Levels of Care

"It is better to be violent, if there is violence in our hearts, than to put on the cloak of nonviolence to cover impotence." Mahatma Gandhi

The official levels of care, as cited by insurance companies, for persons with dementia are:  home care with or without paid aides, day care facilities, assisted care, and nursing home.  But, within the assisted care there is quite a variation -- which we as caregivers need to know.  Several of the assisted living centers I contacted required the person to be very independent.  They would not even manage medication.  It seemed that they included a room and meals, almost what I would call independent living.  To my surprise, some of the assisted living centers would not even consider accepting Dwane, as they saw his needs too great for their services.  It was confusing, because he also was not in need of nursing home care.  At least in this state, there is a level of care that is between assisted living and nursing home.  In our case the facility calls itself assisted living, but they do help with showering, dressing, getting out of chairs; and they do manage medications. They have a license for both assisted living and nursing home, so are able to blend services.  A Mayo Clinic newsletter once said that most caregivers wait too long before placing someone with dementia into assisted living.  I agree.  And, then we find out some assisted living centers do not provide enough services to care for someone with dementia.  There are also long waiting lists at some facilities.  So, it pays for us caregivers to do our homework.  If you think at any point you may want assisting living, it is a good idea to check out what is available, what services they provide and if they have a waiting list.  Even getting on the waiting list is not infallible, as we were on for one facility; but when I called back the management had changed and they had no record of request.  Please do not wait until you are desperate, as too many caregivers do.  Please check into what facilities are in your area now, so that you can plan accordingly if you think that at any time home care will no longer be an option.