Dementia: how to decide on residential care

Residential care is available for people with dementia - here's what to look for and some practical suggestions for making the move.

Making the decision to find an alternative to caring for a person with dementia at home can be one of the most difficult decisions families and carers will make. This may be particularly true if the person with dementia is a long-term partner. Being prepared can help make this decision less stressful. Knowing about the services, government policies and costs of residential care beforehand can help you make the best decision, even if the decision has to be made quickly.

Where to begin?

Talk to:

• Your doctor

• Alzheimer’s Australia

• Other families and carers

• Your local Aged Care Assessment Team (ACAT) The Carer Advisory and Counselling Service provides carers with information and advice about their caring role and about relevant carer services and entitlements.

The Carer Advisory and Counselling Service can be contacted from anywhere in Australia on 1800 242 636 or visit carersaustralia.com.au

Commonwealth Respite and Carelink Centres around Australia provide information about the range of community care programs and services available to help people stay in their own homes. Call 1800 052 222 or visit the website.

The Australian Government has established My Aged Care, a service to provide support and assistance with queries about access to home and community care, respite fees, and bonds and charges. They can also help you look for Government funded aged care homes that meet your particular needs. Call 1800 200 422 or visit the website.

Low level care residential facilities

These facilities are funded by the Australian Government and are suitable for people who are mobile but need some care assistance. They may require assistance with personal care, laundry, cooking, shopping or the supervision of their medications. Accommodation is usually in bed sitting rooms with private or shared bathroom facilities.

High level care residential facilities

High level care accommodation provides 24 hour nursing care for its residents, and is staffed by nurses and personal care assistants. Generally they are most suitable for a person in the later stages of dementia, or those with other medical conditions. The Australian Government funds all high level care residential facilities.

Ageing in place

Many aged care facilities provide ageing in place, meaning that the person is provided with care in the same room even if their care needs, services and funding changes.

Specific dementia units

These are units designed specifically for people with dementia and they can be classified as either low level or high level depending on the level of care provided. Not all people with dementia require a specific dementia unit. People with special care needs, such as those who may not be safely accommodated in general residential facilities, are best suited for these units.

Assessment for residential care

The ACAT will determine the level of care needed by the person with dementia. The team will assess their needs and recommend appropriate types of residential care and provide details of facilities which may be suitable. Any concerns or issues that you may have can be discussed with the team. As applications will usually have to be made to several facilities it may be necessary to visit many places. Try to work through the list of facilities in an organised way taking notes as you go. If possible, take a friend or family member on the visits. Trust your intuition and common sense when assessing residential care facilities for a person with dementia.

Planning for the move

Once a place becomes available in a residential facility a decision may need to be made very quickly, so it is helpful to plan the move in advance. Many people with dementia can be disturbed by change. Explain simply and gently where and why they are moving. Emphasise the positive aspects such as new friends and enjoyable activities. If at all possible, introduce the person with dementia to the new facility gradually so that the place becomes a little more familiar and a little less confusing and frightening. Sometimes of course this is just not possible, especially if the move has to be made quickly.

Ensuring that their new room has as many familiar items as possible may help with the move. Family photos and familiar prints or paintings on the wall and familiar bed coverings can make the new room look a little like their own bedroom at home. Label all personal items with large, easy to read identification.

Check if the facility provides a labelling service, as this may save you some time. During this initial moving stage it will take time for both the person with dementia and their family and carers to adjust to the new situation. Expect a period of adjustment. People do settle. Many actually do better in a structured environment – they feel more secure and get more stimulation.

There is no right number of times to visit or length of time to stay. Some people want to visit frequently during this time. Others will want to rest and recover from the strain of caregiving. The important thing is to make each visit as rewarding as possible.

Remember

It is important to take care of yourself when the move takes place. Residential staff will be looking after the person with dementia – consider who is going to help you at this time. Use family and friends for support during and immediately after the move.

This fact sheet has been reproduced with kind permission from Alzheimer's Australia. For more information, please visit Alzheimer's Australia.