Virtual Medical Centre

Transition of Patients with Dementia into an Aged Care Home

• Introduction
• When to discuss transition into an aged care home with your doctor
• Practical aspects of moving into an aged care home

Introduction

Alzheimer's disease is characterised by the progressive decline of cognitive function including language, behaviour, emotions, judgement and the ability to do complex tasks. As the disease progresses, so too does the level of assistance your loved one requires. Placement into an aged care home is often necessary.

The decision to place a loved one with dementia into an aged care home is one of the most difficult decisions you can make. It is a life event of enormous significance. There are usually many reasons for the move. Some major reasons include:

• Your own health (stress and medical conditions);
• Difficult behaviour from your loved one (aggression, irritability, behavioural problems and inertia);
• Believing your loved one requires more skilled care than you can give (medical problems on top of dementia, incontinence, difficulties with mobilising); and
• Needing more help from other people that you can't get (either from other friends and family members, or from support services).

Following this decision, there are a number of practicalities that must be attend to, including organising assessment through an Aged Care Assessment Team (ACAT), choosing an aged care facility, the actual move, and planning care within the home.

When to discuss transition into an aged care home with your doctor

Moving your loved one into an aged care home is generally considered following an illness or when you reach a "breaking point". You may be able to ease the transition into a aged care home by talking about it with your doctor early on. By discussing your needs with your doctor early, you may gain access to some additional home services, which may allow you to delay the move or, at the very least, allow a timely smooth transition before reaching breaking point.

The more you feel in control, the more able you are to find help and make well thought out decisions. Be open with your doctor regarding your own wellbeing, including your health, level of burden, grief, guilt, lack of participation in social or recreational activities, and mood.

Practical aspects of moving into an aged care home

Moving a loved one into an aged care home is a process. First of all, an ACAT (or ACAS in Victoria) will assesses whether your loved one is eligible for Australian Government subsidised care in an aged care home (low or high level care). The ACAT can provide you with information about finding a home, how to apply, accepting a place in a home, and moving in. Some aged care homes have additional facilities for residents with dementia, including specially trained staff, clear signage and safe wandering areas. The ACAT will provide names and addresses of homes with these additional facilities.

You may find these practicalities difficult due to your own physical health or the high care needs of your loved one (behaviour or cognitive impairments), which can stop you from making an extensive search for an appropriate home. Depression, psychological distress and tension between family members may also make these practicalities difficult. If possible, enlist support from people you trust to help you.

Once a place has been offered, a decision will need to be made quickly regarding acceptance of the place. The move generally takes place within seven days of accepting the place. It is recommended that you begin to plan the move in consultation with other family members as early in the process as possible.

It is advised to make a list of care needs before entering a facility. This includes:

• Physical needs
  • Diet
  • Daily activities that require assistance (e.g. toileting, showering, dressing)
  • Nursing care (e.g. medications, catheters, wounds)
  • Other health care needs (e.g. physiotherapy, occupational therapy, podiatry, etc).
• Emotional, social and spiritual needs
  • Hobbies
  • Community participation
  • Religious provisions
  • Visits from family and friends