When you’re caring for loved ones with Alzheimer’s disease, health decisions are rarely black and white. This is especially true if they have an injury or serious illness. Ideally, a patient’s health crisis can be resolved at a hospital and they can return directly home. If they require transitional care, however, you may find yourself navigating this “grey area” on their behalf.
Skilled nursing or acute rehab facilities are the most likely stops on an Alzheimer’s patient’s road to recovery between hospital and home. This transition can be confusing and disorienting for a person with Alzheimer’s or other dementia – and sometimes unsafe.
In a skilled nursing setting, caregiver-to-patient ratios are much lower than in a hospital. (Kansas requires at least one direct care worker per 30 patients; Missouri has no minimum.) While this may be adequate for “typical” patients, it does not allow for the constant monitoring Alzheimer’s patients need to ensure their safety…or, in the case of dementia-related anxiety, their emotional well-being.
Bottom line: you, as the family member, must advocate for – if not provide – the additional care your loved one needs during their stay in acute rehab or skilled nursing.
Where to start
- Be informed – many facilities have several levels of care (“memory care” units for residents with dementia, skilled nursing units for either hospital-to-home transitions or long-term non-Alzheimer’s residents, and acute rehabilitation units). Know that these areas do not necessarily overlap—for instance, if your loved one with Alzheimer’s is recovering from a fracture, he or she will likely not receive direct care from staff of the memory care unit, but rather from the rehab or skilled nursing staff. Thus, the people caring for your loved one will have varying levels of knowledge and understanding of best practices for patients with dementia. You may need to be a teacher at times!
- Ask questions – ask the Director of Nursing (DON) at the acute rehab or skilled nursing center about their caregiver-to-patient ratio and protocol for working with Alzheimer’s or other dementia patients. Discuss your loved one’s cognitive challenges and what the facility is able (or willing) to do to accommodate their additional care needs. The answer may be “nothing,” but you at least will know what gaps you may need to fill in.
- Know your limits – determine when and how much time you are able to spend with your loved one at the facility to watch them, provide company and ensure their safety. Don’t try to stay with your loved one round the clock to the detriment of your own health and well-being (which leads us to number 4).
- Ask for support – discuss the additional care needs with family or friends in the area who may be able to help during your loved one’s rehabilitative stay. Develop a schedule that others who care may use to sign up to help. Remember, a trained healthcare aide isn’t necessary – the priority is simply to have a “sitter” with the patient as much as possible to prevent wandering, anxiety or accidental injury.
- Hire a companion – Ultimately, you may need to private-pay someone to be with your loved one when you can’t be. Again, this person doesn’t need to be a nurse or nurse’s aide…just a companion and advocate who can provide personal supervision not provided by the skilled nursing facility. ConciergeCare can help you find the right companion for your family member.
For support in monitoring your loved one’s skilled nursing care via random check-ins and assessment reports, as well as educating family members on how to work with facility staff to ensure the best possible care, contact us today at (913) 553-6226.