can cause a dementia patient to become unusually agitated and confused. If the resident is already being treated for BPSD, the regular medication may not be sufficient to address the heightened period of agitation.
As a standard of care, doctors can prescribe additional medication, or an adjusted dose of the regular BPSD medication, to be administered during the few days preceding the moving date. This would serve as a transitional medication that can be discontinued after a few days or weeks, as the residents become familiar with their new home.
The use of transitional medication can help bridge the emotional gap between disconnecting from a previous home and creating new bonds with the new care home and care team.
Working with a Senior Care Consultant
There are professionals, senior care consultants or placement specialists (myself included), who can assist you in the selection of homes and in identifying transition strategies.
Prefer working with LOCAL consultants, those with experience in senior care and extensive knowledge of the care homes, services, and other resources available to seniors in your area. We can help with finding the best care homes, connecting you with available services, assisting with the required paperwork, and guiding you in navigating complex medical systems. We can also help you keep care expenses within your budget—memory care is notoriously expensive—potentially saving you a lot of money.
Overall, senior consultants can greatly increase the chances of a good match, avoiding the trauma of having to relocate the resident on a future date.
After moving, your continuous support, your attention to detail, and your loving reassurance to your loved one will be very important for their adaptation process. Collaborate closely with the care staff to devise supportive strategies that are unique to your loved one’s needs.
Assuming that a perfect match between resident and memory care home has been made, expect up to two months for your loved one to feel secure in their new home and comfortable with their new care team, although some feel perfectly at home after just a few days.
You will notice that your quality of life too will be greatly enhanced, and your own levels of anxiety will decrease. At this point, many family members express a deep sense of relief, and the previously conflicting questions disappear to be replaced for: Why did I not do this sooner?
That’s how a successful placement feels like.