What Senior Housing Is Right for My Loved One With Dementia?
Last updated: May 2023
When I was faced with the agonizing decision of whether it was time to move my mom into senior housing, it was like walking into a new world. This new world had mountains of stigma, stubborn stereotypes, and a whole new language of terms and services to sift through.
Additionally, my mom lives with Alzheimer's disease and needs help with specific things. Let's map out and clarify the many options people have when looking for the right senior housing for a loved one.
A new world of senior housing choices
Senior housing in many parts of the United States has changed dramatically. Many now feel more like upscale hotels than the depressing places that formerly came to mind. The buildings are still designed with safety and well-being in mind, but they are bright and clean and even smell good! Administration competes for residents with luxe amenities like multiple restaurants, swimming pools, and elaborate entertainment options.
Most importantly, standards of care have increased, and staff is trained in best practices for the medical and emotional care seniors might need. Activities directors plan enviable schedules of diverse and interesting events like live music performances, trips to the theater, and themed parties open to the community.
I say all this to encourage caregivers that the housing options for our loved ones these days are probably better than we think. Don't give up before you look at the options.
Let’s talk about the stigma
The decision to move a loved one into residential care still carries an enormous stigma. Some caregivers struggle to even talk about it because it conjures up too much guilt and pain.
Many people negatively refer to this decision as putting your loved one "in a home" or "in a facility." You can just picture a cinematic scene in which a family member is protesting, "How could you put your own mother in a home?" It feels very dramatic and pulled straight from Hollywood, yet many people actually feel this way in real life.
Caregivers want the best quality of life for their loved ones. And with the many physical and emotional demands of Alzheimer's disease, sometimes the safest and best option for everyone is some type of senior housing. Take heart, knowing you are doing the right thing for your loved one.
When I call it "senior housing," I'm trying to neutralize the negative association around senior residential care. Much of it comes from how we talk about senior housing and how we mush all the types together.
Senior housing 101
There can be a dizzying amount of terms for senior housing. What is the difference between independent living and assisted living? What is a retirement community, and what is a nursing home?
I use "senior housing" as an umbrella term for any kind of residential care for seniors, including independent living, assisted living, retirement communities, memory care, and nursing homes.
Deciding which type of senior housing can be a challenge in itself, but there are many resources to help. They are all different, yet many have overlapping features. The Alzheimer's Association outlines a good summary of the differences between the types.1
Here are the most common...
Independent living homes
Retirement homes are sometimes called independent living and could be a good option for people in the early stages of Alzheimer's who can still care for themselves independently. These provide housing and often include meals in a dining room, light housekeeping, transportation, and social activities. Independent living has limited healthcare services but sometimes provides medication management or basic help with diabetes.1
Assisted living homes
Assisted living is the level of care between independent living and a nursing home. It typically includes not only housing and meals but also more healthcare services. It offers support to an individual who needs help with activities of daily living (ADLs) like eating, bathing, and moving around. Assisted living homes are not regulated by the federal government, so requirements and definitions vary between states. Not all are designed for people with dementia, so it is important to look into staff training and offered services.1
Nursing homes, sometimes called long-term care communities or skilled nursing centers, provide the most advanced level of care aside from memory care. Residents can be there for short-term reasons (like rehabilitation after an injury) or long-term care (like chronic health issues).1
Nursing homes have 24-hour care, can provide long-term medical care, and typically have a staff with a wide range of services like physical and occupational therapy and personalized nutrition for those with special diets.1
The regulations, staffing, and training requirements in nursing homes are stricter than in assisted living because nursing homes are licensed by the state and regulated by the federal government.1
Memory care homes
Memory care homes, or Alzheimer's Special Care Units (SCUs), can vary widely in what they look like and how they function. An example of an innovative approach is in the Netherlands. Hogeweyk is a residential care village of 23 houses designed specifically for residents living with dementia and is heralded for preserving residents' autonomy, self-dignity, and overall health.2
Most commonly in the U.S., memory care units are paired with other residential care communities like assisted living. In these homes, the persons living with dementia are grouped together on their own floors or unit. The memory care units may or may not be locked or secured to help with wandering.3
Multi-tier care homes
These homes with multiple levels of care are also called life plan communities or continuing care retirement communities (CCRCs). They offer different levels of care in the same building or campus for convenience and comfort. A resident can start in an independent living apartment and then move to assisted living or skilled nursing/memory care if needs change.1
Take it one step at a time
If you find yourself looking for a safer living situation for a loved one living with dementia, you are not alone. Nearly all dementia caregivers reach this point and must find a safer option for their loved one (and family and caregivers). It is an overwhelming decision, but knowing a little more about the vast world of senior housing can help it feel less scary.
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