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When Does Someone with Dementia Need 24-Hour Care?


Nearly 5.8 million people in the United States have Alzheimer’s disease, the most common form of dementia. In the early stages of the disease, most individuals can successfully manage activities of daily living independently but may experience forgetfulness, mood shifts, coordination problems, and difficulty learning new things. However, as the disease progresses into the middle and late stages, those with dementia may be unable to communicate and often rely on support for basic tasks. At some point, family members and caregivers may be asking themselves, “At what point do individuals with dementia need 24-hour care?” While every individual is unique, many older adults with dementia will eventually rely on 24-hour care to maintain their health and safety. In addition, as Alzheimer’s disease progresses, care requirements can become more intensive and complex.

Housing Options for 24-Hour Care

Many dementia patients get referrals for 24-hour care in mid to late-stage dementia, usually by their healthcare providers. Finding the appropriate care can feel like a major task, but several different housing options provide round-the-clock care for those with Alzheimer’s disease or dementia. Here are a few of the most common housing options:

  • Assisted Living. Many individuals living with mild or moderate Alzheimer’s disease may require additional support with personal care, opportunities for socialization, and help to manage their medications. Assisted living facilities provide care options based on the individual’s needs. In these communities, medical care staff is always on-site.

  • Memory Care. Memory care is not the same as assisted living. Memory care is specifically designed for individuals with Alzheimer’s disease or other forms of dementia. Memory care staff are specially trained to meet the needs of those with Alzheimer’s. Like assisted living, memory care offers residents a routine and daily schedule but often with more hands-on support and structured activities. Many memory care communities offer enhanced security to mitigate wandering and provide soothing environments for those with dementia.

  • Skilled Nursing. Many nursing facilities offer a secured memory care unit that can provide high-quality medical care for those with complex health needs in addition to dementia and Alzheimer’s disease. In skilled nursing, much emphasis is given to meeting the medical needs of residents and managing chronic conditions.

  • In-Home Services. It’s possible to provide 24-hour care within an individual’s own home. Home care companies can assist with personal care, meal preparation, companionship, and medication management, while home health offers in-home medical care such as physical therapy, occupational therapy, and wound care.

Signs It’s Time for 24-Hour Care

Dementia can progress slowly for many years, which makes knowing when to transition to full-time care difficult, especially for family members. Many caregivers may experience guilt or hesitancy when deciding to transition their loved one into memory care or skilled nursing. While it may never feel like the “right time,” there are signs that may indicate additional support is needed.

When safety becomes an issue. Caregivers and family members should look for an overall decline in their loved one’s health. If an individual with dementia has unexplained weight loss, change in posture, or bruises, these are signs they are no longer safe at home. In addition, those with dementia are also at an increased risk of falling as balance becomes an issue. If a loved one is experiencing falls or is sitting for most of the day, 24-hour care may be necessary. According to the Alzheimer’s Association, six in 10 individuals living with dementia tend to wander, which can result in falls and unsafe conditions. Those trained in caring for someone with dementia will be able to manage these behaviors while also preventing wandering.

When experiencing caregiver stress. Caring for a loved one with dementia is extremely stressful. Stress can exacerbate even minor medical conditions, which can make the physical and emotional aspects of caregiving even more difficult. It’s important that caregivers also take care of themselves. Sometimes, transitioning into a facility that provides 24-hour care is beneficial to both the caregiver and the individual with dementia.

When experiencing unhealthy living conditions. Managing a household while also caring for a family member or spouse is difficult to juggle. If you notice bills going unpaid, dishes piling up, expired food in the refrigerator, lack of general hygiene, or other signs of unsafe living conditions, it’s time to consider transitioning into an environment with more care.

When isolated and withdrawn. Those with Alzheimer’s disease or other forms of dementia will become increasingly confused, often causing them to withdraw from social events they used to enjoy. This retreat inward can lead to social isolation, which can exacerbate the symptoms of dementia. Memory care communities have specially curated social activities for individuals with dementia that encourage social interaction and provide productive stimulation.

When having issues managing medication. Most older adults take medications to manage one or more chronic conditions. In fact, according to the National Institute on Aging, approximately 85% of older adults have at least one chronic health condition, and 60% have at least two or more chronic conditions. Managing medications can become more difficult as dementia progresses. Most facilities offering 24-hour care, such as a memory care unit, will administer an individual’s medication while also observing for certain signs and issues that may signal a health problem.

When receiving long-distance caregiving. Caregiving from a distance is very hard to manage, especially when a loved one is living with a progressive illness such as Alzheimer’s or another form of dementia. It’s nearly impossible to provide adequate supervision and support from afar. Many family members rely on long-term care facilities to ensure their loved one is receiving the care they need. Memory care units have staff available 24 hours a day to provide care to those with cognitive conditions.

Oceana Memory Care at Inspīr

Oceana at Inspīr includes personalized, wellness-focused lifestyle programming, customized care plans, and a highly trained staff, all in a therapeutic and secure setting. Our evidence-based approach to memory care is integrative, intentional, interdisciplinary, intimate, and individualized, enabling our residents to get the most out of every moment, every day.

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