Choosing memory care for a loved one: 4 common questions

Credit: Michigan Medicine.

A diagnosis of dementia or memory loss is difficult for caregivers and loved ones alike.

One of the most important issues caregivers face is deciding whether and when a memory care facility is appropriate.

Although it provides the same core services as typical assisted living facilities, memory care is specialized and serves the needs of residents with Alzheimer’s disease, dementia and other memory issues.

Often complex and deeply painful, the transition is pursued with the patient’s best interests at heart.

“This part of the journey is all about making life with dementia or memory loss as good as it can be for your loved one — and for you and your entire family,” says Nina L. Abney, L.M.S.W., a social work supervisor at the University of Michigan Geriatrics Center.

She answered some common questions about the process.

When should people begin looking into a memory care center?

Abney: It is not necessary to jump to the conclusion that everyone with memory loss issues will need residential care. But it’s always a good idea to start looking at alternative options early, whether residential care will be needed or not.

Include your loved one’s input early and regularly. Those conversations can later serve as a guide when family members need to start making decisions on behalf of their relative.

The University of Michigan’s Housing Bureau for Seniors’ annual Senior Living Week is a good time to research and learn about different housing options for seniors.

Last year’s brochure defines the different levels of care and includes descriptions of several Ann Arbor-area facilities and possible costs. Senior Living Week 2017 will be held from May 8-13.

Other areas across the country may have similar senior housing bureaus, events or helpful brochures. The National Association of Area Agencies on Aging may also be a resource.

What signs might indicate such care is necessary?

Abney: If or when the amount of daily hands-on care starts to add up for the caregiver, it may be time. It often also becomes a question of finances: Paying for 24-hour care at home easily exceeds the cost of residential care.

Or it may be time if a person with dementia has been living alone, but there are more safety concerns due to memory and cognitive changes, such as a person who can no longer manage their daily activities — which include taking medications, handling finances or operating a stove without putting themselves or others in danger.

Sometimes the behavioral changes that may accompany the dementia become too difficult for a caregiver to handle on their own and the caregiver needs to have more support and help than is available through in-home care.

How can I help ensure that a facility is the best fit?

Abney: I believe it’s important for family or caregivers to visit and review any potential residential care facility with a clear idea of what would be important for the care recipient. Take into consideration their interests, likes and dislikes.

Families also need to ask the difficult questions: What happens if or when the care recipient cannot stay in the facility? Under what circumstances may the facility ask the resident to leave or move elsewhere?

I think too many times the what-ifs don’t get addressed or asked.

In general, how can families pay for a residential care facility?

Abney: That’s a complicated issue, based on a number of factors such as the loved one’s resources and eligibility for financial assistance.

Medicare only pays for skilled nursing care as part of a short-term rehabilitation stay following an acute hospital stay. The official government site for Medicare has information about paying for nursing home care.

And the website offers suggestions on how to pay for assisted living. Assisted living facilities, including memory care residences in Michigan, are not covered by Medicare or Medicaid, and are generally only private pay.

It is important to clarify what the monthly charges cover and what additional charges may apply. For example, medication administration, assistance with bathing or dressing are usually not included in the monthly cost of an assisted living residence and will result in additional charges.

Some individuals have invested in long-term care insurance, which will pay for in-home care as well as residential care to varying degrees. It is important to locate and carefully review any long-term care policies for specific details.

Veterans and their spouses may be eligible for long-term care benefits through the VA’s Aid and Attendance program.

Read as much as you can, and talk with others. A good first step is to talk with a geriatric social worker or an elder care attorney who can help lay out a financial plan for how to budget for long-term care needs based on an individual’s retirement income, savings and any potential long-term care insurance benefits.