It can be difficult to figure out the right time to transition a dementia patient to assisted living. While assisted living will not be the right choice for everyone, it can be beneficial for some patients and offer caregivers respite and support.

In order to make the best decision possible for you and your loved one, it’s important to consider the individual needs of the patient and their stage of dementia. Likewise, take into account the capabilities and resources available to the caregiver(s) in their life. Every family’s case is going to look different, but this article will offer a few guiding points to help get you started.

Throughout the article, we will use “assisted living” as a general term, but it is also a specific type of care facility you can consider for your patient. However, Memory Care facilities are usually considered the best type of facility for individuals with dementia, as they are specialized in the condition.

For guidance in selecting the right care facility for your dementia patient, read our article on choosing the right living facility here.

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Determine the Level of Care Required

Generally speaking, the time to move a dementia patient into assisted living is when their required level of care exceeds your ability or capacity as a caregiver. As dementia progresses, your loved one’s care requirements will increase.

For example, they may need help with activities of daily living (ADLs). ADLs are common behaviors that many of us take for granted that are necessary for maintaining an independent lifestyle. Elderly or disabled individuals may require assistance with some or all ADLs. Here is a list of some ADLs:

Basic ADLs

• Ambulating: being able to move about freely, independently, and safely.
• Feeding: being able to feed oneself.
• Dressing: putting together an outfit and wearing it appropriately.
• Hygiene: maintaining personal hygiene, including brushing teeth, grooming, and bathing.
• Continence: the ability to control bladder and bowel movements.
• Toileting: being able to use the restroom and clean oneself properly.

Instrumental Activities of Daily Living (IADLs)

• Transport: driving or arranging other methods of transport.
• Shopping: buying groceries and other essential goods for oneself.
• Finances: paying bills, managing assets, and handling money.
• Meal preparation: not to be confused with Feeding, the ability to put together a meal for oneself.
• Cleaning & Home Maintenance: cleaning & maintaining living areas, and staying on top of home maintenance.
• Communication: ability to manage telephone, mail, and other forms of correspondence and communication.
• Medications: ability to obtain & take medications as prescribed.

These lists are meant to function as a guide for you and your loved one, and are able to be expanded upon if needed. For example, you may want to split Cleaning & Home Maintenance into subgroups of your choosing if your loved one is able to do laundry, but not housework. Or for Hygiene, they are able to wash and groom themselves, but need help bathing.

The number of ADLs they need assistance with can be a good benchmark for the level of care they require. Try keeping a running list or spreadsheet of specific activities they are getting assistance with. There are also many free, printable checklists available online that can get you started.

If the patient, yourself, and other caregivers are unable to adequately meet covering all of the ADLs, it may be time to consider assisted living or a memory care facility.

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Assess your own caregiving capabilities

Caring for a dementia patient can be incredibly physically and emotionally demanding. It is important for caregivers to honestly assess their own abilities and determine if they are able to provide the necessary level of care. You should consider your own health and wellbeing and benchmark your wellness levels. If caring for your loved one is causing unmanageable physical or emotional strain, it may be time to consider enlisting in help or looking into livng facilities.

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Is the home environment safe to continue living in?

There are a few key factors to look out for that could indicate your loved one requires a higher level of care or supervision.

• Are dangerous appliances such as stovetops being left on accidentally?
• Is your loved one frequently getting lost or confused, and you aren’t available to provide guidance?
• Are they wandering outside of the house and putting themselves in dangerous situations?
• Are pets being well-cared for and attended to?
• Have they grown increasingly aggressive with you or other caregivers? If other methods haven’t worked and you or others feel unsafe, it may be time to consider a care home.

These are all signs that it may be time to consider assisted living or a memory care home.

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Get evaluated by a doctor

Many doctors, especially those specializing in geriatric care, can offer mental status and memory exams that can create a baseline for tracking a patient’s dementia symptoms. These can help determine if it’s time for memory care.

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Consider your available resources

There are many options available to help ease caregiving burden. Are there family members, friends, or neighbors nearby who are willing and able to provide care and support, perhaps covering ADLs that you do not have the time or ability to help with? Are there other resources nearby, such as home health aides, or adult day care available? If you have looked into all of these options already, assisted living may be the next step.

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Evaluate quality of life

When making the decision to move your loved one into an assisted living facility or memory care home, it’s important to consider what’s best for your loved one. Look into what you can do or change to make their daily lives more enriching, or research whether a prospective space will meet all of their needs. Does the facility offer activities and programs that will help keep them engaged and stimulated? Are there opportunities for socialization and companionship? What is most important to your loved one? Check out our article on selecting the best living facility for your loved one.

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Consider Finances

The cost of assisted living can be a significant factor when deciding if it’s an option for your patient. Caregivers should research the costs of assisted living in their area and evaluate their financial resources. Additionally, caregivers should consider if they are eligible for any financial assistance programs or insurance coverage to help cover the cost of care.

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Conclusion

Making the decision to move a dementia patient into an assisted living facility can be difficult. However, it is important to remember that it can be the best choice for some patients, offering them safety and a higher quality of life. Caregivers should take their time in making the decision, considering the individual needs of the patient and the resources available. Ultimately, choosing the right care environment can make a world of difference for both the patient and the caregiver.

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