9 Key Aged Care Home Considerations for People Living with Dementia

When it came time to find full time care for my aunt who is living with dementia, I was on the lookout only for a few factors. I knew she needed somewhere that would accept pensioner with limited assets, somewhere that provided regular activities, and somewhere she wouldn’t need to share a room. I did not know some factors that now seem obvious: that outdoor spaces were important, that activities could vary widely between different homes, or that different homes have different arrangements for medical care. I did not know much at all.

Through my own experience visiting aged care homes, trawling through the latest scientific research, and speaking directly to medical specialists, I’ve compiled a list of what’s truly needed for the highest quality dementia-specific care. This is the information that I wish I had known.

Before you start looking for aged care, remember that having your loved one stay in their own home for as long as possible is always best for their wellbeing. You can contact My Aged Care for support with cooking, cleaning, bathing, shopping and other care needs. But of course, care needs are complex, and sometimes an aged care home is absolutely the best option.

If full time care is needed, the first step is to contact My Aged Care for an assessment from ACAT (Aged Care Assessment Team). They will visit your family member at home, with you present, and ask you both questions to decide if they are ready for full time care. A couple of weeks later, if they agree that your loved one is ready, they will provide a referral number you will need before you start the search.

Here are some key questions to assist you in making the best choice when choosing an aged care home for someone who is living with dementia.

1. Is there a dementia-specific unit? 

Not all aged care homes have dementia units, so this is one of the first questions to ask. While the government doesn’t require aged care homes to have any dementia specific training, or to be run in a way that differs from the rest of the facility, these units are generally more secure than a general unit. Since 60% of people living with dementia are prone to wander, security is an important factor.

2. Does the facility have a familiar home-style layout?

Is the environment is home-like, or hospital-like? How much privacy your loved one will have? In most aged care homes, residents will have their own room with a lockable door (although staff have keys). However, there are homes where residents are required to share a room. When you visit, pay attention to the noise levels, and to whether staff are respectful of resident’s spaces by knocking and pausing briefly before entering rooms.

3. Does the aged care home routinely provide meaningful activities to enhance wellbeing?

Aged care homes often employ staff such as diversional therapists or activity coordinators to give residents focused events throughout the day, but it is worthwhile finding out exactly what types of activities are provided. Ideally, the home will prioritise activities that have been shown to slow cognitive decline, such as cooking, craft, art therapy, singing and dancing.

When you visit the facility, you can always check the activities schedule for yourself (you’ll usually find it pinned up in a common area) and get a feel for what’s being offered. If the home has only one full-time diversional therapist, it’s worth asking what happens on weekends, or when that person is sick or goes on leave, as the days can get very long and lonely.

4. Does the aged care home prioritise movement?

We have known for quite a while now how important regular physical activity is for maintaining good mental health, which should be a priority at any aged care home. In addition, many geriatricians state that resistance exercise — like squats, resistance bands and lifting weights — is particularly important to slow the progress of Alzheimer’s disease.

Many aged care homes offer physical therapy at least weekly, however some don’t offer it to residents in dementia-specific units. In my opinion can be seen as a lack of care (or education) from management, which will often flow into other areas.

In addition to physio, proactive aged care homes also schedule regular walks with residents who are more mobile. This is highly enjoyable for most residents, especially when these walks are in green spaces.

5. Does the aged care home provide well-designed outdoor spaces?

These should be easily accessible, interesting, safe and secure. Residents should be free to come and go from these spaces, there should be fixed seating, and residents should have the ability to easily return indoors.

6. Does the home employ mostly full time and/or part time staff to work In the dementia-specific unit?  

Having consistent staff in the dementia unit, with the majority of employees being full time or part time, is very important. Regular staff are more likely to understand your loved one’s specific needs, frustrations and personality, and can therefore care for them better. A consistent care team also fosters a feeling of safety for a person with dementia, and facilitates improved communications between staff and families.

7. How does medical care happen at the home, and what is the communication strategy?

Dementia affects the way people think, behave and perform everyday tasks. To improve care and better manage the needs of people living with dementia, there needs to be highly skilled registered nurses and care assistants working collaboratively with the person, their family and their GP.

There are many different ways an aged care home can operate. I visited several where resident doctors attend the facility (that is, people who have graduated medical school and are in the process of completing a post-graduate training program), which means that the visiting doctor will change every year or so, which is unfortunate for people living with dementia who truly need to build an ongoing relationship with their medical team.

Others required residents to have their own GP, as long as the GP was willing to visit the facility.

It’s also important to ask about the nursing home’s communication strategy. How will they communicate any changes in the resident’s condition?

8. Can your loved one afford the aged care home?

Dementia care should be affordable for all. Unfortunately, many aged care homes only take residents who can pay considerable fees. Some require payment of a RAD (Refundable Accommodation Deposit) which is often around $500,000. Others have a smaller refundable deposit but high daily fees, and some accept penioners who cannot pay any RAD.

9. How big is the unit?

Studies have shown that the physical environment of small-scale living facilities (maximum of 8 residents) can be highly beneficial for people with dementia. However, the same studies also emphasise the importance of these facilities providing residents with meaningful activities and using the physical environment to its full extent (in other words, small-scale alone isn’t enough). Dementia units in Orange are typically around 20 residents, so this may be one requirement that currently cannot be met locally. We are hopeful this will change.

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On a final note, it may be better to have the dignity of choice by putting your loved one’s name down in a few places, since wait lists can be many months or even years. Keep calling the appropriate administration person every month or so to check if a space is opened up; most facilities don’t offer places in the order of who has been on the wait list the longest, but rather who they perceive is in the greatest need. So it can pay to stay front of mind.

Aside from these 9 factors to consider when choosing an aged care home, what do you think is important in an aged care setting for people living with dementia? Please let us know.