As a caregiver with a wife in a locked down Assisted Living Facility I have a few opinions. She has Frontotemporal Dementia (FTD) though we are trying to get the name changed to Frontotemporal Degeneration. I guess this is my Ted Talk.
First, my wife and I are in our 50s. Dementia is not a normal part of aging.
Skilled Nursing Homes are for residents who have severe needs. They have problems with at least 2 Activities of Daily Living (ADLs), such as dressing themselves, going potty, or eating. No way help at a Holiday Inn is going to meet those needs. I don’t think the original author has any idea that a Nursing Home isn’t a retirement community.
So lets skip Nursing Homes and discuss Assisted Living Facilities (ALF).
The definition of an ALF varies greatly. In the US they are regulated by the states, their definitions and regulations vary a lot. Residents might need just housekeeping and meals, in which case a Holiday Inn is fine. They might need medical assistance (medication given to them, help walking, being kept on site). There are Memory Care ALFs which are designed for people with dementia. They might be a dedicated facility or just a floor in an ALF. The staff/resident ration is higher than a regular ALF.
Let’s see. In my wife’s facility the residents would not survive on their own. My wife would have been kicked out of a Holiday Inn for violent episodes (many people with dementia are aggressive, though this can be controlled by behavior of staff and medications) and other behavioral issues.
I’ve also had paid staff at home so I could work during the day. If I had 3 people taking care of her (8 hour shifts, 24 hours/day) it would be more expensive than her current care. My wife is taken care of by 24/7 staff. They get to go home at the end of their shift. They get training, the thought that anyone can do NH or ALF work is deluding themselves. We expect people to be poorly paid for skilled work. OK, doing housekeeping in a Holiday Inn is also skilled work, but different skills.
I am constantly impressed by the staff at my wife’s ALF. They notice if she is off. If they think she is sedated, they will work on changing/reducing her meds so she can be more active. If she is striking or biting another resident they will work on behavior mod (which cannot be expected to work for someone with FTD) and/or med changes and/or other changes in the environment. My wife has built special attachments to various staff. I’m not sure how Holiday Inn staff will redirect someone who is walking around in circles without her pants on (this happened only once).
Plus activities. And providing a great deal of routine.
And my wife has better cognitive function than most of the residents at her facility.
