Web MD defines dementia as an “impairment of brain functions such as memory, reasoning, and judgment so severe that it affects a person’s ability to function at his or her usual level.” Perhaps the most talked-about form of dementia is Alzheimer’s disease, but dementia can be caused by other ailments, such as stroke, Parkinson’s, or head injuries. Since dementia is progressive, and frequently irreversible, once a diagnosis of dementia is made, no matter what the cause, it’s clear that significant life changes are on the way — for the patient and the patient’s family.

Since most of the ailments that can cause dementia are most common in older people, it is often up to adult children to become the caretakers of parents that suffer from some kind of progressive memory loss. It’s a difficult road, no doubt, particularly as the dementia progresses. And while there are many choices to be made, one of the major ones is often how the adult child is going to care for his or her parent.

Broadly speaking, people faced with this decision have three options: caring for the parent themselves, hiring an in-home care agency to care for their parent, or placing their parent in an assisted living facility.

Taking a parent or relative into your home to care for them can be challenging. Individuals in early stages of dementia may retain many of the capabilities required to care for themselves, such as being able to bathe and dress themselves, remembering to eat, and so on. But as the disease progresses round-the-clock constant care is often required. Luckily, there are a number of resources, including books, magazines, classes, and support groups that can help caretakers (see sidebar, “Resources for Caregivers”).

If you are determined to have your parent stay with you, but you know you can’t be there around the clock, or if you want to help them stay in their own home for as long as possible, in-home care agencies are another option. Kitsap Home Care of Bremerton and Abiding Home Care of Silverdale are two local, non-medical, in-home care agencies that provide in-home care services.

“Our goal is to keep someone in their home for as long as possible,” said Robyn Dexter of Kitsap Home Care.

These agencies help clients with the basic daily activities of life, such as cleaning, cooking, bathing, and shopping. For memory care clients, they can also supervise to make sure that the client is not a danger to himself or herself.

“The care we provide is the same no matter what,” said Dexter. “With memory care patients it’s all a matter of finding the right technique that will work with each one.”

There are many reasons, of course, why in-home care may not be the right choice, or there may simply come a time when in-home care is no longer realistic. A number of assisted living facilities in Kitsap County specialize in memory care, including Marine Courte at Bay Pointe Retirement Community in Bremerton, Merrill Gardens at Shoreline View in Gig Harbor, and Harbor House at Liberty Shores in Bremerton.

“It’s a lot different than normal assisted living,” said Ruth Sword of Bay Pointe Retirement Community, referring to their memory care living facilities. Assisted living communities that focus on memory care residents normally have staff on hand 24 hours a day, and many also have 24-hour nursing capabilities. Merrill Gardens at Shoreline View also has an Adult Registered Nurse Practitioner who comes to the community on a regular basis.

“We provide all levels of care here,” said Sheryl Page of Merrill Gardens at Shoreline View “from the early stages to the end stages when we bring in hospice.”
Memory care communities normally provide the same services as other assisted living communities, but with more diligence.

“We have to step up our services,” said Sword. “Memory care residents often don’t know what’s going on around them and need help on a constant basis.”

Assisted living communities can be costly, of course. Residents normally rent their living space, with some utilities included, on a month-to-month basis. But additional services — such as those often required by memory care residents — may cost extra. Most assisted living communities in Kitsap County are private-pay facilities, so you can’t count on insurance to cover the cost. Some long-term health insurance policies will reimburse policyholders for the costs of living there, but many standard health insurance policies will not.

Sword noted that Bay Pointe will allow current residents who had been on a private pay plan to remain at the community if they convert to Medicaid, but that the community does not accept new residents currently on Medicaid. Medicare does not cover the costs of assisted living.

When is the “right time” to move a parent with dementia into an assisted living facility? There really isn’t one, according to Page.

“It kind of depends on what the family dynamics are,” she said “and how the family is able to manage at home.”

Note: Be sure to check with your insurance company before making any assumptions about your own coverage when it comes to long-term care, in-home services, and assisted living.