At home, in adult day care, in assisted living…how do you know if it’s a good fit?

dementia-by-day:

How can you tell if where your loved one with dementia is currently living is…well, working? How do you know if it’s the right fit? It’s pretty difficult to ask someone living with dementia what their opinion is on the subject. Even if you were to move them, would that make them happier? Would it be safer? 

“It’s getting late,” Maryann said, looking out the window. “I think it’s time I head home.” 

I’d heard this phrase a million times from a million different people. “I want to go home,” is a common phrase from someone living with dementia. There’s always a sense that, where they are, isn’t where they ought to be.

In this case, however, Maryann was home: she’d been living in the same house for over fifty years! In her mind, however, she wasn’t home at all. For her, I came to realize, “home” was where she’d grown up.

“Let’s go tomorrow morning,” I offered. “It’s getting dark. I don’t like to drive in the dark.” Maryann agreed. “Me neither,” she said, shaking her head. 

Remember that we never, ever want to “convince” someone with dementia of something. We don’t want to tell them that their loved ones are dead, we don’t want to tell them that where they are living IS their home, we don’t want to remind them that they have dementia. 

So, we can’t really ask someone living with dementia if they like where they are living: that’s a very open-ended question that supposes they understand their options. And most people with dementia cannot understand their options.

Then, how do we know if where they are living is a good fit? Let’s see:

  1. Is it safe? For them and for you, we need to ensure that where they are living is safe. Does home have way, way too many stairs? Does the assisted living building not keep track of their comings and goings? 
  2. Do they socialize? I’ve had residents in my dementia care communities who will tell their family members that “they have no friends and they are bored all the time” and after the family leaves, they’re sitting at a table laughing and talking with their friends while doing a craft. (So, you may need to remove any bias you have while evaluating this.)
  3. Do they seem happy, generally? Again, we can’t really ask someone if they are happy, we just need to evaluate.
  4. Do they get the right nutrition? Not just food, but water. Are they eating and drinking enough?
  5. Are there things to do to alleviate boredom—and are these things at their level of need and skill? I’ve seen many people with dementia living in independent living communities who have such a hard time “keeping up.” They don’t know what to do when or how. Their level of need is much greater than the population that independent living was designed for.

My point is this: your loved one living with dementia will probably, at some point, mention “going home.” Assuming that a MOVE is the right answer is probably too quick of an assumption. There are a lot of factors worth evaluating!

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Published by Residential Forum

The Residential Forum is to promote the achievement of high standards of care and support for children and adults living in residential care and nursing homes, supported housing, residential schools and colleges, hospices and hostels. It contributes to improving the quality of service to the public. Members of the Forum are people of standing and experience drawn from the public, private and voluntary sectors, as well as some who can speak for service users and carers.

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