Unfortunately, sub-par Alzheimer's care and assisted living facilities with less-than-attentive staff do exist, and unless you know what you're looking for, it's easy to choose one that will ultimately fail to meet your requirements for quality care and supervision.

If you understand enough of the process to know what you're looking for, however, choosing an Alzheimer's care facility can be much easier. My job is to make your selection process simple - we'll take a look at the many highlights and features of superior care facilities around the country and get into the nitty-gritty of things in order to help you find Alzheimer's care and assisted living facilities that will provide the kind of attention your loved one needs.

Aside from the major qualifications you should look for - a meal plan, housekeeping, transportation, staff training, and extensive safety and security measures - you also need to be prepared to evaluate Alzheimer's care and assisted living facilities based on hygiene, diet, décor, and activity time, four hallmarks that, if met adequately, often reflect the level of care that is provided at the facility. Even though I fully understand the challenges you face in trying to find a quality facility, don't feel overwhelmed - you'll be better prepared to ask questions about the care provided and find the perfect place for your aging parent or loved one with time. Let the following highlights of unique Alzheimer's care and assisted living facilities around the country be your guide to finding superior treatment and care for your loved one.

Hygiene:Because bathing is carried out by the facility's staff, cleanliness is both monitored and controlled on a daily basis. A good facility should work with a resident's existing bathing schedule to make him or her feel more comfortable. If, on your walk-through of the facility, residents are poorly groomed, it should be a pretty good indication of the level of care that residents are receiving.

Slips and falls can be common with bathrooms located in a resident's personal room; the Los Angeles Jewish Home for the Aging, for instance, created a separate bathing area from the residents' rooms to prevent these types of accidents. Alzheimer's care and/or assisted living facilities in Connecticut, for example, must provide a separate apartment with a bath as well as assistance with bathing (1). While a plan of care will be created by the staff upon your loved one's arrival, you should discuss with the facility's director how issues of hygiene are handled, the existence of grab bars and other safety equipment in bathing areas, as well as how often residents are monitored throughout the day.

Diet:Getting residents to eat properly is an often cited problem in Alzheimer's care and assisted living facilities. Even though a facility may serve three square meals per day, if the food is not of a high enough quality (or quantity), residents will lose weight.

To encourage residents to eat, the Woodlands Assisted Living of Hallowell offers a residential kitchen with supervised cooking activities for Alzheimer's patients (2). Similarly, Potomac Homes in Ramsey, New Jersey has created a NutriCare food program allowing for the changes that Alzheimer's disease causes in senior diets, including the frequently overlooked decrease in both taste and smell. The current make-up of a diet for a senior with Alzheimer's disease should be about 55 - 60% carbohydrates, 12 - 15% protein, and 25 - 30% fat (3). Substantial snacks, 'comfort' foods, and a variety of beverages should always be available to residents on an ongoing basis.

The thing to note here, however, is that Alzheimer's care patients have difficulty distinguishing food from a plate, and either the food or the plate needs to be colorful enough to prevent things from blending together. When touring the facility, make sure to visit the dining room to get a feel for how residents are accommodated at meal times as well as ensuring that the plates are colorful and the food is easily distinguishable.

Decor:The design of a room plays a big part in selecting Alzheimer's care and assisted living facilities. The wrong carpet pattern has led to some Alzheimer's patients believing that hundreds of bugs were crawling along the floor. The Wilsonville in Wilsonville, Oregon emphasizes the feeling of home with unique architecture and interiors that are designed to evoke the atmosphere of a home or hotel that residents may have visited at one point in their lives; the facility even boasts a lovely craftsman style and antique décor (4). Bright, warm lighting is recommended, and dramatic or busy carpeting, drapes, and other upholstery should be avoided.

The residents' rooms should be able to be easily identified, whether by a name plate or artwork. The Barton House in Texas, for instance, installs a small curio cabinet outside every resident's door that can be filled with personal items to help quickly identify his or her room. The colors of the room and bathroom doors also match so that residents know it's their own personal space (5).

Activities:Scent and music therapy have been shown to elicit positive responses from Alzheimer's and dementia patients. Asking residents to identify certain smells or sing along with old songs are great ways to get residents' cognitive juices flowing. Puzzles, games, gardening, reading, sorting, and organizing are also the kinds of activities you should look for when visiting Alzheimer's care facilities.

Small group activities are highly important as large groups just don't work the way they should. It's vital that you watch an activity session to get an idea of how caregivers interact with the residents during these group and one-on-one activity times. And of course, the more caregivers the better - make sure you consider the ratio of caregivers to residents as this allows more time for interaction with your loved one.

Many Alzheimer's care facilities now have what I'll call a 'Memory Lane.' Antique objects, furniture, clothing, and dolls are placed around a room along with other reminders from a past time to help residents continue their memory-jogging exercises. The only problem is that most of these communities do not fully utilize these highly effective retrospective areas. It's important that caregivers engage residents in these small memory corners in order to be practical, so take note if it is being properly used.

Final Thoughts:Residents of Alzheimer's care facilities need a schedule that's extremely consistent as activities done on a whim or changes in eating or bathing times can trigger attacks of anxiety or confusion. Alzheimer's care residents in superior assisted living facilities have well-scheduled, structured lives with round-the-clock customized care. If the facility does not stress these prime requirements for Alzheimer's care, my suggestion is to thank the director for his or her time and begin hitting the pavement once again. Attentive, thorough research of the facility's features and your loved one's needs guarantee that you find an Alzheimer's care facility that will be as committed as you are to the level of care that's administered. Remember - if it's a concern to you, speak up! You'll learn much more that way.

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