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My aunt is suffering from this disease and we are not able to handle her alone. While browsing, I had noticed that there is some efficient elderly care home in Toronto ( c-care health services ) which are providing 24 hours nursing care. Some are providing independent and assisted living services. Which will be best for my aunt? By the way, she is refusing to go to any nursing home. Do I want to hire a caregiver instead? I’m confused. Please help me.

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What stage is the disease in? What are your aunt's current impairments?

Where is she living now? Persons with dementia cannot live alone beyond the very earliest stage, so either in-home help, living with family, or placement in a care center is required.

Many ALZ patients can live in a private home (with aides or with family) for many years. In other cases the patient quickly moves into a stage where a professional care setting is needed. Perhaps that is where your aunt is at, since you are not able to handle her alone.

For most of us, cost is a factor. The most expensive option is usually 24-hour care at home, either live-in caregivers or 3 shifts per day.

Explain a little more about your aunt's situation and we may be able to tell you things to consider. But each case is different and one size does not fit all!
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My wife now no longer walks. I am in good health and handled everything by myself as long as she could walk, but found I was overwhelmed once she stopped walking. She is in our home, in a corner room with windows on two sides, and on a hospital bed. She is bed-bound and chair-bound, needing help with all ADL's including dressing, bathing, hand feeding, placing her on the toilet, transferring with wheelchair, etc. During the day she is up and is moved between the kitchen and various chairs in the family room. Her dementia stage is severe and entering into the very severe. From nine to five, she has an Aide, who is a private, independent, contractor. The Aide is highly proficient in all aspects of home health care. From five to nine the next morning, I handle the work and responsibilities. I am free to exercise, play duplicate bridge, swim, grocery shop, etc. during the day. We are self-funded for this phase in our lives, and the cost is about the same as a 24x7 skilled nursing memory care facility. I believe her quality of life is much superior to what it would be in a facility. She enjoys music, benefits greatly from the continuous one-on-one interaction, has family and friends visit, and has adjusted to her current reality. Our objective is the best possible palliative care, and I believe we are currently on target.
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I'm not familiar with the Canadian social/healthcate system, but here in the US, you would start with what is called a "needs assessment". Your aunt's physician may be able to help you find an agency, like the Visiting Nurse service who can conduct this.

The question is, what does she need assistance with? Can she walk, toilet, bathe and dress herself
? Prepare meals, feed herself?

Look up "activities of daily living" and you'll get an idea of what she needs help with.
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No one "wants" to go to a nursing home. However, do you really think a person with dementia has the ability to reason what is in their best interests? You choose what you think would be best. Canada has different healthcare requirements than does the U.S.
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I believe you should get an evaluation through Social Services whereas a nurse comes in and evaluates your aunt. She can determine what kind of help she needs and what types of services are in your area that can help.

Also I would contact the Office of the Aging in your area as they are very helpful to connect you with resources/Nursing Homes/Assisted Living Facilities that are available in your area. Some Assisted Living Facilities are for Veterans here too.

Some Nursing Homes here in NY (USA) have Assisted Living and then if needed a place to go into Long Term Care if needed which is a part of the facility.
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The "needs assessment" is a good idea. I would make sure that someone who really knows her needs is present though to ensure that the person taking the information is able to get the full and accurate picture. Some people report that they are able to do a lot of things, that they are not able to do. They may report that they an bathe themselves, but in fact, they haven't bathed on their own accord in months. They may say they can cook, but they don't actually have the skills to cook.
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Sunny makes a good point. A family member should be present.
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All very good posts and I agree that someone with an impairment can not and SHOULD not make decisions. My mother would NEVER had agreed to go to a facility but when she got hard to handle that was our only choice. If you talked with her for 5 minutes she could trick you into thinking she was fine but longer than that and anyone could see she wasn't. That s why It's best to have her evaluated by a geriatric doctor for more than 5 minutes. Not sure how far along she is but sounds like she can't live by herself. Might have to "trick" her into going to dr. for a place you want the dr. to look at on her back. My mother would never go to the dr. Ohhhh, the stories I could tell. :) Funny now, not then. Social worker is a good place to start also. Attny next to get financial things in order. Might have to tell her attny is for you and that you need her to "help" you sign things. Anyway, good luck and God Bless.
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In Toronto you would need to contact your local community care access centre (CCAC) for an evaluation by a care coordinator. They can help you determine what level of care she needs. She will not be considered for a nursing home (long term care) unless she meets the criteria, and in the GTA I expect the waiting list to get into one is long.
Some ALs will be better equipped to handle someone with Alzheimer's than others, you will need to shrewdly assess the level of care each one truly provides and have it in writing if you go that route. And remember you always pay more for each additional service.
A limited amount of home care can be provided by CCAC, up to 60 hours a month (but good luck getting that much). You can also purchase extra care as needed.
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angelina32: She must go to an NH. Alzheimer's patients can't be handled at home.
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75% of all Alzheimer's patients live with family.
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LadyMiller: Does this 75% live with family from onset of Alzheimer's until death? I don't see how that would be possible as the patient worsens. The home caregiver would have to be a saint.
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We had a neighboring family where the mother and four of her ( grown) children developed Alzheimer's. The mother ended up in a NH. She was a widow. All the sons stayed home. Wives took care of them. The daughter and her husband both on hospice now in their home. So like was said before not all are the same. And yes their wives were/are saints.
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97yroldmom: Yes, those caregivers WOULD have to be saints!
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Angelina32, Will you keep her in Canada or move here? I couldn't tell where you live. Most states have different laws on Long Term Care facilities. I'd look into the options and the ones in Canada.

In the US, nursing homes are normally for those residents who need skilled nursing care. Whereas Assisted Living is for those who don't need skilled nursing care, but do need assistance with their daily functions, like bathing, dressing, taking medications, etc. Memory Care is also assisted living, but geared towards those with significant dementia that requires more extensive one on one care for their daily needs. In NC, residents of Memory Care facilities can stay there for the rest of their lives, even if they become bed bound, as long as they don't require skilled nursing care. They handle those residents who are incontinent and hand feed those who need it.

I might discuss her diagnosis and prognosis with her doctor. Do you have legal consent to act on her behalf? I might discuss what that involves with legal counsel where she resides.
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Llamalover47..My husband was diagnosed almost 10 years ago with Alzheimer's and I said from the start that I will keep him home as long as I can safely care for him. Safely for me as well as for him.
I have progressed from dealing with hoarding, to wandering. Then a broken hip, we pretty much went through rehab together. Walking with a walker, then having to use a "sit to stand" to help him get up. Then progressed to no longer walking and using a Hoyer lift.
He is still at home. He is safe.
I will admit I have it easier than some he is not combative or abusive. He has been non verbal for about 6 years.
It is not easy.
It is not fun.
There are rewarding times.
but I know he is getting good care.
he is probably healthier than he would be in a facility.
he is alive longer than he would have been if I had placed him when he broke his hip 3 years ago.
So some
Alzheimer's patients can be handled at home.
Again it is not easy.
At this point I do have help and support from Hospice. And for that I will be ever grateful.
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Grandma1954: Great job! I had a late friend whose husband was in the local N H for 12 years with Alzheimer's. She went to said NH every day-365 days X 12 =4,380 trips.Each and every day, she made sure he was pristinely dressed and perfectly coiffed for 4,380 days!
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Llamalover...I guess at my age and the way I was raised you do what you do for the ones you love. My Dad and Grandma took care of my Mom. My Dad took care of my Grandma, his M-I-L during her illness and I helped, as much as I could to take care of my Dad while he was ill. At least as much as a 16/17 year old could. I married my husband and if I recall there was something about ..in sickness and in health...I guess this counts.
I guess it helps that we have had a good life and that we love each other. I can not imagine doing this for a spouse that you do not love. And we all know someone in a marriage like that.
and I also could not do this if my safety or his was in doubt.
Thanks for the "great job." it is nice to hear that. I think we all need to say that to ourselves a little more often. Don't be so hard on ourselves. Nothing will ever be perfect but we can hope that we have done our best and that is all anyone can ask of us.
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Grandma: You're welcome.
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