Okay, so where can someone with dementia live? And how do I know what works best? You know, in terms of moving somebody? So let's first review, how do you know where somebody could live? Like, how do you even figure out if you need to move them? The good news is there's no one size fits all answer to figuring out where someone that you love who's living with dementia can live.

That news is that you do have to decide what does fit best. Just go like, well, we're just gonna keep on doing what we're doing, even though it's not working very well, probably isn't a super great answer, right? Here's some reasons that you may want to reconsider where that person lives, mental health reasons, be it your own, or there's physical reasons. Maybe they're living at home and there's a ton of stairs in the house where they're living. And you're like, this is not working out. Behavioral reasons.

Maybe they're having some behavioral issues that make it difficult for them to be with other residents in assisted living, familial reasons. Maybe someone in your family wants to take over the caregiving duties, okay, maybe they need to move distance reasons. Maybe you are the caregiver and you live miles and miles away. And you need to make sure they're being cared for because living in their house is not really working out. Comfort reasons maybe where they're living is not comfortable for them for a variety of factors. personal preferences I've said before, I'm a huge extrovert, I do not want to be in the house by myself, pretty much ever.

So living at home and having someone take care of me at my house would not flow would not work flow well for me right. Here are your long term care choices and we will go into more detail in just a second. But I want to show you a huge list. Because I think that a lot of times people hear Oh, someone has dementia, well either I need to keep them at home and take care of them 24 seven or I need to quote unquote, move them into a nursing home. There's actually a lot of options here. They could be at home by themselves with a homecare agency coming in.

And I say this because I really do not recommend somebody past a very early stage of dementia. Being at home alone. I do not recommend this. I don't care how many technological advances you have in place that you have cameras and you have GPS on them and you've got you know, notes everywhere. I really do not recommend just leaving somebody at home. At Home With a family member and or some home care coming in.

And someone else's home with other family or homecare coming in you know, maybe it's a really small like home situation where a couple people with dementia live there. Those are getting more and more popular, adult day care, assisted living or personal care. community, maybe there's a special quote unquote Memory Care wing, maybe there's a memory care part of it. I like to refer to memory care as dementia care because not everyone with dementia has a memory problem. Hence my book when someone you know is living in a dementia care community, maybe a dementia care specific community to stand alone community, skilled nursing facility, independent living facility, which I do not recommend for people living with dementia. Although people do it all the time, so sometimes I'll go see a house a family will hire me to go evaluate a living situation for their loved one and, you know, mom or dad lives in independent living and the family's like, you know, how's mom or dad doing here?

And I say, well, not well, you know, independent living is not built for people living with dementia. They're not independent. Okay, at the end of life, hospice communities, hospice, in home and even hospice at a long term care community where there are already living in homecare, this could be you're taking care of them, this could be a family member taking care of them could be their neighbor taking care of them. This could be an in home care agency coming in to provide care, right? Anything at home. So this is a this is an option and there's a mix of services here where the person could still live at home, but maybe an agency like Home Instead Senior Care is a big one could come in and provide non medical home care.

I want to mention that there's something called non medical home care agencies and medical home care agencies. So these are different things. They will look the same when you first read about them and you'll realize that non medical home care agencies cannot like give a you know, diabete like cannot give insulin right they can't like technically manage medication they can like keep an eye and make sure that your loved one takes their medicine, but they can't do any injection. They can't put the medication in your loved ones mouth for them. So odd differences here. But if your loved one has a lot of physical needs more likely you would need a physical you'd need like a medical in home care agency.

Daycare. This is an option that I think a lot of people forget about. daycare is what it sounds like. So it's essentially kind of the best of both worlds. I like adult daycare, at least a good one. Because it is kind of a mix of homecare plus assisted living, where that person during the week and during the day gets to go and be with other participants in the adult day program.

You know, they get their needs taken care of they do activities and they hang out and then they get picked up or get dropped off at the end of the day. The thing here is that usually they need to be able to do a lot of things. Their own care in terms of like going to the bathroom and they usually don't provide showers or anything like that. But this is a great program if your loved one lives at home and you know you want to keep them there, but you don't want to bring in a homecare agency in there. Maybe they're really social and you want them to get out and do stuff. Assisted Living.

In Pennsylvania, we see personal care communities, which are allegedly different from their allegedly different from assisted living, but I'll be honest, I mean, like if I walk into one of these communities, I have no idea if it's licensed as personal care or assisted living. So assisted living, is what it sounds like, right? It's usually older adults live there, and there's a little bit of extra assistance. There's a difference between assisted living and like dementia care because dementia care, I like to think about it like this assisted living kind of reminds me of, like, independent living just like college right? You live there, there's activities and stuff and you can go to them if you feel like it. Assisted livings more like high school where they're stuff that you're kind of mandated to go to, like they make sure you come for meals most of the time and, you know, they kind of keep track of your whereabouts and things like that.

And then Dementia Care is more, you know, like, grade school in terms of the amount of supervision is much greater. So in dementia care, we're going to assume that the person cannot take care of themselves the way that people living in assisted living could. So sometimes what'll happen is someone will start in assisted living, and then as their dementia progresses, they'll end up moving into the dementia care environment. So this is like a memory care only a dementia care only building or it could also be a part of assisted living. So a lot of assisted living communities have a part of the community that offers dementia. Care specific care.

That's, in my opinion, you know, if you don't have that person at home, or you don't have them in an adult day program and you're trying to look for care, sometimes that stepwise thing is nice where, you know, you're paying for assisted living because it's cheaper than dementia care. And then you migrate them into dementia care, when it comes time for that. And then also a skilled nursing facility. So this is when people say nursing home, usually their what they are talking about is any of these things, but actually a quote unquote home a quote unquote nursing home is actually a specific type of care. So a nursing home is a sniff a skilled nursing facility. SNF in a skilled nursing facility, is usually for people who have a lot of a lot more physical needs.

Sometimes skilled nursing facilities don't even have like long term stay. Sometimes they're just rehab And short term. So if you know even a loved one without dementia just falls and breaks a hip. I mean, sometimes there's young people in these sniffs as well. People who are paralyzed or you know, they need a lot of physical care can be in a nursing home or a skilled nursing facility. I don't I try not to call it a nursing home because people don't know what that means.

Skilled nursing facility or a sniff, as we like to call it in the business, right. And some of these places have like long term stay areas and a lot of times people living with dementia are in these long term areas. A sniff will typically accept Medicaid and in the beginning, some Medicare that's the big difference. I think the other big difference is that because they accept Medicaid, the other big difference is that a lot of us are super expensive because of the amount of care needed, but because of the state or the state can cover some of that with with Medicaid. So a lot of times, you know, people in here either have a lot more physical needs, or the care was too expensive and assisted living and if somebody flips to using Medicaid, maybe moving to a skilled nursing facility actually makes more sense. A lot of assisted living communities do not take Medicaid depends on the state honestly, Pennsylvania.

Personal Care communities do not accept Medicaid. My understanding is and assisted living communities, some of them do. But they'll have like a certain amount of quote unquote beds for Medicaid beds. So skilled nursing facilities tend to be a lot more physical care. For example, when I worked in this one assisted living community, they would send me out to evaluate potential new residents. And I remember saying to my boss at the time, I was like, this person needs so much physical care.

We had a woman who was You know, 400 pounds, like, we don't really have too much we can help her with, you know, if she falls, we're gonna have a really hard time we don't really have the things necessarily like a Hoyer lift, we don't normally have a Hoyer lift, which is this crazy looking contraption that's actually pretty clever. It's essentially a fulcrum, it works on levers, and you can lift people up with it. It's kind of amazing, actually. But anyway, that, you know, we don't normally see stuff like that in assisted living or in personal care. And that's the kind of stuff you see because it's more medical in skilled nursing. So yeah, if somebody needs a lot of physical care, a sniff may be a better option than assisted living.

Okay, so maybe you've decided to move somebody and I want to cover this kind of basic stuff really quickly. And again, if you want more information on this, you're thinking about moving somebody, I really cannot recommend my book enough. Not just because it's my book, but really because I wrote it, too. answer these questions for caregivers. So if someone's saying to you like I want to go home, here are the things we need to keep in mind. Don't panic, right?

If you're moving somebody, don't panic, the first couple of weeks are not probably going to be go going super smooth. No matter what you do. If you bring that person home, if you take them to the hospital, you take them to a sniff, you take them to adult date, whatever, it's not going to go smoothly, immediately at first. Because transitions take longer for people living with dementia. We have to think of ourselves a little bit here. I mean, if you pick up and you move to a new state, it's going to take you at least a couple weeks, right to kind of get situated figure out where to unpack your boxes, figure out where the grocery store is, you know, figure out where this data and the other is.

You have to take you take some time to get situated. Somebody with dementia may not have to do all of that stuff. But emotionally they need to get situated. Please don't tell anyone with dementia that quote unquote, this is where you live. Now, that's really permanent and really scary to say that to somebody who doesn't really understand the concept of time, right? We talked a lot about time in the last section, so we don't want to just throw it out like, Hey, this is where you live now.

And you're going to be here forever because you have dementia, right? Not, not great. So we can always say things like, you're here. The doctor wants you to be here for a little bit. You know, you're here until your arm heals, pick something physical and blame it on that. Do not tell them that they live here now.

Avoid the word home. Oh, yeah. Oh, I'm go, Oh, hey, it was great to see you. But I'm going home. And then they think Well, well, whoa, you're going home? Well, I'd like to go home.

Right and you kind of painted yourself into a tough corner here. I really recommend bringing the activities to do with them. We have a whole section after this about activities to give you some ideas that you can bring with you. Finding a way to engage your loved ones. Something before you leave. So, especially those first couple times when you're bringing your loved one dropping them off, and I have, again, a whole section about this in my book, and I talk about it a lot on my blog as well.

You know, don't just Peace out, right? Don't just be like, Okay, I'm going home by right you really want to get them in involved in something, you know, bring them to lunch and have them meet some friends before you just like run out of there. Seriously, don't run out of there. I once helped somebody move their loved one into a care community and the family literally ran for the door. It was ridiculous. unprofessional and completely inappropriate for the situation and I was really frustrated with the family for that.

Know what time of day is best to visit. I really recommend visiting before like 2pm even earlier, if possible, because people sometimes tend to sundown right they get a little agitated in the afternoon or evening or Earlier in the day is best