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Alzheimers care can quickly turn from a convenience into a nightmare. “It was then that realization dawned about exactly what our family was facing: Dad was a ward of the county and no longer in our care. For five days, [my father] remained in the psychiatric hospital, mostly in the highchair and strapped to a bed at night,” writes US News & World Report writer Kerry Hannon. Her father had been through all sorts of debacles in the nursing home. The 88-year-old had fought with orderlies, refused his medication, developed bed sores, come down with a Staph infection and would up in a psychiatric hospital. Once patients wind up in the psych ward, they’ll have a heck of a time getting them out again, since the law says a “severely mentally disabled person may be subject to involuntary examination and treatments” as medical personnel see fit.

Many American families face similar horrific scenarios when dealing with Alzheimers care facilities. “Hard-to-manage nursing home residents with Alzheimer’s and other dementia are often committed involuntarily from nursing home facilities to psychiatric units,” says Eric Carlson, an attorney with the National Senior Citizens Law Center in Los Angeles. However, the federal Nursing Home Reform Law mandates that the senior care facilities must provide a written notice 30 days prior to evicting someone. This written notice must also detail the appeal process and direct families to a local organization that may help them with their nursing home care rights. Carlson warns that families should look out for facilities that suffer a high turnover rate, which is a sure sign that the Alzheimer’s patient will not be receiving top quality care. He also adds that some facilities may use sedatives or restraints inappropriately, but not all establishments use these behavior modification mechanisms. “Many nursing homes now function completely restraint-free,” he explains.

Many families can hire nursing services for home if their elderly parents can generally get around the house, but may require extra assistance cooking, cleaning and running errands. However, Alzheimers care patients generally need more attention. They may forget their medication, wander out of the house or become panicked when alone. There are several different types of long-term care facilities to choose from. Retirement housing gives patients their own apartment that includes a kitchen, living room, bathroom and bedroom, but staff is in the building for emergency care. This option may work for patients in the early stages of the disease who wish to remain independent but not manage a whole home. Assisted living settings are best for people who need help with personal care and guidance, but may not require significant medical help. Specialized dementia care facilities are for people who might benefit from activity-based programming, specialized staff and memory care. Lastly, a nursing home will provide 24-hour skilled care, with special units for people with Alzheimer’s.

Many families wonder how much they can expect to pay for their loved one’s Alzheimers care. The average price of dementia care in assisted living facilities is around $56,316/year for a private bedroom (or about $154/day), according to the National Investment Center for the Seniors Housing and Care Industry. However, a top-caliber establishment with medical professionals from John Hopkins Medical Center (like Cooper Ridge in Maryland) runs $205 - $311/day for assisted-style living and $385/day (or $140,525/year) for nursing home care. Most families will pay privately, although some Medicaid patients may be accepted into the nursing home. Despite the hefty price tag, it’s not uncommon for facilities to encounter a waiting period of several weeks.

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There are many instances where you may need to seek out nursing services for a loved one. Sometimes Alzheimer’s and dementia patients require around-the-clock maintenance to remain out of harm’s way. Other times, elderly patients are unable to feed themselves, get to the bathroom, remember their medications or clean the house any longer. Finding an assisted living facility can be an agonizing decision for the family, so it’s especially important that they find the right establishment to find that peace of mind. In this article, National Senior Citizens Law Center Attorney Eric M. Carlson will tell you what to look for in an elderly care center, what sort of problems to expect and what to do should an issue arise.

Staffing is, hands down, the biggest factor when it comes to the quality of elderly care received, Carlson says. “Annual turnover for nurse aides runs at 100 percent or higher. Nurse turnover rates are also high at 50 percent annually,” he explains, adding that existing staff may be asked to work double shifts, which contributes to declining quality in care. To ensure the most attention and get the best value, you should look for a home with low staff turnover and a high aide-to-patient ratio. Ideally, one staff member will work with five or six patients at most. If administrators are reticent to share turnover rates with you, ask how long the employees have worked there to gauge who you’re dealing with. The best nursing home health care generally comes from places where the aides have been there for at least two or three years. That way you know these people genuinely want to be there and have a positive attitude toward their patients.

Secondly, if you have a loved one who needs elderly care for Alzheimer’s or dementia, then examine your options because not all places are created equal. “Some nursing homes are trying a different approach, commonly called resident-centered care, which offers a homelike environment that works to meet a resident’s preferences, such as eating frequent snacks, waking up later, or being able to take walks,” says Carlson. “These homes work harder to try to get people up and find activities that work for them as individuals so they are not sitting around in wheelchairs watching The Price Is Right every morning. They stress intellectual and physical stimulation, exercise, calming music and pets for therapy.” The best elderly caregiver will approach patients with dementia slowly, call the person by name and talk kindly to facilitate better communication, despite the disease.

“Many nursing homes follow procedures that are in conflict with the federal Nursing Home Reform Law, which has been in effect since 1990,” warns Carlson. Far too often he sees trouble getting Medicaid-eligible patients re-admitted after their hospital stays, even though they are entitled by law to the elderly care facility’s next available bed. He adds that families can contact their state ombudsman who will provide advocacy for residents free of charge. For more information, visit the National Long Term Care Ombudsman Resource Center at www.itcombudsman.org. “I know at the time it is a difficult period and people feel unsupported, and it’s baffling to them that this possibly could be happening,” says the attorney, “but nursing homes need more consumer pressure. A lot depends on consumers knowing more about them and not being intimidated talking to these people.”

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