By Luciana Mitzkun Weston, The Dementia Lady
Santa Barbara residents are no stranger to disasters: We’ve seen storms, fires, floods, earthquakes, mudslides, tsunamis, oil spills, and even tornadoes (did you receive that tornado warning this December?). There are also personal emergencies that could possibly happen to any of us, such as falls, accidents, or an unexpected health event.
If you are a caregiver for a person with dementia, any of those situations can suddenly restrict your ability to provide care. A common trip and fall can possibly leave a person in a cast for 6 weeks! Should you be temporarily incapacitated, have you planned for uninterrupted care for your loved one?
Anticipating and preparing for what to do in case of an emergency is the key to overcome adversity with minimum disruption to the continuity of care. Every caregiver should have a contingency plan for care that is ready to be put into place should the need arise.
A good emergency care plan should include provisions for immediate temporary placement in a memory care community. These facilities can become a second home for dementia patients, where they can be safely housed while receiving assistance with every activity of daily living in a nurturing and socially stimulating setting. Having your loved one comfortably placed in a memory care home would allow you to fully attend to your own emerging needs without having to also attend to the many tasks of direct caregiving.
Temporary placement in a residential care facility is commonly referred to as respite care. Not every memory care offers respite, and not every home that does offer respite care has beds available when you need one. To maximize your chances of finding respite care when you need it, make sure you follow these steps – and do it before an emergency happens:
1. Identify a suitable memory care home. They come in all shapes and sizes, some are particularly appropriate for your loved one, some are not. Research available homes, visit them in person, talk to the administrator. Make sure the home is equipped with wandering prevention systems and offers plenty of activities that are engaging and stimulating for a dementia patient. Ask about their nursing team, caregiver per resident ratio, and length of shifts of their care staff. Prefer a home that offers a team of caregivers with longevity in their positions and long history of caring for dementia patients: stability and experience matter.
2. Request a nursing assessment. Once the home is identified, ask the administrator for a nursing assessment. The nursing team should meet with you and your loved one to review all information regarding medical and social needs. This assessment will help confirm the appropriateness of the services provided for your loved one. It could also result in recommendations for additional services and care strategies.
3. Ask the doctor for a report. You will need a physician’s report in hand for placement of any kind, permanent or temporary. In California, the Health and Human Services Agency requires a form 602A (easily downloadable on the web) with a valid test for tuberculosis (TB) signed by the doctor within 1 year of placement. As there are many doctor visits throughout the year, there are many opportunities for you to renew this form, making sure you always keep a current 602A with TB test.
4. Keep current prescriptions signed by the doctor. For residential care, all medications must be accompanied by a signed prescription from the doctor, with dosages and frequency, even for medications that are bought over the counter (such as Tylenol and supplement vitamins). On these days where everything is in the computer, this requirement is not as easy to fulfill as one would think it is! Get in the habit of collecting written prescriptions at every visit with the doctor, and every time there is a change in the medication.
5. Compile copies of required documents. In a folder with the 602A and signed prescriptions, keep copies of the following: photo identification, Medicare card, and insurance cards. If applicable, also add copies of power of attorney, health care directive, and POLST (Physician Ordered Life Sustaining Treatments).
6. Prepare an overnight bag. You may want to have an overnight bag prepared in advance with essential toiletries and clothing enough to last for 3 days. The care home should be able to provide incontinence supplies as needed, although you are welcome bring your own. Other items that should accompany your loved one include: all current medications (in their original bottles), adaptive devices (cane, walker), corrective devices (eyeglasses, hearing aids), items of personal comfort, and items of personal interest. All items should be marked with the person’s name. DO NOT include any valuables such as cash, jewelry, irreplaceable mementos, or anything that has intrinsic or emotional value.
7. Share your contingency respite plan with a trusted proxy. Identify a family member or a trusted friend to assist you in case you need help. Share the knowledge of your plan and the location where the above items are stored with them, so they could quickly assess the bag and documentation when needed.
You can now tell that there are several steps in arranging for a respite stay, and how difficult it would be to do it all overnight, while immersed in an emergency event.
Having completed these 7 steps, you are prepared for a quick placement in case of an emergency. Hopefully, there will be no emergency, although things do not always turn out as expected. It is best to be prepared.
On a happier note, keep in mind that a short stay in a memory care home may also be used to accommodate a fortunate event. Caregivers often use respite stays to take a well-deserved break, to attend a reunion out of town, to visit with friends and family, or to travel abroad. Having a respite plan in place may also offer you the peace of mind to take more breaks from caregiving, knowing that your loved one is safe, comfortable, and content in his home away from home.
The cost of a respite stay is close to that of a 3-star hotel. In our area, it currently averages around $250 per day. Fortunately, there are grants that may help you pay for some of these costs. Your pre-selected care home can help you find some of these programs. Also, contact the local office of the Alzheimer’s Association (805-892-4259) and the Coast Caregiver Resource Center (805-569-8950 ext. 1) for additional information on respite grants.
Do not wait for an emergency. Organize your respite care strategy now and allow our community to be there for you and your loved one should you need assistance.
Luciana Mitzkun Weston (The Dementia Lady) is an Author and Health Educator specialized in Memory Care. Her books Ahead of Dementia (also in Spanish) and Ahead of Memory Loss are available at Amazon. She is the Community Services Director at Villa Alamar, a secured Memory Care home in Santa Barbara. Villa Alamar offers residential care, respite care, and can assist families with finding funding alternatives.
Luciana is available for care consultations and can be contacted at