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How to Use Care Categories to Choose an Assisted Living Facility Part 3: Memory

When looking for care for a loved one with any dementia symptoms, it’s important to start with a visit to the doctor’s office. Dementia can be caused by Lewy Body Disease, Parkinson’s and Huntington’s disease. It can also be due to brain injury through a stroke which would cause what is known as vascular dementia or multi-infarct dementia. If someone comes to us without a formal diagnosis, we always recommend a visit to the doctor for diagnosis. This will ultimately help in making the best long-term care choice for your loved one.

To get a simple baseline, we often use the Dr. Folstein’s, Mini-Mental State Exam. This test is very simple, nonintrusive and can be done at home with your loved one. We’ll get a copy of this up on the website. For now, you can do a search for “folstein’s mmse” and several good options will pop up.

Here are some essentials to look for when assessing a care facility and their memory care.

Care Ratio: One of the most difficult aspects of dementia is the confusion is causes its victims. Imagine always being lost and not knowing what is going to happen next. Ample help always around can help alleviate the stress dementia causes. Any sort of balance or mobility issue is always amplified when dementia is in the picture. Lots of staff is needed to constantly run to the aid of someone who sets out to go to the restroom, but because of his memory loss has forgotten that he hasn’t walked since his knee surgery six months ago. Staff ratios range from 1-to-3, all the way up to 1-to-16. We strongly believe that excellent care hinges on the ratio and quality of staff a facility has.

Appropriate Engagement: All people are uniquely different and have a life history filled with experiences and preferences that make their activity needs unique to them. Because of that, we suggest to look at multiple options that different facilities provide. The overarching theme to look for is the goal of daily engagement, and flexibility that can build around your loved one’s preferences and desires. This is much more difficult than to herd a group into a circle and to just play a game that is next on the activities calendar. But this goes back to the point above, individual engagement requires enough staff to have the time to sit with individual residents and engage.

Clear Communication: Because dementia is often connected to confusion and difficulty in understanding, good communication is essential. That means the care team needs to be willing to use whatever tools they can to engage and communicate at the level of their resident. This means possibly using white boards, note cards and appropriate props. But frankly this also means speaking clearly in the language that is native to the resident. Many may say, “She has dementia, she doesn’t care if we speak amongst ourselves in a different language.” That is a demeaning and degrading attitude to have toward people. Imagine the confusion someone is experiencing while suffering from dementia, he strains to catch words and connect them to sentences. Then, someone in the room starts speaking and now he can’t understand anything. Imagine the confusion and hurt that causes since he probably thinks it’s something wrong with him. Even a thick accent can be difficult and hard to decipher for the elderly suffering with dementia. Good communication is essential to good care.

Safety: This is easy to overlook but as mentioned above in this article, mobility dangers are heightened when combined with dementia symptoms. Probably the biggest concern is wandering, and exit seeking behavior. If your loved one is “exit-seeking” then usually that means a facility that is a “locked-unit.” Though that sounds terrible, it’s just a community that has been laid out purposefully (usually in a circle) to keep people with wandering behavior safe. But a locked facility is not always necessary. A basic question to ask is, “What measures has your facility taken to protect the safety of residents suffering from memory loss?”

Look for the next and last article in this four part series. I sincerely hope these have helped you become better informed and started you down the right path of inquiry to help you find the best care suited for your loved one.