As early as possible: care planning!
In the early and middle stages of the disease, dementia patients can usually still manage their daily lives on their own, sometimes with a little help from relatives. Many can also still live in their own home. Sooner or later, however, more help is needed in everyday life. For this reason, dementia patients and their relatives should find out early on what help is available and what housing options are possible if the patient is no longer able to live independently.
Dementia: care at home
Around two out of three people with dementia currently live in their own home. For older people in particular, home is usually the center of life. Familiar surroundings bring back memories and offer safety and security – factors that are particularly important in dementia. This is why many dementia patients want to stay in their own home for as long as possible.
In the early stages of dementia, this is usually not a problem. Patients are often still able to cope with everyday life on their own. They only need help from relatives with activities that require a lot of concentration (correspondence with the authorities, going to the bank, etc.).
Care planning for dementia also includes ensuring that the patient’s home is dementia-friendly. This includes, for example:
- large symbols on the doors in the home that indicate the use of the respective room (kitchen, bathroom, bedroom, etc.)
- Transparent closet doors (make it easier to find desired items of clothing such as underwear or coats)
- Converting the stove so that it switches itself off after a certain time (prevention of fires and injuries)
- Light elements in the floor (prevention of falls)
- Safe storage of cleaning products (reduces the risk of confusion and poisoning)
- Removing hooks and keys that can be used to lock the bathroom door from the inside, for example
The task of caring for a person with dementia requires a great deal of commitment and patience from relatives – and increasingly so as the illness progresses. The family should therefore consider how much support they can provide and when external help (e.g. from outpatient care services) is necessary. The attending physician will help relatives with this assessment.
Outpatient care
Relatives caring for a dementia patient are entitled to professional support from an outpatient care service. The specialists help the patient to get up, wash and go to the toilet, for example.
24-hour care
If the support provided by outpatient care staff is not sufficient, but the person with dementia still wants to stay in their own home, 24-hour care can be useful. Sometimes local care services offer such all-round care. The monthly costs for this amount to several thousand euros.
Many dementia patients are also cared for by nursing staff from Eastern Europe. Relatives should always observe the legal framework and employ the carer legally. Illegal employment is a criminal offense and can result in severe fines and back payments of social security contributions.
Care groups for dementia patients
Many places offer group care for dementia patients. The participants meet regularly, for example to eat, sing, do handicrafts or play games together. The groups are usually supervised by volunteers. Participation in a care group usually only costs a small amount (e.g. for food and drinks).
Day care
The costs for day care can range from 45 to 90 euros per day. The care insurance fund contributes to this amount up to a certain level – depending on the patient’s care level. Patients and their relatives must pay the rest themselves. However, the social welfare office may also make a contribution.
Short-term care and respite care
If family caregivers fall ill or need a vacation, for example, dementia patients who would otherwise be cared for at home can be temporarily accommodated in short-term care facilities.
Alternatively, there is the option of respite care (substitute care) in such cases: The person with dementia is then temporarily cared for at home by a professional care service. The costs for short-term or respite care are covered by the care insurance fund up to a certain amount.
Assisted living
Assisted living can be a suitable form of housing for older people: Here, senior citizens live in their own senior-friendly apartments in a house or a complex of houses. However, depending on their wishes or needs, they can take part in communal meals and make use of housekeeping services (such as laundry service) and care.
Advanced dementia: Nursing home
If relatives are no longer able to provide all-round care for a dementia patient and 24-hour care is not affordable, accommodation in a care home or alternative forms of living (such as a dementia flat share) is an option.
When choosing a home, relatives should inform themselves carefully and compare the offers critically. In addition to conventional nursing homes, many places also offer special living and care facilities for dementia patients. Such home communities, residential groups or care oases are tailored to the special needs of people with dementia and usually have 12 to 20 members. However, these special services are not cheap.
Outpatient dementia residential communities
In some cases, a dementia flat share can be an alternative to a care home. Here, several dementia patients live together in a large apartment. Each patient has their own room and can usually bring their own furniture and furnishings.
Other rooms such as the kitchen, living room and bathrooms are shared. The dementia patients are cared for by professional nursing staff.
There are now more and more offers for such dementia shared flats throughout Germany.
The care costs
The Medical Service of the health insurance funds assesses the dementia patient (after application to the care insurance fund) and assigns them a certain level of care. The higher this classification, the higher the care insurance fund’s contribution to the care costs.
When it comes to care planning for dementia, relatives must consider the amount of this allowance as well as their own financial means. This usually influences the decision as to where and how a person with dementia should live and be cared for.
