When Your Loved One May Need Assisted Living

More than 15 million Americans devote time and energy to caring for a loved one with Alzheimer’s disease or dementia, according to the Alzheimer’s Association. Sometimes the cost of caregiving becomes too high. Caregivers often find themselves unable to bear the burden of providing home health care without suffering from disease themselves. Then it’s time to consider whether to move a loved one into assisted living if their health needs become too much to handle at home.

Moving a loved one is never an easy decision all around. There are, however, some signs that caregivers can look for in order to recognize when it’s the right time to consider assisted living.


Physical aggression frequently happens in those with dementia. Caregivers or other family members may suffer or begin to feel resentful due to aggression.

Caregiver Stress

Caregiver symptoms like increased stress can be just as challenging as dementia behavior.

Escalating Care Needs

Ask yourself, “Are the person’s care needs beyond my physical abilities?” or “Is the health of the person with dementia or my health as a caregiver at risk?” If you’re answering yes to those questions, it might be time to have that family conversation.

Home Safety

Consider your senior family member’s health and your own abilities to care for them. Is the person with dementia unsafe in his or her current home?


“Sundowners syndrome” — stressed behavior that becomes more pronounced throughout the day — is a common characteristic of those with Alzheimer’s. This can take a heavy toll on caregivers, and when it begins to severely disrupt family routines, this may be a sign that the caregiving burden is too hard to handle.


In later stages of dementia, the risk posed by wandering becomes much greater. A loved one can wander even if you just take the time to go to the bathroom and the probability of falls and injuries increases.


Stress May Indicate a Need for Help

There are costs to caregiving and making difficult care decisions, which some professionals are likening to the effects of post-traumatic stress disorder. Caregivers may experience symptoms like:

  • Avoidance behaviors
  • Disabling anxiety
  • Hyper-vigilance
  • Intrusive thoughts and more

Caregivers attribute these symptoms not only to the pressures of caring for someone with dementia, but also to the disruptions to normal eating and sleeping patterns that result when one is spending so much time on caregiving. When the brain is always on alert, many things are going to happen — you won’t eat well, nutrition is not a priority and then the caregiver’s health suffers.

The emotional, mental and physical toll of caregiving can be particularly pronounced for spouses of those who need care. It might be clear immediately when the demands of care become too great. In other cases, it might not be so obvious.

If you are feeling isolated and alone, or you begin to feel resentful of your loved one, it might be time to examine the source of those feelings.

Anger, resentment, sleep deprivation and stress may become part of what happens to a caregiver. You may also experience guilt when you think, “I’m not doing enough.” When that happens, it’s important to recognize how much you’ve been giving to your loved one, and perhaps tell yourself, “Okay, I’m not living a life for myself anymore, I’m living for that person.”

What If My Loved One Needs More Help Than I Can Give?

Deciding between assisted living vs in-home care is never easy, and caregiver grief and guilt are common reactions to moving older adults out of their homes.

We lose our family member twice: once to the disease, and again when they pass.

Caregivers may wonder if they could or should have done more; they may feel separation anxiety in moving their loved one to another location. If family dynamics are difficult — if, for instance, a caregiver caring for a parent had an unhappy childhood — that may further complicate the decision process. This is why planning ahead is so important.

If you know your family member is in the early stages of [illness], first and foremost you want to get all your paperwork together. Our culture can keep us from talking about these things, but before dementia affects your loved one’s cognitive health, it’s important to have someone help collect the right paperwork and make those critical decisions, whether you are  a family member, friend or physician. Planning ahead and involving the appropriate persons in the decision will ultimately help ease the process when it’s time to move your loved one into care.

The best way to be there for your loved ones is to know that they are in the proper place for getting the care that they need. Visit communities before choosing one, and make sure they have activities and medical support appropriate to dementia patients. If you’ve done your research, chances are good that your loved ones  are going to thrive.