Senior Living Options
Retirement communities and independent living facilities are housing exclusively for adults (normally 55 or older). The person is generally healthy, and any medical or personal care can be provided by visiting nurses or a home health aide. Staff at the retirement community does not take on the general responsibility for the safety and well-being of the adult.
There are all kinds of planned retirement communities from large scale, single family home developments to smaller-scale, senior houses or apartments.
Washington State does not license retirement communities.
Assisted living usually offers apartment style living and is designed to provide a bit more hands-on assistance for residents who can’t independently do everything life requires. Trained caregivers provide round the clock attention and assistance with medication management, bathing, dressing and meal preparation. In addition, staff will coordinate services with outside healthcare providers.
Assisted Living Facilities that serve Medicaid clients are contracted by Washington State to provide three levels of service packages.
Cost varies depending on the type of community, size of the apartment or room, type of care and frequency.
Adult Family Home
Adult Family Homes are regular neighborhood homes where staff assumes responsibility for the safety and well-being of the adult. A room, meals, laundry, supervision and varying levels of assistance with care are provided. Some provide occasional nursing care and others offer specialized care for people with mental health issues, developmental disabilities or dementia.
The home can have two to six residents and is licensed by the state. They must meet fire, sanitation and state DSHS regulations. Each home is unique, providing a homey, family atmosphere with activities and 24/7 care and housing. Some homes accept state funding clients, while other are private pay only. This is often a more affordable option to a nursing home. Monthly fees range from $4500.00 to $11,000.00 per month depending on the level of care type of room selected.
Skilled Nursing Home
Skilled nursing homes facilities provide a high level of care for complex medical conditions, and surgical recovery. Entering a nursing home no longer means every person stays forever. People also go to a nursing home for rehabilitation or for short-term, intensive nursing care. Often people get better or decide they want to return home and get services there.
Residents receive an in-house physician, 24-hour supervised nursing care, personal care, therapy, nutrition management, organized activities, social services, room, board and laundry.
Generally, insurances pay for care for a period. Average daily cost for private pay patients range from $240-$380.00 or more a day.
The Federal agency that has oversight for state certification of nursing facilities is the Center for Medicare and Medicaid Services (CMS). The state agency (SA) responsible for licensing and oversight is the Department of Social and Health Services (DSHS), Aging and Long-Term Support Administration (ALTSA), Residential Care Services (RCS) Division. Federal law requires DSHS to conduct an unannounced full health survey or inspection at least every 15 months
Dementia Specialty Care Communities
Specialized Dementia Care Program is for a person with dementia who can no longer live at home. Specialized Dementia communities are secured and can be connected to larger retirement community or a stand-alone secure memory care community.
The goal of these services is for the person with dementia to maintain the highest possible quality of life and physical health while living with the typical losses of dementia.
The Specialized Dementia Assisted Living Facility must offer:
- Care, supervision, and activities tailored to the specific needs, interests, abilities, and preferences of the person.
- Coordination with the person’s family to ensure the person's routines and preferences are honored.
- Dementia-specific training for staff.
- Awake staff twenty-four hours a day.
- A safe outdoor environment with walking paths and access to a secure outdoor area.
- Intermittent nursing services help with medications, personal care, and other support services.
The Benefits of Music for people with Dementia or Alzheimer’s
Many research studies, as well as anecdotal evidence, have cited situations where music has been able to evoke a response or a memory in people with Alzheimer’s. For example, your mother may have difficulty finding the right words to use but be able to sing an entire song with no problem.
One research project studied people with Alzheimer’s and found that their memory for music was not affected by the disease: They performed similarly to those without Alzheimer’s in recognizing songs and lyrics. Although that’s certainly not true for everyone with dementia, I’ve seen numerous people who could play complete songs on the piano or sing every word to an older song, even as they were well into the middle stages of Alzheimer’s and could not remember the names of family members.
These lasting memories of music are likely an important factor in understanding why its use to treat and interact with those who have dementia can be beneficial. Research studies have demonstrated that music is an effective way to provide meaningful activities, reduce challenging behaviors, and decrease feelings of anxiety and depression in Alzheimer’s. Many of us enjoy and benefit from listening to music, and this often does not change after someone develops Alzheimer’s.
Music in Early Stage Alzheimer’s
In the early stages of Alzheimer’s, many people enjoy playing music or singing. Encourage them to continue to be involved in music; it may be an area in which they can feel success and accomplishment and be encouraged by its beauty.
You can also make compilation recordings of their favorite songs, which are often songs or music that date back to their younger and middle years.
Some older adults may have strong spiritual beliefs and will appreciate songs of faith.
Music in Middle Stage Alzheimer’s
Some people in the middle stages of Alzheimer’s can continue to play the piano (or whichever instrument they may have played) well, and benefit from it. Others may become frustrated when they forget the chord or can’t read the music.
In the middle stages, when behaviors can sometimes be challenging, music is an often-effective way to distract someone. A nurse aide that I know, for example, almost always sings a song with the person she’s helping while they walk together. The person walks farther because he’s singing along and has a more enjoyable time getting his daily exercises accomplished.
Music may also be beneficial to mood and sleep patterns for people with Alzheimer’s. A study published in the journal Alternative Therapies in Health and Medicine was conducted with 20 male residents who had a diagnosis of probable Alzheimer’s at a nursing home. These men participated in music therapy five times a week for four weeks. Following the four weeks, their melatonin levels were tested and had significantly increased—and remained elevated even six weeks after the conclusion of the music therapy programming.
(Melatonin is a hormone that helps regulate sleep cycles. Some people living with dementia take supplemental melatonin to aid them in sleeping better at night.) Therapists also noted that the men demonstrated an improved ability to learn the songs and lyrics, increased social interaction, and a more relaxed and calm mood.
Music in Late Stage Alzheimer’s
In the later stages of Alzheimer’s, music is often used to connect with a loved one and evoke a response. People may enjoy listening to the recordings you made in the earlier stages of dementia of their favorite songs.
Familiar music may be able to calm someone who’s restless or uncomfortable in the end stages of life.
Some people with severe Alzheimer’s will mouth the words of a familiar song upon hearing it, and visibly relax and rest during music.
Alternative Therapies in Health and Medicine. 6 (Nov 1999): 49-57. Music therapy increases serum melatonin levels in patients with Alzheimer’s disease. http://www.alternative-therapies.com/index.cfm/fuseaction/archives.main
Alzheimer’s Association. Music, Art and Alzheimer’s. http://www.alz.org/care/alzheimers-dementia-music-art-therapy.asp#music
Alzheimer’s Foundation of America. Education and Care: Music. http://www.alzfdn.org/EducationandCare/musictherapy.html
Boston University. Music Boosts Memory in Alzheimer’s. http://www.bu.edu/today/2010/music-boosts-memory-in-alzheimer%E2%80%99s/
Medical Hypotheses. Music, memory, and Alzheimer’s disease: is music recognition spared in dementia, and how can it be assessed? http://www.ncbi.nlm.nih.gov/pubmed/15607545
Neuropsychology Review. Memory for music in Alzheimer’s disease: unforgettable? http://www.ncbi.nlm.nih.gov/pubmed/19214750