Community Based Care - Dementia

COMMUNITY-BASED CARE

At least half of all nursing home residents have Alzheimer’s disease or some other illness that causes dementia. In addi-tion, for every person with dementia in a nursing home, two or three with similar impairments are receiving care in the community by some combination of family members, friends, and paid caregivers.

Programs and services for clients with dementia and their families have increased with the growing awareness of Alzheimer’s disease, the increasing numbers of older adults in the United States, and the fundraising efforts for education by noted figures (e.g., the family of former pres-ident Ronald Reagan). Home care is available through home health agencies, public health agencies, and visiting nurses. These services offer assistance with bathing, food preparation, and transportation as well as with other sup-port. Periodic nursing assessment ensures that the level of care provided is appropriate to the client’s current needs.

Adult day care centers provide supervision, meals, sup-port, and recreational activities in group settings. Clients may attend the center a few hours a week or full-time on weekdays if needed. Respite care offers in-home supervi-sion for clients so that family members or caregivers can run errands or have social time of their own.

Residential facilities are available for clients who do not have in-home caregivers or whose needs have progressed beyond the care that could be provided at home. These clients usually require assistance with ADLs such as eating and taking medications. Clients in residential facilities are often referred for skilled nursing home placement as dementia progresses.

The physician, nurse, or family can initiate referrals for community-based services. Families can contact the local public health department or the department of human or social services listed in the phone book. If the client has been admitted to the hospital, social services also can assist in making an appropriate referral.