Where should Alzheimer’s patients live?

January 25, 2008 by  
Filed under ALZHEIMER'S

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“I don’t want to be in a nursing home,” my grandmother said. She didn’t say it often, because she knew her children had promised not to put her in one, and she knew that if they did, she couldn’t do much about it. Like my grandmother, most Alzheimer’s patients would rather live at home. Moving is a risk factor that can lead to death, as people lose hope because the old familiar places are gone.

Unfortunately, many private homes are not good places for Alzheimer’s patients and even for many other elderly people. There may be unavoidable stairs inside, dangerous steps outside, poor lighting, inefficient bathrooms, etc.

Conventional wisdom among Alzheimer’s family members says, “Wait until she doesn’t know where she is anyway, and then move her.” But that means waiting until she can’t learn or understand where she is, when she should have given herself time to become accustomed to her new home while her mind was still fairly sharp. Why not start early and make sure that your living situation will be adequate for the future?

Some senior communities have assisted living units and nursing facilities integrated into their housing. A person can move from an active senior apartment, to another one closer to staff who can assist them, to another one with round-the-clock nurses. But they have to move to make it work, and moving becomes less attractive as you get older.

Instead, some experimental Dutch housing developments show more forethought. They look like ordinary apartment communities, but they are all designed so that the residents will not need to leave if they become frail: wheelchair-friendly and all that. We’ve reported about how the Amish farms have a daadi haus for the elderly, where grandparents move when their children are grown so they never have to leave the farm.

The hard truth is that sometimes the best care is not practical ,or affordable. Children who are young enough to care for their parents already have jobs, while children who don’t are too old to provide the care painlessly. People who are trained in caring for people with dementia may not have enough training, or enough incentive, to do it the way they would like. In our society, we not only don’t treat elderly people with enough respect, but in our society, we almost can’t.

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