Indeed, the assistance of community-based establishments is beneficial to friends or family members living with Alzheimer’s disease (A/D) or dementia, but it gets challenging over time. In later phases of the illness, numerous individuals will require more consideration and help than their relatives can give. Notwithstanding for individuals whose conditions have not deteriorated badly, it is still important to put their safety into consideration with a personalized aid at home. In-house care alternatives might have the capacity to give great attention to their needs, but decision-making and planning can prove difficult. The management of Alzheimer’s disease and management require skilled professionals.
Guardians ought to research different choices for their friends and family before the dementia advances to the final stages. Respite care and elderly daycare are great alternatives for individuals who need to keep their beloved ones at home, yet, needs a break from their obligations. At the point when older folks are in charge of caring for someone living with mental ailments, it is essential to consider that the capacities of the guardians may likewise diminish with age.
Private Care Options for Dementia
The characteristic deterioration of Alzheimer’s Disease and different types of dementia will result in consideration for friends and family living with these medical conditions. Subject to the phase of Alzheimer’s/dementia, and his/her capacity to work, the level of care and supervision differs. For most families, this implies some special in-house care.
At this stage, establishments like assisted living, “memory care,” also called Special Care Units (SCUs) or Alzheimer’s Care Units, and skilled nursing homes become beneficial.
Assisted Living Centers
Assisted living homes like continuing care retirement homes are particularly suited for those people in the beginning periods of Alzheimer’s disease and dementia. This is true especially in those who do not have numerous medicinal issues, yet who do require more focused help for Instrumental Activities of Daily Living (IADLs). Numerous individuals with dementia will require help with IADLs. These are daily actions that substantiate the quality of life, yet are not as fundamental to self-care as Activities of Daily Living (ADLs). ADLs are the essential activities that enable individuals to manage themselves through the day. People with dementia may require help with these tasks. Below are examples of IADLs:
- Overseeing personal finances like issuing cheques, spending money, etc.
- Taking the suitable dosage of pills adequately
- Cooking and using the microwave
- Housekeeping such as performing light and heavy household chores
- Operating the phone, TV, or vacuum cleaners
- Shopping for products and recognizing the appropriate items to buy
- Extracurricular activities like maintaining interests in hobbies or sports
ADLs commonly refers to the tasks below:
- Bathing without help with cleaning or getting into the tub or shower
- Using the toilet and cleaning up
- Self-restraint of urination till the appropriate time place
- Dressing and preparing (i.e., buttoning up shirts/blouses, closing zippers, picking the proper dress)
- The ability to get out of a seat or bed, and walking
- Eating without any form of assistance
The individuals who are in the middle stage of dementia need a more prominent level of attention or supervision. Also, they need personalized care than those at the beginning phase of dementia, and for those in the middle stage dementia, assisted living is additionally a decent alternative. In assisted living offices, people live in a private studio, private loft, or apartment shared with another person. There are staffs available to help them throughout the day. This sort of program is perfect for the individuals who can still handle themselves with some autonomy, but still, require help with ADLs. Additional services are getting them to meet up with the physician for medical appointments and social exercises that are offered at the assisted living residences as well. Additionally, there are dining rooms for eating.
Residential Memory Care
For people with dementia who require additional professional care and supervision, memory care units are a perfect alternative. This option provides both private and shared living places. In some cases, they exist as a wing inside an assisted living facility or a nursing home, while occasionally they are offered as stand-alone homes. Thorough supervision is given twenty-four hours/day by staffs skilled in catering for the specific needs and demands of dementia patients. Memory care units operate like assisted living offices, with added exercises that are proposed to stimulate the memory of those with Alzheimer’s and different forms of dementia. These exercises are activities like music, arts, games, and handcrafts that potentially moderate the advancement of the sickness.
“Memory Care” Vs. Assisted Living regarding Alzheimer’s/Dementia
Vast numbers of similar programs are offered at assisted living places like those in memory care units. Be that as it may, there are additional aspects by which the dynamics of assistant living are different from memory care facilities.
Special Care Units (SCUs) Vs. Assisted Living regarding Physical Differences
Memory care units also called Special Care Units (SCUs) are typically intended to meet the particular needs of Alzheimer’s patients. In contrast to some assisted living homes, memory care facilities do not have personalized kitchens for their occupants to avoid increasing the stress of those with dementia as much as possible.
While some assisted living centers do have safe territories to suit those with mild dementia, memory care units have upgraded security to keep patients, especially those with advanced dementia, from straying away or wandering off. The outdoors is large enough for amusement and fun activities without patients having the opportunity to leave the property.
Since people with dementia may effortlessly wind up pushed and confused, memory care units prioritize on establishing a very relaxing atmosphere and environment. This is achieved by having a place where occupants can assemble and watch the TV. Also, having corridor walls painted with splendidly colorful, as well as beautiful and bright-colored paints, with rooms that allow a great deal of natural sunlight helps in maintaining relaxed moods amongst the people. Another basic appearance of Alzheimer’s disease is the loss of appetite, which is addressed by some memory centers with an aquarium placed in the dining hall. Research has shown that something as subtle as watching swimming fishes can help cause an increase in the appetite of people.
Memory Care Vs. Assisted Living from other Perspectives
For the most part, security checks are accomplished all the more habitually in memory care units, and a few centers even use tracking braces that will go off if an occupant gets too close to an exit. Memory care units typically operate on a more uncompromising mode of scheduling, since those with dementia, can be triggered easily when in new environments and conditions, hence the need for the firm schedule.
It is regular for those with Alzheimer’s not to feel the need to eat, so memory care units have special meal plans that are attractive, flexible, and enticing to promote interest, as well as, appetite. Also, the plate on which the food is served to the occupants is also selected specially to create interest from the patients to eat and get the required nourishment they need. Additional safety regulations are set up in memory care facilities to guarantee the well-being of their inhabitants. All the things that are dangerous to the health of these occupants are kept away carefully away, for example, cleansers, soaps, and alcohol-based mouthwash.
Training of the Members of Staff
In assisted living, the staff is prepared to help patients with their activities every day. For example, helping a person to bathe, using the toilets, cleaning up after them, and offering assistance with putting on new dresses. In memory care units, the staffs are also skilled in aiding inhabitants with daily actions and tasks, but they possess vital skills in managing the specific needs of those residents with Alzheimer’s and other dementias. The training they undergo incorporates seeing how the ailment shows, knowing why dementia patients may display questionable attitudes, how to react to that behavior, and how to speak with residents living with dementia.
Staff to Patient Ratio
For assisted living centers, national laws are absent at present with regards to what a fitting staff to patient proportion should be, as it is left to the discretion of the communities to decide the “adequate” ratio as it suits their program and inhabitants. That being stated, memory care units do require a higher staff to patient balance with the end goal good enough to give the attention expected to people with dementia. The perfect staff to occupant proportion is one member of staff to five inhabitants, although the ratio of a staff member to six occupants is more common. It is significant that even in memory care centers that are adequately staffed, the necessities of individual occupants may surpass the capability of the employees. In these circumstances, the family might be approached to pay for extra hours of external care daily.
The Population of Occupants
Assisted living homes offer various alternatives to the number of residents. Some centers accommodate four to six individuals, medium centers that house 11 to 25 individuals, expansive centers that house 26 to 100 individuals. Moreover, there are communities that take more than 100 individuals. Similarly, with assisted living networks, memory care centers likewise house from as few as four occupants to as large as 100, but memory care centers with 100 inhabitants are somewhat uncommon. Some people with dementia are more relaxed with a large group of inhabitants, while others are only comfortable with a fewer number of residents.
Memory Care Centers that are Stand-alone Compared to Memory Care Wings
Stand-alone memory care centers are more suited and structured to address the issues of people living with Alzheimer’s or related dementias explicitly. Regularly these homes are planned and designed to make inhabitants feel as great as required. A model is a center built as a round structure because those with already at the advanced stage of dementia regularly feel more pressure and stress when moving toward the end of a corridor. This additionally enables occupants to move safely around the house.
Fees
For both assisted living and memory care centers, payment of fees is an integral factor of service delivery. These incorporate the geographic zone in which one lives, regardless of having a self-contained or a shared room, and the level of care and supervision one requires. Nonetheless, because of the particular dementia care that is offered at memory care units, this kind of consideration is, in general, higher than assisted living. One can hope to pay around $3,700 per month for assisted living centers and memory care centers may charge a monthly payment of up to $5,400.
Inquiring about Assisted Living, Adult Independant Living Communities and Memory Care Centers
While looking for an assisted living office or a memory care center, it is vital that one carry out a thorough inquiry. These centers differ on the basis of the care and supervision being rendered, the number of tenants and staff, the design of the community, and fees. It is crucial to locate a home that best addresses the issues of one’s friend or family. This procedure can be challenging, but there are places to get free help, available to enable families to find and assess assisted living and memory care centers.
ICD 10 Code For Alzheimer’s Dementia Diagnosis
It is also beneficial to understand the diseases as well. The former President of the United States, late Ronald Reagan, died of Alzheimer’s disease. There are around 6 million Americans who are living with this illness and much more everywhere in the world. The neurodegenerative sickness, which was first analyzed in Auguste Deter Well, affects the brain gradually at the early stages before getting rapid in the later stages.
Diagnosing Mental Disease and Mental Health Care Programs
The disease which affects one’s cognitive and intellectual behavior can be diagnosed by checking the family history of the person, physical medical examinations, and behavioral observation. More tests can also be conducted utilizing medical imaging. Further diagnosis can be carried out with Magnetic resonance imaging (MRI) which uses magnetic radio waves and a computer to examine the brain, and reveal any abnormalities and Computed tomography (CT) which takes shots of the body from different angles using X-rays to show cerebral damage common in late stages of Alzheimer’s disease.
Also, Positron emission tomography scan (PET) shows the tau formation and amyloid aggregation characteristic to the neurodegenerative disorder of such magnitude and also Single-photo emission computed tomography (SPECT). Patients are subjected to tests with these machines to exclude other brain diseases or dementia, mainly medically imaging assists in eliminating the other possible diagnosis as the physician works on confirming if the patient has Alzheimer’s disease.
When an individual begins to experience a sudden state of forgetfulness, and the memory does not quite serve the person as it typically does, one could try to get assessed to put to bed any worries. Even if it is Alzheimer’s disease, discovering the condition at the beginning phase, before the degeneration and progression ensues, has a much better prognosis. There are lots of standard and easy to use criteria developed for the proper and adequate diagnosis of the disease in patients.
The criteria used in testing by the Alzheimer’s association requires that the individual has a cognitive impairment and as well as confirming any case of dementia with neuropsychological testing. To fully confirm the diagnosis of Alzheimer’s disease, the brain tissue of the person is required for examination in order to be fully certain and definite. Since, brain biopsy is not advisable, using the diagnostic criteria have proven to be good and consistent when the disease is eventually confirmed using histological confirmation, post-mortem. There are about eight cognitive skills that are usually affected, as listed by the American Psychiatric Association. Memory is one of them; the others are attention, language, perceptual skills, orientation, cognitive abilities, functional abilities, solving problems and orientation. The criteria are documented in the book the American Psychiatric Association published on NINCDS-ADRDA Alzheimer’s criteria listed in the book, Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
Screening Test for Alzheimer’s Disease
The neuropsychological screening test scan is very useful in the diagnosis of Alzheimer’s disease. People are given memory tasks, testing how well they can copy paintings, recollect words, and perform calculations and their reading ability. An example of such screening is the Mini-mental state examination also known as MMSE. It is used in identifying the cognitive impairments that are necessary for use in the diagnosis, such as the attention span of the individual, the memory capabilities, the problem-solving skills, and counting skills. All these are needed to identify the part of the brain that may have been affected in some way. However, for confirmation of the disease, family members would be questioned to give information about the routine of the individual concerned. If they have a caregiver, they are also interviewed to provide insight into the behavior and abilities of the person most especially questions concerning the mental health of the person. The role of the caregiver is significant because the healthcare professionals are trained to pick out the signs of Alzheimer’s disease in people which the family members may not have noticed due to their activities or emotional bias. Often, the people involved have no idea of what they are going through or the changes happening to them. Initially, that could be a problem as they may be asking people about an issue they have discussed over and over again. That is usually frustrating for people close and surrounding them as they do not understand what they are combatting. However, as soon as one keeps in mind that older people are likely to have not just memory loss but also degenerative mental inadequacies, then one can be a bit lenient and lean towards the angle of getting them to the hospital to assess their state of mental and physical health.
A wide array of medical examinations is very helpful in eliminating differential diagnosis. Common ones like blood tests, which can pinpoint the causes of dementia much more than Alzheimer’s disease or confirm if the person is anemic as this may point towards delirium. Thyroid function tests (TFT) helps in ruling out syphilis. Kidney function test assists in eliminating the metabolic problem, measuring electrolyte levels for diabetes diagnosis.
Treatment of Alzheimer’s Disease
There are no medications for the treatment of Alzheimer’s disease, but the symptoms of the patient can be managed using drugs. Donepezil, Galantamine, and Rivastigmine work by helping the brain function improve remarkably especially in the early stages of diagnosing the disease. Other medications such as Memantine can be prescribed by Doctors for patients to use together with the ones mentioned above, as it helps in managing the level of glutamate usage and it protects individuals with moderate to severe stages of the disease from deteriorating too fast, with very little or no side effects compared to other medications.
Nursing Facilities with Skilled Caregivers and Nurses
Another choice apart from assisted living homes and memory care centers is the nursing homes, which give more broad therapeutic care than assisted living centers and memory care facilities. Nursing homes are most appropriate for people with Alzheimer’s disease or dementia who are in the later phases of the illness and who have more difficult issues with their wellbeing or with everyday living. Notwithstanding your earnest attempts to protect and take care of one’s friend or family, it is crucial to take into consideration a long-term solution for him/her once the following conditions are observed:
- Individuals that are incapable of complete daily activities like taking baths, dressing-up, basic movements, and personal hygiene.
- Cherished one needs more consistent supervision than you can give, regardless of whether for meandering or different practices.
- The family member or friend is becoming increasingly difficult to sustain satisfactorily in terms of hydration, nutrition, and general
- Loved one is a risk to himself or herself or others on account of their conduct and activities.
Memory care centers are specialized facilities equipped with professional caregivers working in a specialized environment to bring comfort and care to people living with Alzheimer’s disease and different forms of dementia. The level of care and attention required is often challenging for family members, not because of the lack of love, but because these illnesses are complicated. Each stage of the disease presents with new sets of difficulties, which is why memory care centers is a better option from the view of medical experts.
References
Alzheimer and Dementia. Alzheimer’s Association. Retrieved 15 February 2018, from https://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
How “Memory Care” for Alzheimer’s Differs from Assisted Living. (2018). Retrieved from https://www.dementiacarecentral.com/memory-care-vs-assisted-living/
Lava, N. (2017). Making the Diagnosis of Alzheimer’s Disease. WebMD. Retrieved 15 February 2018, from https://www.webmd.com/alzheimers/guide/making-diagnosis-tests#1
Lava, N. (2017). The Diagnosis & Treatment of Alzheimer’s Disease. WebMD. Retrieved 15 February 2018, from https://www.webmd.com/alzheimers/guide/understanding-alzheimers-disease-treatment#1
McKhann, G., Drachman, D., & Folstein, M. et al. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology. 1984;34(7):939–44. doi:10.1212/wnl.34.7.939. PMID 6610841.Retrieved 15 February 2018, from http://www.oalib.com/references/7629923
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