At home or in a nursing home?

The prospect that, at a certain point, people with dementia will no longer be able to live alone but will be dependent on permanent care involves a difficult decision for both them and their relatives. A central question is whether it is feasible to care for the person at home with the help of other private or institutional actors, or whether it is necessary to transition their loved one to a nursing home. The question of what the ideal level of care is and where the optimal place is for their loved one remains a constant concern for relatives.

Weighing up, planning, organising

A care arrangement is rarely stable; it must be continuously reassessed and adapted. The relatives try to track the condition of the ill person and adjust the care setting accordingly. It is difficult to predict when the time will come to reorganize care again – after a new event, restlessness, disorientation, sleepless nights? Dementia care involves a lot of organization, such as finding a home or changing homes; moving or organizing caregivers; and coordinating between stakeholders, including the outpatient caretakers, other family members, those who run day programs, nursing home staff, etc. Sometimes, relatives also consider a change in their own living situation such as relocating or making renovations that would be useful.

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Frau Zeller

In order to roughly assess the quality of care, Mrs. Zeller put nursing and hotel costs of the homes in perspective.

When transferring her mother to a dementia-friendly nursing home, Mrs. Zeller searched and waited for a long time. In order to be able to roughly estimate the quality of care, she put the nursing and hotel costs of the homes into a ratio.

At home or in a nursing home?

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Frau Engel

Mrs. Engel plans to care for her husband, who has dementia, at home for as long as possible, which is why she will move into an accessible apartment with her husband.

Mrs. Engel plans to care for her husband, who has dementia, at home for as long as possible. For this reason, she has adapted her home so that it is suited for the care that he needs. She plans to move with her husband to an accessible apartment imminently. Based on her experience with her mother, who also suffered from dementia, she will only consider institutional care if her husband becomes aggressive.

At home or in a nursing home?

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Herr Wolfensberger

Mr. Wolfensberger brings his wife to the day program once a week. Taking her there and picking her up is time-consuming, and the transition period in the morning is difficult.

Mr. Wolfensberger brings his wife to the day program once a week. Taking her there and picking her up is time-consuming. In addition, the transition period in the morning is difficult because his wife often reacts irritably.

At home or in a nursing home?

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Frau Hürsch-Dietrich, Herr Hürsch und Frau Colombo-Hürsch

Mrs. Hürsch-Dietrich's search for a home for her husband took place under great pressure.

Mrs. Hürsch-Dietrich's search for a home for her husband was carried out under great pressure. Since his dementia was considered far advanced and not treatable, he had to leave the clinic they had found. Mrs. Hürsch's children, together with the clinic's social services, helped her find a new care facility. However, the possible options were limited and often too far away, her daughter notes.

At home or in a nursing home?

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Frau Tailler

The organization of regular care through institutional arrangements must be done slowly, says Mrs. Tailler. Otherwise, her husband would lose his bearings and she would feel unsettled.

The organization of regular care through institutional arrangements must be done slowly, says Mrs. Tailler. Otherwise, her husband would lose his bearings and she would feel unsettled.

At home or in a nursing home?

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Frau Ullmann und Herr Thoma

Mrs. Ullmann and Mr. Thoma mention orientation aids for the search for a nursing home.

Mrs. Ullmann and Mr. Thoma, at the urging of the social service in the psychiatric ward where Mr. Thomas's father was, spent more than two weeks searching intently for a suitable nursing home. Orientation offered them: the quality of the leadership, their impression of the residents (lethargic or not), the rooms, the quality of the food, the smells, the mood (no stressed caregivers), the size of the beds, and their own intuition.

At home or in a nursing home?

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Frau Köhler-Münch

A change of nursing home could not be organized quickly, says Mrs. Köhler-Münch.

Due to poor quality of care, Mrs. Köhler-Münch and her siblings decided to move their mother, who suffers from dementia, to another nursing home. However, the change could not be organized quickly, she concludes.

At home or in a nursing home?

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Herr Reinhart

For a long time, Mr. Reinhart and his partner grappled with the idea of bringing his mother, who suffers from dementia, to live with them.

Mr. Reinhart and his partner spent a long time discussing whether he would be able to bring his mother, Mrs. Reinhart, who suffers from dementia, to live with him when she can no longer live at home with the support of her partner. While others advise him against it, he considers the plan feasible because it is compatible with his home lifestyle.

At home or in a nursing home?

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Herr Sonderegger

For Mr. Sonderegger's wife, the nursing home proved to be only a temporary option.

For Mr. Sonderegger's wife, the nursing home proved to be only a temporary option. After her aggressiveness had subsided, Mr. Sonderegger decided to care for her at home again. She was much better at home, much busier than in the home, which was good for her. The depressive mood she had suffered from in the nursing home had subsided.

At home or in a nursing home?

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Frau Hofer

Over time, Mrs. Hofer noticed that her husband was stressed at home alone. A new care arrangement presented itself.

While Mrs. Hofer worked, her husband initially spent the day at home alone. Over time, Mrs. Hofer noticed that he was stressed out alone. A new care arrangement was imposing itself. Because the care hours at the day home were incompatible with her work hours, she had to organize additional drop-off and pick-up, as well as early evening care, in addition to the day structure.

At home or in a nursing home?

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Frau Hofer

Mrs. Hofer had to reorganize the care setting for her husband several times.

Mrs. Hofer had to reorganize the care setting several times. One year after her husband was cared for in a day structure during the day, she had to look for a new day structure for him because the home could not continue to care for him because he was running away and behaving aggressively.

At home or in a nursing home?

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