Which Kind of Senior Housing is Right for Older Adults with Dementia? What You Should Know When Seeking a Home for Your Loved One


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Searching for the right senior housing for a loved one is never an easy task. Whether you’re trying to renovate your loved one’s home so they can continue to live independently, or you’re researching home care or assisted living options, finding the right home for an older adult can be daunting. But if your loved one has dementia, the search can get even more complicated. Adults that suffer from dementia may be prone to wandering and forgetfulness that can put their safety at risk.[1. “Wandering and getting lost,” https://www.alz.org/care/alzheimers-dementia-wandering.asp] You want to keep them safe, but you worry that your goal is at odds with their desire to remain independent. With so many different options, how do you know you’re making the right decision? A closer look at the choices below may help you, your loved one, and your family decide.

Assisted Living

One of the first housing options that often comes to mind for older adults is an assisted living facility. This is where your loved one lives in a building or collection of buildings that acts sort of like a hotel. There are typically staff members there that provide some measure of cooking, cleaning, transport, and recreational activities. There may also be medical personnel available.
Pros: For the dementia sufferer, there are a number of benefits to this arrangement. They no longer have to take care of things like cooking, cleaning, medication management, and driving, many of which they may have lost the ability to do. Another benefit is that they’ll have the opportunity to socialize on a regular basis with their peers.
Cons: Many assisted living facilities still require that their residents perform ADLs (Activities of Daily Living) such as toileting and bathing on their own. The presence of medical staff and supervision may be limited, and the promise of high-quality care has proven tenuous in recent years as several assisted living facilities have undergone controversies about neglect and poorly trained staff.[2.”Lessons We Can Learn From Frontline’s Exposes of Assisted Living,” Forbes, July 31, 2013, https://www.forbes.com/sites/howardgleckman/2013/07/31/lessons-we-can-learn-from-frontlines-expose-of-assisted-living/.] The high costs of assisted living can also be a problem for families on a budget.

Nursing Home

Nursing homes are the only 24-hour facility that provides supervision around the clock. They will typically take residents with any level of ADL ability, including those who can’t perform any self-care. Cooking, cleaning, and medical needs are all taken care of by staff members. There is also usually some form of recreation provided.
Pros: For the dementia sufferer, this is one of safer options available. It’s similar to assisted living without the drawbacks of limited staff and supervision, ideally. There is little chance of the patient wandering or forgetting important things like meals or medications.
Cons: Understandably so, a lot older adults wish to spend their golden years in the home where they’ve lived for years. Those with dementia are often no different, even if they can’t express it. There’s also good reason to think that remaining in a familiar environment, like their own home, may help them hang onto important memories longer. As with assisted living facilities, the high costs of nursing homes can be a major barrier for many families looking for care options for their loved one.

Independent Living

Independent living is the ideal option for many older adults, but this option is particularly tricky for people with dementia. With independent living, they stay in their house or apartment, but they’re also responsible for its cleanliness, maintenance, their self-care, transport, and other essential tasks. Also, they must look after their health and provide their own socialization outlets.
Pros: The older adult gets to live in a preferred, familiar environment, which may help counterbalance their dementia symptoms.
Cons: This option can be the one that poses the greatest risk to the dementia patient’s safety. Without assistance or supervision, older adults with dementia may be prone to wandering, isolation, a lack of self-care, or worsening medical conditions that go unnoticed. However, these issues can often be solved by having a home care aide in addition to the caregiving provided by the family.

Home Care

Home care isn’t a type of residence, per say, but it still bears special mention in our list of housing options for older adults. With home care, a licensed or certified aide or nurse can visit the home regularly, whether for a few hours a day, a few days a week, or even 24/7. These professionals can take care of things such as the following:

  • Cooking
  • Light housekeeping
  • Transportation
  • Bathing
  • Feeding
  • Toileting
  • Companionship
  • Wound care
  • IV infusions
  • Medication monitoring

Pros: Its adaptability to a number of different living situations makes home care an attractive option for those who suffer from dementia. It combines the benefits of supervision, companionship, support, and health monitoring that assisted living and nursing homes offer. The best part? It offers all of these in the patient’s own home, so the benefits of independent living remain as well.
Cons: Cost is a concern for many clients considering home care, as it’s not covered by Medicare. However, other insurance programs, such as Medicaid, do cover home care options. It can also be surprisingly affordable in comparison to both assisted living and nursing homes.

The Right Senior Housing Option Depends on Your Loved One

In the end, finding the right senior housing depends on the needs and wants of you and your loved one, the progression of their illness,[3. “Stages of Alzheimer’s,” https://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp] and your budget. But it’s important to realize that when it comes to dementia sufferers, supervision should be your number one concern when looking for housing. If you keep that in mind, then no matter which option you choose, you’ll have done everything in your power to keep your loved one comfortable and safe.
If you’re unsure of how to best help an aging loved one, the trained and compassionate staff at the Institute on Aging is here to help you make that decision and gain the best in at-home care for older adults. Contact us to find out more.

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Sophia became a part of the Community Living Fund team in December 2022, joining at a critical time when additional coverage was required for certain cases. Additionally, CLF was in the process of introducing a new assessment and implementing CalAim services for San Francisco members.

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Three and a half years ago, Maggie Fang started her journey as an Assessment Specialist in the Support at Home Program at IOA. Her excellent people skills enabled her to manage a caseload of older adults and individuals with disabilities, helping them receive homecare to age in place. Maggie was selected to pioneer the Temporary Respite Caregiver Support program, and we are delighted to have such a skilled and dedicated individual leading our newest program at IOA. Thank you, Maggie, for your exceptional work! 

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