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Alzheimer's Care in Nursing Homes
Memory Care in Skilled Nursing Facilities

According to the Centers for Medicare and Medicaid, unnecessary antipsychotic drug use is a challenge in dementia care.

Data from CMS show that in 2010 more than 17 percent of nursing home patients had daily doses exceeding recommended levels. Because of this event in overdosing, CMS launched the National Partnership to Improve Dementia Care in 2012.

It's the National Partnership's goal to reduce antipsychotic drug usage by 15 percent by the end of 2013.

Here's how it's playing out:

  • Antipsychotic use have reduced by 9.1 percent in the first quarter of 2013, compared to the last quarter of 2011.
  • 30,000 fewer nursing home residents are now on these medications.
  • 11 states hit or exceeded a 15 percent target: Alabama, Delaware, Georgia, Kentucky, Maine, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee, and Vermont.

Alzheimer's Care in Nursing Homes

Alzheimer's Care
Alzheimer's Care

Dementia is an illness that affects the brain. An individual living with the disease loses the capability to take of self and perform daily activities like bathing, grooming, cooking, cleaning, properly taking medications and more. In general, it affects all areas of the disease.

The person living Alzheimer's, a form of dementia disease, will eventually lose abilities like learning new information, making decisions, and planning the future.

Communication with others, family members, and friends, becomes difficult. Seventy percent of individuals with dementia live in the larger community, and their family members (caregivers) help them remain at safe at home. But in order to achieve safety, the family must watch over the loved one 24/7.

How Dementia Changes an Individual

  1. Early Stages - the person is aware of some changes in memory and rely on others or written notes to remind them.
  2. As it worsens - the person may get lost easily, leaving them unable to drive, manage finances, eat, drink, bathe, dress or use the toilet without help.
  3. Dying of dementia - the person is unable to swallow, talk, get out of bed. She is totally dependent.

Types of Care and Services for Alzheimer's Disease


Basic. Nursing home services that will help maintain a person with daily functions; personal care, getting around, staying safe, and being supervised and directed.

Skilled. Nursing homes services that offer the skills of a registered nurse for treatments and procedures on a regular basis; physical, occupational, and respiratory therapists.


Nursing home services differ, yet most include:

  • Room and board
  • Monitoring of medication
  • Personal care like dressing, bathing, and toilet assistance
  • 24-hour emergency care
  • Social and recreational activities

What to Look for When Evaluating Nursing Homes

Evaluate a Nursing Home
Evaluate a Nursing Home

Nursing home care for loved ones living a form of dementia or Alzheimer's disease, gives medical, personal, and social services designed to help with physical, social, and emotional needs. It's one of the best choices for those requiring 24/7 medical supervision.

When searching for nursing home care, begin it early, before you need it because waiting lists exists.

Planning ahead makes moving into a nursing home facility easier and smoother.

Here's a simple list to help you get started when evaluating Alzheimer's care in nursing homes.

  • Will the facility provide your loved one with the care she needs - basic or skilled care?
  • Is the nursing home facility licensed by the state?
  • Does the administrator of the facility have a license and is it current?
  • Does it have a sprinkler system, fire-resistant doors, and a plan for evacuating residents? (State fire regulations)
  • What are the visiting hours?
  • What is the policy on personal property?
  • What are the medical emergency plan(s)?
  • Does it have a Medicare license?
  • Is there a waiting period? How long is the wait list?
  • What are the requirements for admissions?

Paying for Care

  • What are the costs of services? How do they compare to other nursing home facilities?
  • How often do costs of services increase?
  • Are the cost for care services easy to understand?
  • Are the levels of care charged per item or category?
  • What are the billing, payment, and credit policies?
  • What services does the monthly rate include?
  • What services are extra?
  • Is Medicare, Medicaid, Medicare Supplemental Insurance, Supplemental Security Income accepted?
  • What's the cancelation policy?
  • What is the refund policy?

Care Plan and Resident Assessment

  • Does the nursing home staff perform a written care plan for each resident?
  • Does each resident participate in the care planning?
  • Do family members have a say in the care plan and health care assessment?
  • Is the resident's health care and needs assessed during admissions?
  • What's the initial assessment procedure?
  • How often are needs reassessed and measured?
  • How often is the care plan reassessed and redesigned?
  • Are family members encouraged to play an active role in advocacy for loved one?

Nursing Home Staff

  • What types of education, specifically for Alzheimer's disease, do nurses, social workers, and administrators receive?
  • How much experience and training do they have regarding elderly patients?
  • How many staff members on-site for each resident?
  • Can each meet the resident's scheduled and unscheduled needs?
  • Do employees appear to like working with the residents?
  • Do employees assist those experiencing memory and judgement loss?
  • Are residents respected and treated with dignity?
  • Do residents appear happy and content?
  • Is a physician on staff to regularly visit residents for check-ups?

Current Residents

  • Are current residents happy?
  • Do they appear comfortable?
  • Do residents have frequent visitors?
  • Do visitors have high regard for the facility?
  • Are residents clean and appropriately dressed?
  • Are the rights of residents clearly posted?
  • Are residents encouraged to participate in social activities and fitness?

Nursing Home Environment and Design

  • What's the environment like?
  • Do you like the neighborhood?
  • Does it have an inviting decor and style?
  • Is it home-like?
  • Is the floor plan easy to follow?
  • Are elevators easy to access/
  • Can residents in wheelchairs easily maneuver through the doorways, and hallways?
  • Can they manage easy access within the private rooms?
  • Are shelves placed for easy reach?
  • Are carpets secured and floors made of a non-skid material?
  • Is there good natural and artificial lighting?
  • Is the residence clean, odor free, and appropriately heated/cooled?

Medication and Health Care

  • Who administering the prescribed medications?
  • Where are they stored?
  • Can the resident self-administer medication?

Nursing Care Services

  • Is staff available 24/7, if needed?
  • Do they give help with: dressing, eating, mobility, hygiene and grooming, bathing, and incontinence issues?
  • Is the resident given help with other functions like using the telephone or setting medical appointments?
  • Is transportation available to the residents?

Personal Residencies and Rooms

  • Are rooms for both single and double occupancy?
  • Do the rooms and residencies feel home-like?
  • Do all rooms have a PERS installed? (A personal emergency response system)
  • Are bathrooms private?
  • Are bathrooms wheelchair accessible?
  • Can residents bring furniture? What's not allowed to move with the resident?
  • Do all rooms have a telephone? How is billing handled for long-distance calls?

Social and Recreational Activities

  • What are the activities?
  • Do residents get involved in planning activities?
  • Are the activities posted for residents?

Meals and Food

  • Does the food appear appetizing?
  • Are meals nutritious?
  • Do the residents participate in meal planning?
  • Can they participate in cooking, if one wishes?
  • Are three nutritionally balanced meals served each day of the week?
  • Are snacks available 24/7?
  • Are special diets honored?
  • How are special diets handled?
  • Are dining areas home-like?
  • Are common dining areas available?
  • Can residents take meals in their rooms?
  • Are all meal times set by the nursing home facility?
  • Can residents choose to eat when they want?
  • Is assistance available for residents who need help with eating?
Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.