In the early stages of Alzheimer’s disease or other forms of dementia, people desire and choose to remain in the comfort of their own homes. As limitations increase, frustrations often follow, and overwhelmed family caregivers turn to supportive services to help with the challenges that arise.
Read on to learn how in-home care benefits people with dementia, what types of dementia-specific services home care can provide, how to choose a home care provider, and other tips on finding in-home care for dementia patients.
Do dementia patients do better at home?
Choosing the best care setting for a person with dementia depends on many factors. The biggest advantage of home care is that it allows seniors to remain in their own homes for as long as possible. This option may be less disorienting for someone with dementia than a move to an assisted living facility, a memory care unit, or a nursing home. Familiar environments offer a great deal of security and peace of mind for individuals with memory issues. In-home care can be the ideal starting point for families who need extra help with their loved ones but want to prevent or delay placement in a long-term care facility.
Just as familiar surroundings are safe and soothing, the same can be said for daily routines. Maintaining a schedule similar to the one an individual followed prior to their cognitive issues can help reduce anxiety and confusion. For example, for someone who takes a shower every morning, remaining in their own home can make it easier for them to navigate the bathroom they’ve used for years and use the shower faucet at their preferred temperature.
A fundamental aspect of home care is that services are provided for all clients (with and without dementia) according to personalized scheduling tools called care plans. This technique easily translates into a set routine for dementia patients who thrive on familiarity and repetition.
Professional caregivers are trained to facilitate daily activities, including chores and personal care tasks, at the appropriate times and provide assistance as needed. Humans are creatures of habit and preserving these very personal and deeply ingrained routines can help aging loved ones retain a sense of control and understanding of what’s going on around them.
With in-home dementia care, professional caregivers provide one-on-one care and supervision that’s fully customizable. Since they only have one client to supervise and assist at a time, it’s much easier to keep a set schedule and adapt it as needed. Staff members in senior living communities are responsible for multiple residents at once, which can make it difficult to keep a consistent routine.
While routines are often kept in long-term care communities, they can be difficult to individualize. For example, people living in long-term care communities often do the same activities at the same time each day. However, when a new resident comes in having had a very different routine at their previous residence, there’s less room for personalization. They’ll likely need to adjust to the community’s set routine.
If a person with dementia doesn’t have adequate support and supervision at home, or their residence isn’t conducive to aging in place safely, then moving to a senior living community may be in their best interest.
Specialized dementia home care services
Professionals trained in dementia care
Home care companies provide assistance with activities of daily living (ADLs), companionship, transportation, and other core services. In addition, many companies provide professional training in dementia care for their employees so they can offer in-home memory care. Common aspects of this training include methods for staying engaged with a person with dementia, managing unpredictable behaviors through validation and redirection, communicating effectively, and breaking down activities into smaller steps that are easier to follow.
There are many training programs and schools of thought when it comes to dementia care. Be sure to inquire about the education a home care company provides to or requires of its caregivers. This includes the specific types of training, as well as the amount and frequency of education. Safety training is also part of professional caregivers’ initial and ongoing education. This is largely because people with dementia may be prone to wandering and other risky behaviors.
A 2013 study published in the Journal of the American Geriatrics Society found that 90% of people with dementia living in their own homes had unmet safety needs. These were particularly for fall risk and wander risk management and home safety evaluations. Increased supervision and assistance from companions and home health aides is a crucial component of helping those with dementia and their families reduce safety risks in their own homes.
Meaningful activities for dementia patients
For people with dementia, home care can be an invaluable source of companionship and stimulating activities throughout the day. Knowledge of the clinical aspects of dementia allows home health aides to better serve their clients and enrich their lives with social interaction and activities.
Perceptive caregivers can provide a positive environment for people with dementia by learning about a senior’s interests and adapting the way they engage in these hobbies both in the home and in the community. For example, if golf is something an individual enjoyed, then that individual and their caregiver may visit a golf course for a walk or to watch others play the game.
Sensory stimulation is another crucial component of dementia care, especially in the later stages of cognitive impairment. Studies show that participating in music therapy, light therapy, aromatherapy, dance, or other outlets has a positive effect on mental health, physical health, and social functioning in older adults. An experienced caregiver will work to engage clients in activities, even as their interests and abilities change.
At-home dementia care that evolves with the client
Dementia home care services can be customized to provide as much or as little assistance as a family requires, and changes can be made as often as necessary. Services may include companion care, homemaker services, personal care, and skilled nursing care. Home care can be provided occasionally for respite, on a round-the-clock basis, or anywhere in between.
This flexibility is a significant advantage for family caregivers and people who are dealing with progressive diseases like dementia. As a loved one’s condition declines, in-home caregivers can offer the adaptability needed to continue caring for a dementia patient at home.
How much does in-home memory care cost?
As your loved one’s needs evolve, so will their care plan and cost of in-home dementia care. When it comes to budgeting for their care, it’s crucial that you understand their needs and start planning ahead of time. Factors that can affect the cost of care include the following:
- What products or supplies your loved one needs
- Whether home modifications are necessary
- Whether your loved one needs medical or nonmedical care
How to find home care for dementia patients
Handling a loved one’s care needs alone may work for some people, but it’s often unsustainable. For more guidance on selecting a home care agency, consider talking with one of AgingCare’s trained Care Advisors. They can answer your questions, offer their advice, and match you with an in-home care provider that suits your loved one's unique needs, all at no cost to you.
When home care is no longer enough
Home-based services for people with dementia can help delay the move to long-term care, but growing needs will eventually necessitate higher levels of care and round-the-clock supervision. Without a robust team of family caregivers to share the burden, stress levels are sure to rise and caregiver burnout inevitably sets in. It’s important to look elsewhere for assistance before a loved one’s care becomes physically and emotionally unsustainable.
As an example, after receiving their diagnosis, a person with Alzheimer’s lives for four to eight more years on average but could live for up to 20 more years, according to the Alzheimer’s Association. While it’s possible to receive more intensive dementia care services in the home, the cost of 24/7 home care is often too much for the average family to pay for privately over the long term.
The time for thinking about a move to assisted living, a memory care unit, or a nursing home is different for everyone. Ultimately, the decision depends on whether family members and hired caregivers can continue to cope with changes in a senior’s condition at home.
A reputable home care company will closely monitor their ability to provide the best care for their clients. Should a client’s needs surpass what is noted in their current care plan, the company will let the family know that additional services and/or changes in setting are needed.
Tips for caregivers helping a loved one with dementia
Dementia caregivers face unique challenges. Below are a few tips to help you navigate this phase of your loved one’s life.
Understand what the diagnosis means
Perhaps one of the most meaningful things a caregiver can do for a loved one with dementia is learn about their condition. Dementia is defined as a loss of cognitive functioning that ranges in severity and affects a person’s ability to control their emotions and behaviors, according to the National Institute on Aging. However, not all dementias are the same, and each person experiences dementia-related symptoms differently.
Talk with your loved one’s doctor about the type of dementia that’s present, what new symptoms to anticipate, what next steps will look like in terms of care, and what can be done to help you both cope with the diagnosis.
Caring for a loved one with dementia isn’t easy, but it can help to seek out support. Consider joining AgingCare’s online Caregiver Forum or finding a local in-person caregiver support group. Doing so will put you in touch with other caregivers who can share their own experiences, listen to your frustrations, and offer their sage advice and answers.
Conversations with someone who has dementia can often feel challenging. Improve communication with your loved one by following these tips for talking with dementia patients:
- Limit distractions
- Speak clearly and simply; using hand gestures can help
- Maintain eye contact
- Talk about one thing at a time
- Be patient, and understand that some days may be better or worse than others
Manage sleep and behaviors
With dementia comes a myriad of behavioral changes, like sleep issues, wandering, confusion, and angry outbursts. These can all present major challenges for patients and caregivers alike. To help manage a loved one’s problematic behaviors, try the following tactics:
- To minimize wandering, make sure all doors in the house are secured, and consider installing a surveillance system or alarms to help keep your loved one safe.
- For sleep issues, keep them active and engaged throughout the day, and set a routine sleep schedule. Unless recommended by a physician, avoid alcohol or sleeping pills to promote sleep as those can increase their fall risk and cause drowsiness the next day.
- Use companion cards when going out in public together. These wallet-size cards display a message that says something along the lines of, “My companion experiences memory loss and confusion. Please excuse any unusual behavior.” It’s a discreet way of informing people that your loved one may exhibit strange behavior because of their condition.
Make home modifications
Any home can be adapted to help reduce fall risks and other accidents. Consider the following home safety modifications to help keep your senior safe and secure at home:
- Create clear walkways by keeping floors clean and clutter-free.
- Improve lighting throughout the home, and add night lights where they’re needed.
- Add grab bars and handrails near toilets, showers, and bathtubs.
- Temporarily disable kitchen appliances to prevent burns and fires.
Reviewed by dementia care expert Adria Thompson, M.A., CCC-SLP.
Recognized Dementia Care Training Programs (https://www.alz.org/professionals/professional-providers/dementia-care-training-certification/recognized-dementia-care-training-programs)
Unmet needs of community-residing persons with dementia and their informal caregivers: findings from the maximizing independence at home study (https://pubmed.ncbi.nlm.nih.gov/24479141/)
Sensory stimulation for persons with dementia: a review of the literature (https://pubmed.ncbi.nlm.nih.gov/27030571/)
Stages of Alzheimer’s (https://www.alz.org/alzheimers-dementia/stages)
What is Dementia? Symptoms, Types, and Diagnosis (https://www.nia.nih.gov/health/what-is-dementia#types)