How to Choose Care for Alzheimer’s and Dementia (Updated July 2025)

When someone you love is diagnosed with Alzheimer's or dementia, the questions start immediately. What kind of care do they need? How much will it cost? When is it time to consider different options?

The truth is, there's no one-size-fits-all answer. Every family's situation is unique, and care needs change as the disease progresses. But you don't have to figure this out alone. Understanding your options—and having the right support—can help you make decisions that honor your loved one's wishes while keeping them safe and comfortable.

Understanding the Journey

Care needs change as Alzheimer's and dementia progress. What works in the early stages may not be enough later on, and that's okay. Planning ahead doesn't mean giving up hope—it means being prepared to provide the best care possible at every stage.

Early Stage: Your loved one may still live independently with some support and modifications to their routine and environment.

Middle Stage: 24-hour supervision becomes necessary, and families often need professional help with daily care tasks.

Late Stage: Around-the-clock medical care and specialized support become essential for safety and comfort.

The goal isn't to find the "perfect" solution right away. It's to understand what's available so you can make informed decisions when the time comes.

Early Planning: Including Your Loved One

Have these conversations early, while your loved one can still participate meaningfully. Their preferences matter, and involving them in decisions helps preserve their dignity and sense of control.

Important topics to discuss:

• Where they want to live as their needs change
• What kind of daily activities matter most to them
• Their feelings about different types of care
• Financial considerations and available resources
• Who they trust to help make decisions later

These conversations aren't easy, but they're invaluable. When difficult decisions arise later, you'll have their voice guiding you.

Care Options by Stage and Need

Staying at Home

For many families, home remains the preferred option for as long as safely possible. The familiar environment can provide comfort and stability for someone with dementia, while allowing family members to stay closely involved in daily care. Home care isn't just one thing—it's a flexible range of services that can be combined and adjusted to meet changing needs as the disease progresses.

Companion Services

These services provide the social interaction and gentle supervision that many people with early-stage dementia need to remain safely at home. A companion might spend time talking with your loved one, engaging them in meaningful activities like looking through photo albums or working on puzzles, or simply providing a reassuring presence. This type of care is particularly valuable for preventing isolation and maintaining cognitive engagement. Companions can also provide light assistance with daily routines, such as reminding your loved one to take medications or helping them stay on schedule with meals and appointments.

Personal Care Services

These become essential when your loved one needs hands-on help with intimate daily activities. Trained personal care aides can assist with bathing, which often becomes challenging and potentially unsafe as dementia progresses. They help with dressing, ensuring your loved one stays clean and appropriately clothed for the weather and activities. Toileting assistance maintains dignity while preventing accidents and health complications. Personal care aides also help with eating, whether that means preparing meals, assisting with feeding, or ensuring proper nutrition when appetite or eating abilities change. Medication management is another crucial service, as people with dementia often forget to take medications or may take them incorrectly.

Homemaker Services

These address the practical aspects of daily life that become increasingly difficult to manage. Professional homemakers handle housekeeping tasks like cleaning, laundry, and maintaining a safe, organized living environment. They can do grocery shopping and run errands, ensuring your loved one has food and necessary supplies. Many homemaker services also provide meal preparation, creating nutritious meals that meet dietary needs and preferences. Transportation services help your loved one get to medical appointments, social activities, or errands when driving is no longer safe.

Skilled Home Health Care

Skilled home health services involvs licensed medical professionals who provide medical services that would otherwise require visits to clinics or hospitals. Nurses can handle wound care, manage injections for conditions like diabetes, and conduct regular health assessments to monitor changes in your loved one's condition. Physical therapists work to maintain mobility and prevent falls, while occupational therapists help adapt the home environment and teach new ways to perform daily activities safely. This level of care requires a physician's order and is often covered by Medicare when medically necessary.

Making Home Safer

This becomes increasingly important as dementia progresses and judgment, coordination, and awareness decline. Home safety modifications aren't just about preventing falls—they're about creating an environment where your loved one can move around with confidence and independence for as long as possible. Installing handrails on stairs and marking step edges with bright tape helps prevent dangerous falls. Removing tripping hazards like loose rugs, electrical cords, and clutter creates clear pathways throughout the home. Safety locks on cabinets containing cleaning supplies, medications, or sharp objects prevent accidental poisoning or injury. Improved lighting, especially motion-activated lights for nighttime bathroom trips, reduces confusion and fall risk. Alert systems, whether medical alert bracelets or door alarms that notify caregivers if someone wanders, provide additional safety nets.

Adult Day Programs

Adult day centers offer much more than just supervision—they provide structured social engagement and meaningful activities that can significantly improve quality of life for people with dementia while giving family caregivers essential breaks. These programs typically operate during business hours, making them ideal for families where caregivers work or need regular respite to handle other responsibilities or simply recharge.

Most adult day centers provide nutritious meals and snacks, which is particularly valuable for people with dementia who may forget to eat or have difficulty preparing food. The social interaction with peers and trained staff helps combat the isolation that often accompanies dementia, while structured activities are designed to engage cognitive abilities and provide a sense of purpose and accomplishment. Many centers offer personal care assistance, helping with toileting, medication reminders, and basic hygiene needs throughout the day.

The health monitoring aspect of adult day programs is particularly valuable, as trained staff can observe changes in behavior, mobility, or health status and communicate concerns to families and healthcare providers. Some centers provide transportation to and from the program, which removes a significant logistical burden from families and ensures consistent attendance.

Many adult day centers now offer specialized dementia programs with staff specifically trained in memory care approaches. These programs understand how to engage people with cognitive impairment in meaningful ways, manage behavioral symptoms effectively, and create structured environments that reduce confusion and anxiety. The activities are designed to match the cognitive abilities of participants, whether that's reminiscence therapy, music programs, gentle exercise, or creative arts.

Residential Care Options

Making the decision to move your loved one to residential care is one of the hardest choices families face. It often comes with feelings of guilt, sadness, and uncertainty. But sometimes residential care isn't just the safest option—it's the most loving one. When care needs exceed what can safely be provided at home, residential facilities offer specialized environments, trained staff, and resources that can actually improve your loved one's quality of life while giving family members the chance to be family rather than full-time caregivers.

Assisted Living

These facilities are designed for people who need some help with daily activities but don't require constant medical supervision. Residents typically live in private or semi-private apartments that feel more like home than institutional rooms. The goal is to maintain as much independence as possible while providing support where needed. Meals are provided in community dining rooms, which offers social interaction and ensures proper nutrition. Housekeeping and laundry services free residents from these physical tasks, while personal care assistance is available for bathing, dressing, and medication management as needed.

Most assisted living communities offer robust activity programs, transportation for medical appointments and outings, and emergency response systems in each apartment. However, it's crucial to understand that not all assisted living facilities are equipped to care for people with dementia. Some may discharge residents when cognitive abilities decline or behavioral symptoms emerge. When considering assisted living, ask specifically about their dementia care policies, staff training, and what happens if your loved one's needs increase.

Memory Care Units

MCUs are specifically designed for people with Alzheimer's and other forms of dementia. These secured environments prioritize safety while maintaining dignity and providing meaningful engagement. The physical layout is typically designed to reduce confusion, with clear sight lines, familiar objects, and easy-to-navigate pathways. Doors to the outside are secured to prevent wandering, but the environment doesn't feel like a prison—instead, there are often secured outdoor gardens and walking areas.

Staff in memory care units receive specialized training in dementia care approaches, including how to communicate effectively with people who have cognitive impairment, manage behavioral symptoms with non-pharmacological interventions, and provide person-centered care that honors each resident's history and preferences. Activities are structured to match cognitive abilities and may include reminiscence therapy, music and art programs, sensory stimulation, and gentle exercise programs.

Memory care units can be standalone facilities or special units within larger assisted living communities or nursing homes. The benefit of being within a larger facility is the ability to transition to higher levels of care if needed without changing locations entirely.

Nursing Homes

These provide the highest level of residential care, with 24-hour medical supervision and assistance with all activities of daily living. This level of care becomes necessary when your loved one needs constant medical monitoring, has multiple chronic conditions, or requires assistance with basic functions like eating, toileting, and mobility. Modern nursing homes are far different from the institutional facilities of the past, with private or semi-private rooms, person-centered care approaches, and robust activity programs.

Nursing homes have registered nurses on staff around the clock, with physicians making regular visits. They can manage complex medications, provide physical and occupational therapy, and handle medical emergencies. Many nursing homes now have specialized dementia care units that combine the medical supervision of a nursing home with the dementia-specific approaches of memory care.

The social aspects of nursing home care are also important. Activity programs, religious services, and opportunities for family involvement help maintain connections and provide meaning. Many facilities encourage families to personalize rooms with familiar objects and participate in care planning decisions.

Continuing Care Retirement Communities (CCRCs)

These retirement communities offer a unique long-term planning option for families who want to prepare for changing care needs over time. These communities provide multiple levels of care on a single campus, typically including independent living apartments or houses, assisted living units, memory care, and nursing home care. The major advantage is that couples can remain close to each other even if their care needs differ, and individuals can transition between levels of care without leaving the community they've come to know as home.

CCRCs typically require an entrance fee and monthly payments, but they provide security in knowing that all future care needs can be met in one location. This option works best when planning is done early, ideally before significant care needs develop. The social aspects of CCRCs are often robust, with fitness centers, dining options, cultural activities, and opportunities to build lasting friendships.

Specialized and End-of-Life Care

The later stages of dementia bring unique challenges that require specialized approaches to care. As the disease progresses, the focus gradually shifts from maintaining function to ensuring comfort, dignity, and quality of life. This transition isn't about giving up—it's about adapting care to meet your loved one's changing needs with compassion and expertise.

Hospice Care

Hospice represents a fundamental shift in care philosophy, moving from treatment aimed at curing or slowing disease progression to comfort-focused care that prioritizes quality of life over quantity of time. This doesn't mean abandoning your loved one or stopping all care—quite the opposite. Hospice care is intensive, comprehensive support designed to manage symptoms, reduce suffering, and help families navigate one of life's most difficult transitions together.

Hospice teams include physicians, nurses, social workers, chaplains, and trained volunteers who work together to address not just physical symptoms but emotional, spiritual, and practical needs. Pain and symptom management is a cornerstone of hospice care, using medications and therapies to ensure your loved one is as comfortable as possible. This might include managing pain, reducing anxiety or agitation, addressing breathing difficulties, or helping with nausea and other physical discomforts that can accompany late-stage dementia.

The emotional and spiritual support extends to the entire family, recognizing that watching a loved one decline is traumatic and exhausting. Social workers help families process difficult emotions and make practical decisions, while chaplains provide spiritual care that honors your family's beliefs and traditions. Hospice care also includes bereavement support that continues after your loved one passes, helping family members cope with grief and begin healing.

One of the most valuable aspects of hospice care is that it provides medical equipment and supplies needed for comfort care at no cost to families. This might include hospital beds, wheelchairs, oxygen equipment, or specialized mattresses to prevent bedsores. Medications related to the terminal diagnosis are also covered, removing financial stress during an already difficult time.

Respite care is another crucial hospice service, providing trained caregivers who can stay with your loved one so family members can rest, run errands, or simply take a break from the intensity of caregiving. This support recognizes that family caregivers need care too, and that taking breaks actually helps them provide better care when they return.

Hospice care can be provided wherever your loved one calls home—whether that's their own house, your home, an assisted living facility, or a nursing home. The goal is to keep people in familiar, comfortable surroundings surrounded by the people they love. Some hospice organizations also have residential facilities for families who need additional support or don't have appropriate home environments for end-of-life care.

Palliative Care

Palliative care is often misunderstood as being the same as hospice, but it serves a different purpose and can be beneficial much earlier in the dementia journey. While hospice is for people with a terminal diagnosis and a life expectancy of six months or less, palliative care focuses on improving quality of life for people with serious illnesses at any stage. It can be provided alongside curative treatments and doesn't require families to accept that death is imminent.

For people with dementia, palliative care might begin in the middle stages of the disease when symptoms start significantly impacting daily life. Palliative care specialists are experts in managing complex symptoms and can help address issues like chronic pain, severe behavioral symptoms, eating difficulties, or sleep disturbances that are common in dementia. They work closely with your loved one's existing medical team to coordinate care and ensure all treatments work together effectively.

The palliative care approach is particularly valuable for dementia families because it emphasizes communication and shared decision-making. Palliative care teams excel at helping families understand their loved one's condition, explore treatment options, and make decisions that align with their values and goals. They can help navigate difficult conversations about advance directives, feeding tubes, aggressive medical interventions, and other complex issues that arise as dementia progresses.

Palliative care also addresses the psychological and social aspects of living with serious illness. Social workers help families access community resources and navigate practical challenges, while the entire team works to improve quality of life for both patients and caregivers. This might involve managing caregiver stress, connecting families with support groups, or helping coordinate care between multiple providers.

One of the most important aspects of both hospice and palliative care is that they honor your loved one's personhood even as cognitive abilities decline. These approaches recognize that comfort, dignity, and connection remain important even when memory and communication are severely impaired. Care teams work to understand what brings your loved one peace and joy, whether that's listening to familiar music, gentle touch, being outdoors, or simply having family nearby.

Families often struggle with when to consider these specialized care approaches, particularly hospice care. It's natural to feel like choosing hospice means giving up hope, but many families find that hospice care actually allows them to focus on what matters most—spending quality time together and ensuring their loved one is comfortable and surrounded by love. The earlier hospice care begins, the more time families have to adjust to this approach and make the most of their remaining time together.

These care decisions are deeply personal and should be made in consultation with your loved one's healthcare team, taking into account their previously expressed wishes, current quality of life, and family circumstances. Neither hospice nor palliative care is about hastening death—both are about living as fully and comfortably as possible within the constraints of serious illness.

Supporting Caregivers

Caring for someone with dementia is one of the hardest things you can do. The person you love may not recognize you, might become agitated or aggressive, and will need increasing help with basic tasks. This takes an enormous emotional and physical toll.

Building Your Care Network

You don't have to do this alone. Creating a network of support helps ensure consistent care while preventing caregiver burnout.

• Family and friends: Coordinate schedules for regular help with specific tasks
• Professional services: Combine different types of support as needed
• Community resources: Connect with local Alzheimer's Association chapters, support groups, and faith communities
• Healthcare team: Include the primary doctor, specialists, social workers, and therapists

Recognizing When You Need Help

Warning signs that it's time to seek additional support:

• You're feeling constantly exhausted or overwhelmed
• Your loved one's safety is at risk
• Behavioral symptoms are becoming unmanageable
• Your own health is suffering
• Family relationships are strained

Asking for help isn't giving up—it's being responsible.

Understanding Costs and Coverage

The financial reality of dementia care is one of the most stressful aspects families face. The numbers can be overwhelming—the average cost of dementia care is nearly three times higher than for people without cognitive impairment, and Medicare covers far less than most families expect. But understanding your options and planning ahead can help you make the most of available resources and avoid financial surprises that could derail your loved one's care.

The hard truth is that most families will pay significant out-of-pocket costs for dementia care. This isn't because the system is designed to be cruel, but because much of what people with dementia need—daily living assistance, supervision, and long-term custodial care—falls outside the medical model that insurance was designed to cover. Knowing this upfront helps you plan realistically and explore all available resources.

What Medicare Covers—and What It Really Means

Medicare is the primary insurance for most people over 65, but it's built around treating acute medical conditions, not managing chronic diseases that require ongoing daily support. Understanding exactly what Medicare does and doesn't cover helps you plan for the gaps and avoid unpleasant surprises.

Doctor Visits and Medical Care

These are covered under Medicare Part B, including visits to specialists like neurologists, psychiatrists, and geriatricians who may be involved in your loved one's dementia care. This also includes diagnostic tests like brain scans, blood work, and other assessments used to diagnose dementia or monitor its progression. Regular check-ups and care planning visits are covered, which can be valuable for adjusting medications and addressing new symptoms as they arise.

Hospital Stays

Stays in the hospital are covered under Medicare Part A when your loved one needs acute medical care. This might include treatment for infections, falls, or other medical emergencies that are more common in people with dementia. However, Medicare's coverage focuses on treating the immediate medical problem, not the underlying dementia or the daily care needs that led to the hospitalization.

Prescription Medications

Your medications are covered under Medicare Part D, including the medications commonly used in dementia care such as cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and NMDA receptor antagonists (memantine). However, coverage varies by plan, and some newer or specialty medications may require prior authorization or have high copayments. It's worth reviewing your Part D plan annually during open enrollment to ensure it covers your loved one's current medications effectively.

Limited Skilled Nursing Care

This care is covered under Medicare Part A, but only after a qualifying hospital stay of at least three days and only for care that requires skilled medical services. This might include wound care, physical therapy, or recovery from surgery. However, this coverage is temporary—typically up to 100 days with increasing copayments—and ends when your loved one no longer needs skilled medical care, regardless of whether they can safely live independently.

Some home health services

Services like this are covered when they're medically necessary and ordered by a physician. This includes skilled nursing care, physical and occupational therapy, and medical social work services. However, Medicare doesn't cover the personal care assistance that most people with dementia need—help with bathing, dressing, meal preparation, or supervision. The person must also be considered "homebound," which can be challenging to establish for people with dementia who may still be mobile.

Hospice care

Staying in a hospice is well-covered under Medicare Part A and includes all services related to the terminal diagnosis, including medications, medical equipment, and support services. This is one area where Medicare's coverage is comprehensive and can provide significant financial relief for families facing end-of-life care decisions.

What Medicare Doesn't Cover—The Big Gaps

Understanding what Medicare doesn't cover is crucial for realistic financial planning. These gaps represent the largest expenses most families will face and require alternative funding sources.

‍Long-term custodial care is the biggest gap in Medicare coverage. This includes the daily living assistance that people with dementia increasingly need—help with bathing, dressing, eating, toileting, and supervision to prevent wandering or other safety issues. Whether this care is provided at home, in assisted living, or in a nursing home, Medicare generally doesn't pay for it unless there's a specific medical reason requiring skilled nursing services.

Most assisted living costs are considered room and board expenses rather than medical care, so Medicare doesn't cover them. This can be particularly frustrating for families because assisted living may be the most appropriate and cost-effective option for their loved one, but they'll pay the full cost out of pocket.

Adult day program fees are typically not covered by Medicare, even though these programs provide valuable socialization, supervision, and respite for family caregivers. Some Medicare Advantage plans may offer limited coverage for adult day services, but traditional Medicare does not.

Home care focused on daily living assistance represents a significant gap. While Medicare covers skilled home health services, it doesn't pay for the companion care, homemaker services, or personal care assistance that allow people with dementia to remain safely at home. These services can cost $15-30 per hour or more, adding up quickly when several hours of daily assistance are needed.

Most nursing home stays are not covered by Medicare. Only short-term stays following hospitalization for skilled nursing care are covered, and even then, coverage is limited and comes with increasing copayments. Long-term nursing home care for people who need custodial care rather than skilled medical services is not a Medicare benefit.

Medicare Advantage and Special Needs Plans

Medicare Advantage plans (Part C) sometimes offer additional benefits that can help with dementia care costs. These private plans receive Medicare funding to provide all Medicare benefits plus potentially extra services. Some Medicare Advantage plans include limited coverage for adult day programs, home care services, transportation to medical appointments, or care coordination services.

Special Needs Plans (SNPs) are specialized Medicare Advantage plans designed for people with specific chronic conditions, including dementia. These plans may offer benefits specifically tailored to dementia care, such as care coordinators who understand the disease, coverage for some non-medical home care services, or access to specialized providers. However, availability varies by location, and families should carefully review what additional benefits are actually provided.

Other Financial Resources and Strategies

Medicaid becomes crucial for families who exhaust their resources or have limited income and assets. Unlike Medicare, Medicaid does cover long-term custodial care, but eligibility requirements are strict and vary by state. Many families find themselves spending down assets to qualify for Medicaid coverage, which can be emotionally difficult but may be the only way to afford necessary care.

Medicaid waiver programs in many states provide home and community-based services that can help people with dementia remain in their homes or communities rather than entering nursing homes. These programs may cover personal care services, adult day programs, respite care, and other services that Medicare doesn't provide. However, these programs often have waiting lists, and eligibility requirements can be complex.

Veterans benefits can provide significant help for veterans and their surviving spouses. The Aid and Attendance benefit can provide monthly payments to help cover home care, assisted living, or nursing home costs for veterans who served during wartime and need assistance with daily living activities. The VA also provides direct care services through VA medical centers and community-based programs specifically for veterans with dementia.

Long-term care insurance can help cover costs that Medicare doesn't, but only if your loved one purchased this coverage before developing dementia symptoms. These policies vary widely in what they cover and may include home care, adult day programs, assisted living, and nursing home care. However, most policies have waiting periods, benefit limits, and specific definitions of when benefits begin that families should understand clearly.

State assistance programs vary widely but may include cash assistance programs that allow families to hire caregivers directly, including family members in some cases. These "participant-directed services" or "cash and counseling" programs give families more flexibility in how care is provided while still receiving government support for costs.

Life insurance policies, annuities, and reverse mortgages are financial tools some families use to fund long-term care. Life insurance policies may have accelerated death benefits that can be accessed for terminal illnesses, while reverse mortgages can provide cash flow for homeowners over 62. These options require careful consideration of long-term financial implications and consultation with financial advisors experienced in long-term care planning.

Planning Strategies That Make a Difference

Early financial planning can significantly impact your options and reduce stress later. Even if you can't prevent all out-of-pocket costs, understanding the landscape helps you make informed decisions and maximize available resources.

Review insurance coverage annually during open enrollment periods. Medicare Part D plans change their formularies each year, so a plan that covered your loved one's medications well this year might not be the best choice next year. Medicare Advantage plans also change their additional benefits, so it's worth comparing options.

Keep detailed records of all medical expenses, as these may be deductible on tax returns and can help establish medical necessity for insurance appeals. Document the progression of your loved one's condition and care needs, as this information can be valuable when applying for benefits or appealing coverage decisions.

Consider consulting with professionals who specialize in elder law, financial planning for long-term care, or Medicare advocacy. These experts can help you understand your specific situation, explore all available options, and develop strategies to protect assets while ensuring your loved one gets needed care.

Don't wait until crisis hits to explore options. Research local resources, understand your insurance benefits, and have conversations about preferences and financial resources before urgent decisions are needed. This preparation allows for better decision-making and can prevent costly mistakes made under pressure.

Making the Right Choice

The "right" care option is the one that meets your loved one's current needs while considering safety, dignity, and quality of life.

Key Questions to Ask Yourself

• Is your loved one safe in their current situation?
• Are their care needs beyond what you can safely provide?
• Is the primary caregiver's health at risk?
• Would your loved one benefit from more social interaction?
• Are current care arrangements sustainable financially?

Questions for Care Providers

• What experience do you have with dementia care?
• How do you handle behavioral symptoms?
• What happens if care needs increase?
• Can you provide references from other families?
• What are the costs, and what's included?
• How do you communicate with families?

When Transitions Become Necessary

Moving from one type of care to another is often the hardest decision families face. Remember that choosing residential care doesn't mean you're abandoning your loved one—you're ensuring they get the specialized support they need.

Making Transitions Smoother

Care transitions—whether from home to assisted living, between different levels of care, or even from one provider to another—are among the most challenging experiences for families dealing with dementia. These changes disrupt familiar routines and environments at a time when consistency and predictability are most important for your loved one's sense of security. While transitions are never easy, thoughtful preparation and gradual adjustment can make them less traumatic for everyone involved.

Visit potential facilities multiple times and at different hours to get a complete picture of what daily life will really be like for your loved one. The atmosphere, staffing levels, and quality of care can vary significantly depending on the time of day and day of the week. Schedule visits during meal times to observe how staff interact with residents who need eating assistance, and whether the dining experience feels rushed or relaxed. Visit during activity periods to see how engaging the programs are and whether they're appropriate for your loved one's cognitive level and interests.

Evening and weekend visits are particularly revealing because staffing is often reduced during these times, giving you a sense of how well the facility operates when fewer supervisors are present. Pay attention to how quickly staff respond to call lights, how they communicate with residents who have dementia, and whether residents seem content or agitated. Don't just take a tour—sit in common areas and observe the interactions between staff and residents. Listen to how staff speak to people with dementia. Do they use respectful, age-appropriate language, or do they talk down to residents? These observations can tell you more than any brochure about the quality of care your loved one will receive.

Ask to speak with other families who have loved ones at the facility, and if possible, talk to residents themselves who can still communicate about their experiences. Many facilities will provide references from satisfied families, but you can also ask to attend a family meeting or support group to get unfiltered perspectives on the facility's strengths and challenges.

Bring Familiar Items to Make New Spaces Feel More Like Home

Environmental familiarity can significantly reduce confusion and anxiety for people with dementia. The items that matter most are usually not the most expensive ones, but those with the strongest emotional connections and sensory associations. A favorite blanket that still carries familiar scents, photographs from different periods of your loved one's life, or a comfortable chair they've sat in for years can provide enormous comfort in an unfamiliar setting.

Consider items that engage different senses and evoke positive memories. This might include a music player with favorite songs from their youth, familiar books even if they can no longer read them, or small decorative items that have personal significance. If your loved one had a hobby like gardening, knitting, or woodworking, bring tools or materials associated with that activity even if they can no longer use them—simply having them nearby can be comforting.

Religious or spiritual items can be particularly important for providing continuity and comfort. This might include a cross, prayer book, rosary, or other items that connect to their faith tradition. Even for people who weren't particularly religious earlier in life, spiritual comfort often becomes more important as cognitive abilities decline.

Work with the facility's staff to understand what items are practical and safe to bring. Some facilities have restrictions on electrical items, breakable objects, or items that might pose safety risks. However, most are willing to work with families to find ways to incorporate meaningful personal items while maintaining safety standards. Take photos of your loved one's room or living space at home so you can try to recreate familiar arrangements in the new environment.

Maintain Routines that Are Important to Your Loved One

Consistency in daily activities provides structure and predictability when other aspects of life feel chaotic and unfamiliar. People with dementia often retain strong preferences and habits even as other cognitive abilities decline, and honoring these routines shows respect for their personhood while reducing anxiety and resistance to care.

Work with the facility's staff to understand which routines can be accommodated and which might need to be modified. If your loved one always had coffee and read the newspaper first thing in the morning, see if the facility can support this routine even if they can no longer actually read. If they always took an afternoon walk or nap, work with staff to incorporate these preferences into their daily schedule.

Meal preferences and eating habits are particularly important to maintain when possible. If your loved one always ate dinner early, see if the facility can accommodate this preference. If they have strong food preferences or cultural dietary needs, work with the dining staff to ensure these are respected. Many facilities are willing to be flexible about meal times and food choices when families communicate these needs clearly.

Personal care routines are another area where consistency matters enormously. If your loved one always preferred baths over showers, or had specific preferences about when and how personal care was provided, share this information with staff and advocate for these preferences to be honored when possible. The goal is to maintain as much of their identity and personal preferences as possible within the structure of institutional care.

Stay Involved in Care Planning and Decision-Making

Your knowledge of your loved one's history, preferences, and needs is invaluable to professional caregivers who are just getting to know them. Your involvement also helps ensure that care decisions align with your loved one's values and previously expressed wishes, maintaining continuity between their past and present selves.

Attend care planning meetings regularly and come prepared with observations about changes in your loved one's condition, new concerns, or things that are working well. Keep a journal of your visits, noting your loved one's mood, any complaints or concerns they express, and your observations about their care. This information can be valuable for adjusting care plans and addressing problems before they become serious.

Communicate regularly with direct care staff, not just administrators or nurses. The aides who help with daily activities often have the most insight into your loved one's day-to-day well-being and can alert you to subtle changes that might not be apparent during visits. Build relationships with these staff members and let them know you appreciate their work—this investment in relationships often translates into better care for your loved one.

Don't hesitate to advocate for your loved one when something isn't working. If medications are causing problematic side effects, if activities aren't engaging, or if care approaches aren't effective, speak up. Facilities expect and appreciate feedback from involved families, and most are willing to make adjustments when specific concerns are raised respectfully and constructively.

Give Yourself Time to Adjust to The New Arrangement

The transition can betraumatic for family members too, often accompanied by complex emotions including guilt, grief, relief, and uncertainty. It's normal to feel like you've somehow failed your loved one, even when you know intellectually that the transition was necessary for their safety and well-being. These feelings don't disappear overnight, and it's important to be patient with yourself as you adapt to a new role and routine.

The guilt that many families experience after placing a loved one in residential care can be overwhelming. You might feel guilty about the decision itself, about feeling relieved that the daily caregiving burden has been lifted, or about getting back to your own life and interests. These feelings are normal and don't mean you love your family member any less. Consider joining a support group for families dealing with similar transitions, as talking with others who understand can help normalize these difficult emotions.

Your role as a family member doesn't end with residential placement—it evolves. Instead of providing hands-on daily care, you become an advocate, visitor, and source of emotional support. This transition can be difficult, especially if you've been a primary caregiver for months or years. You might feel lost or purposeless at first, and it takes time to find a new rhythm and sense of how you can best support your loved one in their new environment.

Establish new routines for visiting and staying connected that work for both you and your loved one. Some people do best with frequent short visits, while others prefer longer, less frequent visits. Pay attention to your loved one's response to visits and adjust accordingly. Some people with dementia become agitated when family visits end, while others are comforted by regular contact. Work with facility staff to understand what schedule works best for your specific situation.

Remember that adjusting to residential care is a process that can take several months for both you and your loved one. There will likely be good days and difficult days, and it's important not to judge the entire decision based on temporary challenges. Most facilities report that it takes 30-90 days for new residents to fully adjust, and family members often need a similar adjustment period to feel comfortable with the new arrangement.

How Solace Can Help

Dementia care decisions don't have to feel overwhelming when you have expert guidance. Solace advocates are healthcare professionals who understand the system inside and out. They work with you to:

• Assess care needs and explore options that fit your family's situation and budget
• Coordinate between multiple providers to ensure seamless care transitions
• Navigate insurance coverage and appeal denied claims (with a 54% success rate)
• Attend medical appointments virtually to make sure important questions get answered
• Translate medical information into clear, understandable terms
• Provide emotional support throughout the journey

Your dedicated Solace advocate stays with you through every stage, so you never have to repeat your story or start over with someone new. Because when you're dealing with something this difficult, you deserve support from someone who truly understands.

Most importantly, our services are covered by Medicare for most patients, so you can get the help you need without adding financial stress.

Frequently Asked Questions About Choosing the right Care for Dementia and Alzheimer's

When should we start planning for long-term care?

‍As soon as possible after diagnosis. Early planning allows your loved one to participate in decisions and gives you time to research options without pressure. Even if you don't need services immediately, understanding what's available helps you make informed decisions when needs change.

How do we know when it's time to consider residential care?

‍Safety is the primary concern. If your loved one is at risk of falls, wandering, or other dangers, or if the primary caregiver's health is suffering, it may be time to explore residential options. Professional assessment can help evaluate needs objectively.

What's the difference between assisted living and memory care?

‍Assisted living provides general support with daily activities in a less restrictive environment. Memory care units offer specialized dementia care in secure settings with staff trained specifically in dementia care approaches and behavioral management.

Will Medicare pay for dementia care?

‍Medicare covers medical care related to dementia (doctor visits, medications, hospital care) but doesn't pay for long-term custodial care or most assisted living costs. Understanding what's covered helps you plan for out-of-pocket expenses.

How can we make sure our loved one gets quality care?

‍Stay involved in care planning, communicate regularly with providers, and don't hesitate to ask questions or voice concerns. Look for facilities with specialized dementia training and proper certifications. Trust your instincts—if something doesn't feel right, investigate further.

What if our loved one refuses help or doesn't want to move?

‍This is common and understandable. Try involving them in the decision-making process, emphasizing safety and maintaining independence. Sometimes a gradual transition (starting with adult day programs or limited home care) helps them adjust to accepting help.

How do we handle the emotional toll of caregiving?

‍Caregiving for someone with dementia is emotionally and physically exhausting. It's crucial to seek support through counseling, support groups, or therapy. Remember that taking care of yourself isn't selfish—it's necessary for providing good care to your loved one.

Can someone with dementia live alone safely?

‍In early stages, some people with dementia can live independently with safety modifications and regular check-ins. However, as the disease progresses, living alone becomes unsafe. Regular assessment of capabilities and safety is essential.

What should we look for when choosing a care provider?

‍Look for providers with dementia-specific training, good references, proper licensing and insurance. Ask about their approach to behavioral symptoms, staffing ratios, and communication with families. Visit multiple times and trust your instincts about the environment and staff.

How do we pay for care that Medicare doesn't cover?

‍Explore Medicaid eligibility, veterans benefits, long-term care insurance, and state assistance programs. Some families use life insurance policies, annuities, or reverse mortgages. A financial advisor experienced with long-term care planning can help explore options.

What happens if our loved one's behavior becomes difficult to manage?

‍Behavioral symptoms are common in dementia and often indicate unmet needs. Work with healthcare providers to identify triggers and develop management strategies. Sometimes medication adjustments help, but environmental changes and care approaches are equally important.

How do we coordinate care between multiple providers?

‍Keep detailed records, designate one family member as the primary contact, and ensure all providers have current information. A patient advocate can serve as a central coordinator, which is especially helpful during care transitions.

This article is for informational purposes only and should not be substituted for professional advice. Information is subject to change. Consult your healthcare provider or a qualified professional for guidance on medical issues, financial concerns, or healthcare benefits.