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None of us wants to leave home for an assisted living or nursing home facility. None of us wants to see our partner of many years go. What if they have dementia? When is it time? How will we know?

“The best symptom predictors of institutionalization of individuals with dementia have been excessive nighttime activity, immobility or difficulty walking, and incontinence, along with caregiver factors.”¹

Sometimes the person giving care becomes ill or disabled. Sometimes the person needing care needs a Hoyer lift, a mechanism requiring two people, in order to transfer from the bed to a chair. Sometimes the caregiver feels trapped.

Institutionalization is less likely if the caregiver has someone to assist with activities of daily living overnight – but that is usually when helpers are home with their own families. (Ways to help the dementia caregiver.)

Institutionalization is more likely if the person suffers from depression, is losing weight, has extreme function limitations, little physical activity or social contacts, smokes, has impaired vision or themselves perceives their health as poor.²

¹ Hope, Keene, Gedling, Fairburn and Jacoby, “Predictors of Institutionalization for People with Dementia Living at Home with a Carer,” International Journal of Geriatric Psychiatry 1998 Oct 13 (10) 682-90 https://www.ncbi.nlm.nih.gov
² Gaugher, Yu, Krichbaum and Wyman, “Predictors of Nursing Home Admission for Persons with Dementia,” Med Care 2009 Feb: 47(2), 191-8 NCBI National Center for Biotechnology Information


Elder law attorney, Terry Garrett, is a member of the National Academy of Elder Law Attorneys and is an Approved Guardianship Attorney. She assists people in elder law, estate and special needs planning, guardianship and settling estates. She graduated with honors from Cornell University. She was on the Dean’s List at Wharton Business School. She earned her J.D. at Columbia Law School, receiving the Parker Award and a Mellon Fellowship.




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