One of the most difficult experiences for family caregivers of a person with Alzheimer’s disease or a related disorder is deciding when to consider placement outside the home. Caregivers should ask themselves the following questions to evaluate their situation:

1. Is the person with memory loss becoming unsafe in their home?
2. Is constant care required beyond my physical capability?
3. Am I becoming impatient or irritable toward the person for whom I am caring?
4. Would structured activities and increased social interaction benefit the person I care for?
5. Am I neglecting my family, my job or myself in order to provide care?
6. Would placement outside the home result in more enjoyable visits and outings with the person I care for?

Your answers to those questions can help you determine if placement outside the home is the best decision.

License: Ask to see the facility’s valid California State License, issued by the State of California, Dept. of Social Services Community Care Licensing Division.

Atmosphere: When you walk in do you “feel” the nurturing, loving, and supportive environment your loved one needs and deserves?

Living space: Is there indoor and outdoor space? Are there safe walking paths or secured access to fresh air and outdoor activities?

Visiting hours: Does the visitation policy meet your needs? Visit unannounced at different times to see the staff interact with residents.

Structure: Is the facility designed and constructed with the abilities, comfort, and freedom of the resident in mind?

Staff: Has the staff been screened and properly trained? Residents with memory loss present unique challenges to staff, requiring ongoing training.

Administrator: Does the Administrator seem knowledgeable about dementia and the special care required?

Physical contact: Is there positive physical contact between staff and residents – a warm touch, an arm around the shoulders?

Humor: Do staff and residents interact joyfully and set a tone of lightheartedness?

Verbal cues: How do staff redirect a resident? Do they command or encourage?

Personal care: Is care (bathing, toileting, etc.) done with respect and dignity for the resident?

Resident behavior: Are some residents sitting quietly or sleeping? Are some residents moving around freely? These are normal behaviors and should be allowed in a safe environment.

Personal belongings: Are residents allowed to bring in furniture, bedding, and photos that are familiar to them? This helps them to feel “at home” and gives them a sense of belonging and not being lost.

Level of function: Ask what happens when the person needs a higher level of care. Can the facility accommodate residents with a wide range of abilities?

Home life: Can the residents participate in meaningful activities such as setting the table, washing dishes, folding the laundry, etc.?

Programming: What does the structured activity program look like? Are projects interesting and success-oriented? Are activities planned with the dementia resident in mind?

*RCFE – Residential Care Facilities for the Elderly

Nursing Home Compare
medicare.gov/NHCompare/Home