Study Finds Alzheimer’s Care Best in Small Assisted Living Homes

By Michelle Seitzer / Posted on 19 September 2011

For the 80 million people affected by dementia around the globe, specialized care in smaller, more intimate settings is best, says a new study published in September’s Journal of Clinical Nursing.

Residents of two “group living units” (which were part of a larger senior care facility in the suburbs) served as subjects for scientists from Maastricht University in the Netherlands, per a recent post from Medical News Today.

After 2.5 years of research, it was clear that the home-like setting allowed family members, visitors, staff, and residents to engage in a familiar, comfortable routine (e.g. drinking coffee while chatting with a neighbor, helping the staff set and clear the table for meals, reading a book, etc.); the environment lending itself to the development of relationships among staff and residents that would likely not have come about in a larger unit.

Despite these overwhelmingly positive results, this closeness often led to tensions and conflicts much like families experience. Nursing/direct care staff found it difficult to maintain a professional distance as they became more involved with the residents and their family members.

However, the study confirmed that small assisted living homes seem much more conducive to providing quality person-centered Alzheimer’s care than the long, sterile hallways of clinical care settings.

There are 21 Comments about this post

  1. Tracy Cline says,

    I absolutely agree! WE have my father, an otherwise, private man in a smaller memory care facility, Chaparral Winds, in Sun City West and he is very social in his new environment. He is loved and cared for by the staff and residents. To our surprise, he adapted very quickly to his new loving, small community.


    on 29 September 2011 / 3:01 PM

  2. cynthia says,

    How small of a group setting is recommended?


    on 29 September 2011 / 3:13 PM

  3. marty says,

    I totally agree! My husband is in an alzheimer’s facility that only has 54 residents and the building is divided into 4 “neighborhoods”. It is not home but it allows him comforts and socialization and I truly believe that the staff, the other residents and caregivers begin to think of each other as family.


    on 29 September 2011 / 4:02 PM

  4. That’s great, Tracy. Glad to know that things have worked out so well for your father. Thanks for stopping by the blog and sharing your comments!


    on 29 September 2011 / 4:26 PM

  5. I’m not sure it specified an exact number, but I’m guessing something that’s more home/family-like (perhaps 15-20 per wing)?


    on 29 September 2011 / 4:29 PM

  6. Wonderful, Marty. So glad to hear “real-life” stories of how well this arrangement works for those who need this level of care. Thanks for sharing your comments!


    on 29 September 2011 / 4:30 PM

  7. MaryAnn says,

    No one has mentioned the cost of this level of care. What happens to those whose pocketbooks aren’t that deep?


    on 29 September 2011 / 4:35 PM

  8. Gail says,

    Hi Mary Ann,

    I completely understand your concern about the cost of this type of care. The majority of this wonderful care can run into the thousands every month and is not covered by Medicare of Medicaid. No one bothers to tell you that fact. It is all private pay. My Mother is currently in an assisted living facility (no dementia unit there) and it costs over $5200.00 per month in Massachusetts and that was one of the more reasonable ones. The dementia units in the other facilities we looked at were close to $7000 per month or better.
    At the time we moved Mom in 6 mos ago she was able to do her daily living tasks, but, now due to other health issues we struggle witht the idea to move her again because the dementia has progressed and she needs 24/7 care. Once we move her to a dementia unit and there are some small well run places we looked at, we face yet again the issue of what happens when all the money runs out, and trust me it will. Meantime we pay for the cost of the apt she lives in and the 24/7 private aids which leads to thousands and thousands of dollars per month. It is a heartbreaking dilema that no one tells you about until you are in the elder care vortex. Modern medicine and technology is not always your friend or the friend of the elderly. Sorry to be so bleak but that is the truth without someone trying to massage your situation to make you feel better. Lots of prayer, support wherever you can get it, and a sense of humor are the keys from losing your mind and perspecitive. Finding support is exhaustive and I have spent the better part of almost 6 mos on the web and researching data. You will be in my prayers Mary Ann………


    on 30 September 2011 / 8:02 AM

  9. Gail, thanks for this thoughtful, thorough, and encouraging response to Mary Ann’s concerns about the cost of care. You make many great points, and you’re right, many people don’t know about these things until, as you say, “you are in the elder care vortex.” We hope that the resources, advice and information offered here on our blog will help make people aware of the challenges that elder care presents so that they can be prepared and plan ahead as much as possible. Again, thanks for your comments and thanks for stopping by our blog.


    on 30 September 2011 / 10:07 AM

  10. It’s a great question, MaryAnn, and I truly appreciate the response from Gail on the matter. We certainly should be talking to policy makers and leaders about this issue, advocating for more financial support for care costs, and coming up with better solutions/options for paying (besides out-of-pocket) in both the public/private sector.


    on 30 September 2011 / 10:12 AM

  11. dori says,

    Gail, thank you for your insight into assisted living and dementia. My mom, was diagnosed with Alzheimers (she is still in the moderate stage, still function pretty well, but her memory is slowly disappearing. She has been in assisted living for 8 months and is thriving there. We too are concerned about how long we can afford her rent. Did you see a large increase after your mom needed more specialized care? Thank God my Mom is in excellent physical health . Thank you


    on 02 October 2011 / 11:41 AM

  12. Thanks for the comment, Dori. I hope you get the answer you need from Gail, and wish you the best in continuing to care for your Mom even as she is in an assisted living facility. Glad to hear she is thriving there!


    on 03 October 2011 / 10:11 AM

  13. Jack says,

    The only way to avoid losing all of your money for care, is to get an irrevocable trust. The bad news is that there is a 5 year look back, so you have to get one 5 years before the onset of memory loss diagnosis.
    Also, the lawyers are charging $5,000 or more to set up this trust. But, it’s better than losing all of your money at $5,000 every month. Either way, the quality of care for long term facilities sometimes decreases when you are on welfare . . . which is what happens when you run out of money from the irrevocable trust or otherwise. It’s very complicated. It seems that the government and the lawyers want it that way so they get their share of your money one way or the other.
    Asking our congressmen to help the situation is like saying you want everyone else to pay for your parent through taxes. This goes against everyone’s grain that hates taxes. So, that is also unlikely. Sorry to be such a pessimist, but I’ve been researching this for 3 years and have gotten nowhere!


    on 04 October 2011 / 9:18 AM

  14. Barb Ribble says,

    Has anyone looked into Adult Foster Care homes in their neighborhood? They seem more personal and warm
    than nursing homes if Assisted Living does not provide the 24/7 care if your
    loved one is a fall risk.


    on 04 October 2011 / 10:23 AM

  15. Thanks for the comment, Jack. You stated the challenges eloquently and realistically. It is a very frustrating situation indeed and one that will need to be resolved soon because it’s only a matter of time before no one will be able to pay for care. Thanks for sharing your experiences, difficult as they may be, to help inform others.


    on 04 October 2011 / 3:09 PM

  16. Great suggestion, Barb. Thanks for posting it. Hope to hear some responses!


    on 04 October 2011 / 3:09 PM

  17. Leah says,

    My in-laws were in a small assisted-living home (4-6 residents) and were very isolated and depressed. When my father-in-law died we moved my mother-in-law to a large dementia facility with lots of people (about 100), lots of activities, lots of friendly staff. She is happier than I’ve ever seen her. I would recommend looking at this type of facility as well.


    on 09 October 2011 / 10:42 PM

  18. Thanks for your comment, Leah. I think it just depends on what the person prefers…a community of either size (small or large) has its drawbacks and benefits.


    on 10 October 2011 / 9:15 AM

  19. Carolyn says,

    In response to the question re: cost of placing a loved one in a assisted living or memory care assisted living setting: as a geriatric care mgr., I recommend families have a professional assist in completing a long-term care cost analysis prior to placement. This can be done in a couple hours and will help a client determine the best setting for long-term placement. A cost analysis examines income, assets and debt. The outcome will provide a window into long-term care costs for about 5-10 years and how far your dollars will stretch to cover the monthly expenses in an assisted living setting.


    on 11 October 2011 / 6:00 PM

  20. Working with a geriatric care manager/professional is a wonderful suggestion. Thanks for sharing it, and thanks for stopping by the blog!


    on 12 October 2011 / 9:10 PM

  21. [...] This article originally appeared at SeniorsForLiving.com. [...]


    on 14 October 2011 / 1:29 PM


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