Tuesday, 15 November 2016

Many choices of care exist for dementia

Caregivers living with a family member or spouse already have to cope with stress as they watch their loved one’s mental acuity slowly regress to the point where it becomes a full-time job.

There comes a time when the always-painful decision must be made: do we keep those afflicted at home or do we seek professional care.
Either way, it’s costly. Housing someone with dementia can mean making physical changes to bathrooms, kitchens and perhaps purchasing walkers and other items. Placing mom or dad in an assisted living facility or nursing home can be expensive, depending on the stage of the disease and the level of care.
What’s a person to do?
Debbie Selsavage, owner and president of Coping with Dementia LLC, said there are many options, ranging from home care to assisted living facilities. Citrus County also has programs available.
Given its aging demographic, Citrus County is fortunate to have a wealth of facilities to assist the elderly. As of September 2015, there were 22 assisted living facilities and nine nursing homes, according to nonprofit health council WellFlorida Council.
Selsavage said many ALFs have sliding rates, depending on the level of care. Others have set fees and also offer memory care services, she added.
An ALF is not a nursing home. That’s a place where people go if their health gets so bad that it is beyond the scope of an ALF. Nursing homes cater to people with advanced medical issues, including moderate to severe dementia. 
An ALF is more like a home, with residents living in their own apartments. People who live in an ALF can have physical disabilities, limited mobility or a certain amount of memory loss. In fact, for people with declining health, the appeal of an ALF is having someone on staff 24-7 to assist. 
Selsavage said spouses or family members should not feel guilty when placing someone in a care facility. It comes to a point where the caregiver risks harming their own health by taking care of the dementia patient. Also, they may require more medical care than the family is able to provide.
And as dementia worsens and death nears, Hospice can be called in to either the home or ALF.
“I don’t think it’s a bad thing at all,” she said. “You’re looking at placing someone, for their own safety and care when it gets to the point where they can no longer dress them or bathe them. It’s a better quality of life for both of you to find that right place.”

Often, people will swear they never want to be placed in a care center, Selsavage said. But often there is no other choice.
While the idea of living in a large ALF with hundreds of people may seem like paradise to some, for others it may be overwhelming. For those people, smaller residences run by licensed individuals who take in a small number of folks in their own homes. In these adult group homes, mom or dad lives with the family running the place and is treated to home-cooked meals and given assistance.
Yet another option is home health care. Some people prefer to stay in the familiar confines of their home and age in place, taking visits from nurses, certified nurse assistants or therapists by appointment. Home health care works best when dementia is not an issue or when there is a primary caretaker living in the home.
Dementia is a disease that affects whole families because everyone seems to have a different treatment opinion.
“They will have conflict and they will have different ideas as to care — what is needed and what is required,” she said. “It can divide families.”
Selsavage urges caregivers to seek out support groups in Citrus County to help them through the difficult journey.
“It shows people are not alone,” she said.


SOURCE: Citrus County Chronicle, Michael D Bates

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