How To Best Transition Living Situations: Resources For Dementia Caregivers
Have you ever wondered when it’s the right time to move your loved one with dementia to a new living environment?
This is a question that many caregivers face. Let’s imagine Sarah, a devoted daughter caring for her father, who has dementia. For months, she’s noticed subtle changes in his memory and how he interacts with his home. He no longer remembers where the pots and pans are or how to get food from the fridge. Sarah knows that his safety is a growing concern.
But when is the right time to make the transition to a new living environment?
Recognizing the Signs
A key moment in dementia care is when your loved one loses the ability to scan their environment. This isn’t a well-known fact, but it’s a significant milestone in dementia progression.
If they can’t locate food, medication, or other essential items without being able to see them directly, living independently becomes a challenge. They may not even realize they’re hungry if they can’t find food.
Many caregivers believe they should wait until the very last moment to move their loved one, hoping to maintain their independence. However, one lesser-known strategy is to consider moving them earlier.
This allows them to adjust to a new environment while they can still learn and adapt. It may actually prolong their independence in a new setting, such as assisted living.
Two Schools of Thought: What Works for You?
Some caregivers prefer to keep their loved ones in a familiar home environment for as long as possible. This can be done by adding support services or even moving in with them.
Others believe in transitioning earlier so their loved one can get used to a new environment while still able to adjust. Neither approach is right or wrong. What matters is what works best for your family and resources.
When Nursing Homes Come Into Play
Another crucial decision is knowing when, if ever, to consider a nursing home. There’s a big difference between assisted living and nursing homes, something often overlooked.
Nursing homes provide round-the-clock physical and cognitive support, which is necessary only when dementia is advanced, or physical care is too demanding.
If your loved one doesn’t need physical help with tasks like bathing or transferring, they might be better suited for assisted living, where they can still enjoy some independence with support.
Memory care units are also an option, providing safety and supervision for those with more advanced dementia without the high cost of nursing care.
Personal Decisions, No Judgment
Every caregiving journey is unique. Making these tough decisions should never carry guilt. It’s not a failure to seek outside help when your loved one needs more care than you can provide.
As a caregiver, it’s crucial to take care of your own health and relationships too. If that means placing your loved one in a nursing home, know that this decision comes from a place of love and practicality.
There is no single answer for every family, but understanding these subtle signs can help you navigate this challenging journey with more confidence.
Remember, you are not alone in this, and your decisions are valid and necessary to ensure the best care for your loved one.
Ever Wonder How To Know What Is Causing Your Caregiver Stress? Take Our FREE Caregiver Stress Assessment Today!
https://dignicarebydesign.com/quiz
Are You A Christian Dementia Caregiver Struggling To Cope With Caregiving?Join the FREE “Ask the Dementia Mentor” Monthly Meet Up! And be on the podcast, get support and your questions answered.
https://dementiacaregivingmadeeasy.com/ask
Read More:
Talking About Caregiver Burnout With Michelle Gordon
Check the other podcasts: https://dignicarebydesign.com/category/podcast/
Transcript
Welcome to Christian Dementia Caregiving
[0:00] Hey, Christian caregiver, welcome to Christian Dementia Caregiving, the podcast where I teach Bible-believing Christians how to navigate dementia with practical help with a kingdom focus and help you find hope for your caregiving journey.
[0:14] Today’s episode is brought to you by Think Different Dementia, where we create better futures for caregivers by building community around you. I thought I would do something a little different today. A couple of years ago.
[0:28] Probably about four years ago, I had a little Facebook Live that I did every week, which was called The Baffled Brain Demystifying Dementia. And what I did in those episodes was I just came on to a Facebook Live and I literally took questions that people in the audience of a 40,000 plus dementia caregiver group would be asking. So over the last several months, as people have been joining my free Facebook group, I have been asking them what kind of struggles they have related to dementia and dementia caregiving. And so today I thought I would answer a couple of questions from people in the
Transitioning Living Situations for Dementia Care
[1:04] audience that have asked me different questions that I haven’t gotten to. So today’s episode, we are going to talk about how to best transition living situations for people living with dementia as a resource for you as a family caregiver. So here are three questions that I recently got in from people joining the Facebook group. So if you’ve not joined the Facebook group, it’s called Christian Dementia Caregiving. Go ahead. The link is in the show notes. Join the Facebook group. You can ask questions there. You can interact with me. It’s another free way for you to become a part of our community. But the three questions are, is there an optimal window for moving a loved one with dementia to a different living situation? And how do I balance timing with their progression?
[1:52] The second one was, at what point is it okay to place my parent in a nursing home, especially when their dementia has worsened? And the third one is, when should I start living with someone who is showing signs of short-term memory loss? Those are three questions that came up. And I know if people in the audience who are joining the group are asking this, I know these are questions that you have as well. So the first one is, is there an optimal window for moving a loved one with dementia to a different living situation?
[2:24] And how do I balance timing with their progression? So this question begets a couple of things that are just implies certain things. The first one is this implies to me that it is likely a parent of somebody living with dementia and there is not a well spouse who is taking care of them and they are wanting to keep this person as independent as they can for as long as they can end before they move them into a different place. So it has to do with timing related to the progression of their dementia process. And is there an optimal window for moving somebody from one situation to another? So let’s just come up with a few scenarios, right? So if it’s somebody who is living independently at home, a couple of benchmark things that you need to be aware of is there comes a point in a person’s dementia caregiving journey where they are not able to scan their environment, to locate things that are outside of their sight. And this becomes a benchmark time in a person’s dementia caregiving journey because the moment you lose the ability to scan your environment and locate something that you cannot see.
[3:35] You cannot understand that if you’re hungry, you need to go to the fridge and open the fridge and find food to eat. Or if you want to find an object that is in a drawer, Or if you’re not able to scan your environment and notice that something might be out of sight, you’re not going to be looking for food in cupboards. You’re not going to be looking for medication.
[3:56] You’re not going to be looking for toilet paper that is maybe in a closet in front of you. It means that you cannot live without 24-hour supervision. So that’s the first benchmark. So a person who is not able to scan their environment, and locate something that is outside of their eyes, outside of their view, is not able to live at home alone anymore. So a couple of ways one can think through this, and these are just opportunities to make you think, to have you really think through what it is that you’re going to do. One frame of reference is move the person earlier before they get to the point where they cannot learn new information, because then they can learn to adjust in their new environment and living situation.
[4:45] Which means that they may be more independent in their new situation. So for example, if it is a parent who needs to move, you anticipate they’re going to need 24-hour supervision before the end of their journey, and they have the resources, moving them into an independent community, providing additional support for them in that independent community until they get to the point where they need an assisted living setup means that you can maintain their independence longer in the independent living because they’ve had time to adjust to it. Or the other frame of thought is leave them where they are with additional services and support in the house because they are in a familiar surrounding, they are able to to stay there with your support or whatever it is until they are to the point in their journey where they are not going to necessarily know or it bother them that they are moving into an assisted living or a memory care situation.
[5:45] So they’re two totally different frames of thought. Neither is right, neither is wrong. They’re just different ways of looking at this particular situation. Each person’s situation is a little different, which means if you have the resources, resources sometimes people choose to have a person stay somewhere longer with additional support until they get to the point where they are suitable for a memory care so that they do not upset the person because they’re then not aware that they are moving into a different living situation so a few ways that you can look at it so yes there is an optimal window to move somebody if your purpose is to get them to acclimatize to a new surrounding. But each person can move at any time during their progression. We just have to recognize that at one point, a person’s still going to be able to learn new information. And at a next point, a person’s not going to be able to learn new information.
Stress Relief for Caregivers
[6:43] They just create, each one creates a different challenge. So that’s the first question.
[6:47] Are you feeling stressed as a Christian dementia caregiver? Let me help. I offer a monthly dementia care audit to one listener of this program to provide you with personalized but evidence-based strategies from a biblical perspective. We only have one session available each month. Don’t miss this opportunity to make your dementia caregiving journey easier. Schedule your own dementia care audit today. day.
Nursing Home Placement Considerations
[7:18] The second question for today is, at what point is it okay to place my parent in a nursing home, especially when their dementia has worsened? So a couple of things struck me about this particular question. The first one was, let me explain the differences between a skilled nursing facility and an assisted living facility, a memory care. So a skilled nursing facility, in order for For a person to qualify to live in a skilled nursing facility, they need to require 24-hour caregiving.
[7:54] As well as require physical assistance and cognitive assistance, typically. So the burden of care is a lot higher. The person requires a lot more assistance, and it is the most expensive level of care. So if a person is just living with dementia, and they do not have the physical component related to needing assistance with transfers and those kinds of things, sometimes the next level of care, which is an assisted living, is a more suitable place for the person to be. An assisted living, I want you to consider, is a place where a person is starting to get assistance with what we call the instrumental activities, daily living, the things like cooking and cleaning and maybe bathing and housekeeping and those kinds of things. So they’re really just incidental. It’s the stuff that you need in order to run a household, but the person can pretty much still take care of their own physical needs. They may just need a little bit more supervision and help maybe with medication.
[8:55] A memory care is a little bit different. It falls under an assisted living rule set, which means it is not skilled nursing. It’s assisted living, although the person has typically when they’re in a memory care facility, a little bit more physical assistance with bathing and 24-hour supervision. They tend to be locked units, units, which means the person is in a safe environment. They cannot just walk out into the road. So back to the question, at what point is it okay to place my parent in a nursing home, especially when their dementia has worsened? That is a subjective question that you will need to answer for yourself. Many, many people do not ever live in a nursing home, even though they have dementia. Some people do. It just depends on your own specific situation. If it is your decision that this is the right thing because you’ve looked at all the alternatives and there are none, then the point that it is time to place a parent in a nursing home is.
[9:58] When you are unable to continue to provide the care and it is not safe for them to live alone and you cannot provide additional supervision for them and they require the physical assistance. So what I would recommend you do if you are looking at that level of care is perhaps consider reaching out to a couple of nursing homes, having them walk through the admission process with you really so that you understand what your options are. They will tell you if your person is appropriate for a skilled nursing level of care because they don’t just admit anybody to a skilled nursing facility for long-term care placement. And oftentimes, unless you have planned or the person is already on Medicaid.
[10:44] It is a financial outlay that is very surprising to a lot of people as to, you know, the investment cost in providing 24-hour supervision in a skilled nursing facility. And whether or not it’s okay, that is entirely your decision, whether or not it is okay in your particular situation. It’s not sinful to place somebody in a nursing home. There are very, very much so needed for some people. I’m never going to say never put somebody in a nursing home. But my philosophy and strategy is always going to be to try to keep people out of a nursing home if it is at all possible. But it is certainly if it’s what’s suitable in your life, if it’s what you want, and if it’s what needs to occur, then you just start to go through the decisions and the actions in order to make that happen. So I hope that was helpful.
[11:36] If you’re struggling with maybe considering nursing home placement, do understand it’s not a sin to place somebody in a nursing home. There’s absolutely appropriate situations where people cannot live with one another for a variety of different reasons. I initially said I would never place my parents in a nursing home, but the fact of the matter is the longer I’m in this journey and seeing how adversarial some of my interactions with my dad are, I have concluded that I will not be able to necessarily provide 24-hour care for him at home. And so I am thinking and exploring alternatives because my husband and my relationship come first and taking care of my dad comes secondary to that from a biblical perspective. But it just means I have to think about it differently and it means I have to
Living with Memory Loss: When to Move In
[12:24] plan for it differently. And then the last question for today is, when should I start living with someone who is showing signs of short-term memory loss? So that’s a great question. Question. And it kind of goes hand in hand with the first one that I answered about the optimal window of moving a loved one with dementia to a different location.
[12:45] The reality of the matter is the first thing most people notice is that somebody quote unquote cannot remember things. But the fact is, it’s not the fact that the person isn’t necessarily remembering things that means that they cannot do things. There’s more that tends to be involved. It’s when those higher level thinking skills, when those executive functions start to go away, and those are things like planning ahead and anticipating consequences, or being able to manage time.
[13:19] Or being able to organize and think through all of these additional types of things. Those higher level skills, are the ones that mean a person can or cannot live at home alone. But back to the first question, one of the benchmark signs is if a person cannot scan their environment and locate something out of sight, then they are not able to live alone anymore. So that is absolutely the line in the sand. If a person cannot scan their environment and locate something out of sight, they will not go look for food. They will not find things that are in drawers. They will not be able to do all of those kinds of activities that are related to going and locating anything that they cannot see because if they cannot see it, it doesn’t exist. So that to me is that absolute line in the sand when somebody absolutely requires 24-hour supervision.
[14:20] But when should you start living with someone who is showing signs of short-term memory loss? That also is notwithstanding what I just said. Going to be a personal decision? Because there’s so much that goes into a decision like this. Is the person anxious? If they’re anxious, then they shouldn’t be alone because they’re going to make poor decisions because of fear and anxiety. And those kinds of decisions are going to have consequences.
[14:47] If the person is not remembering to take their medication, then we have to have strategies in place to ensure that they’re taking their medication. If the person is not not remembering to take a shower every single day, then it doesn’t necessarily mean that we have to live with them. It just means that we have to start to notice and pay attention and start to put strategies in place to ensure these tasks are actually getting done.
Practical Solutions for Caregiving Challenges
[15:13] So today was just a little bit more a question and answer type of an episode. I am trying to make sure that I give you guys some real nuts and bolts, boots on the ground, practical applications.
[15:26] Practical questions, practical solutions to your dementia caregiving problems so that this is a resource for you as a family caregiver of a person living with dementia. So I really know that this was a very valuable episode for you. I am excited to try these types of episodes. I try a lot of different things to see what works. But if you haven’t yet signed up for one of our dementia audits, where I will sit with you for 20 to 30 minutes and have a conversation and help you along your journey, then please go to the show notes and sign up for one of these free coaching sessions.
[16:05] I’m really looking for people who are willing to come and actually dialogue with me. There is no pressure. I’m just here to serve. So I really do hope that you will join me for one of these episodes so I can answer your specific questions and we can help other people who are navigating dementia in a different way. And you can message me on Facebook, the word audit, or you can message me on Instagram, the word audit, and that’ll send you to a place where you can register for one of these free sessions. So I really hope you take me up on that. I’m hoping to grow that part of the program. If I can get a couple of people who are willing to come on and can be extremely valuable in helping you along this dementia caregiving journey. So as I end all of my episodes, may the Lord bless you and keep you and I will see you in our next episode.
