Is Home Care or a Nursing Facility Better for Your Loved One With Alzheimer’s?

Ray Burow avatar

by Ray Burow |

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Circumstances surrounding caregiving differ from family to family. Some prefer to provide care at home, while others choose to place their loved ones in a caring facility. There is a debate about which choice is best.

Our family was fortunate. My sister and I lived in neighboring towns and cared for our mother, who had Alzheimer’s disease, in our homes, right up until the day she left us. According to the U.S. Centers for Disease Control and Prevention, we were in the majority. About 80% of people with Alzheimer’s disease and related dementias receive care in their homes, often from family members or friends.

Alzheimer’s disease and other dementias present similar challenges to all caregivers, and those challenges gain momentum with time. However, the physical, emotional, and financial ability to meet those challenges varies. Don’t allow someone to pressure you into a situation that doesn’t work for your loved one or you and your family. Depending on your circumstances, a nursing facility might be the right choice from the beginning, or going forward when symptoms and stages become overwhelming.

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Things to look out for

You know the old saying, “One spoiled apple spoils the whole bunch?” The few poor nursing facilities that exist stigmatize the many good ones and cause loved ones to fear placement. But you can match your loved one to a nursing facility that meets their needs for a higher level of care.

Depending on your circumstances, the following signs may indicate your loved one needs more care than you can provide at home:

  • Mobility. Naturally, mobility is often an issue for older people, but those in the late stages of Alzheimer’s disease may lose their ability to walk. Getting them up from a chair or bed becomes more difficult for at-home caregivers.
  • Falls become more frequent.
  • Refusing to eat is causing your loved one to lose weight and is affecting their physical health.
  • Swallowing is an issue and makes it difficult to take medications.
  • Incontinence increases.
  • Showering, bathing, and hygiene are more significant challenges for caregivers.
  • Your loved one is becoming combative and possibly a danger to those living in the home.
  • Round-the-clock supervision is required.
  • Caregivers are experiencing burnout.

Choosing the right nursing facility

A good start for choosing a suitable nursing facility is learning whether it is certified by Medicare or Medicaid, which you can check by visiting Medicare’s website.

Identify the needs of your loved one and compare them with the nursing facility’s services. Medicare- and Medicaid-certified facilities will provide the information in writing, and charges are also included.

Research facilities close to where you live, so it’s easier to check in with your family member. When researching the facility, be sure to ask about visitation. Can you drop in without scheduling time? Dementia patients will require special care.

Finally, inspections are required by state and local governments. You can access this survey to learn if a facility meets federal health and safety regulations. Ask the facility for the survey or access it via or your state survey agency’s website.

There probably always will be a debate surrounding nursing facilities and in-home care. Caregivers must choose based on the level of care required and their ability to provide that care. Guilt and pressure have no place in the decision.

Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Alzheimer’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Alzheimer’s disease.


Connie Sue avatar

Connie Sue

I am lost, in tears all the time. Promising my dad that I would take care of mom just hours before he passed. I have lived with my mom for 20 years we are best friends. Mom has always been there for me. Now it is my time to be there for her.
I am losing her and cannot stop it. She wants to come home and live with me, that will only be ok for a short time. How upsetting to take her some place that is not "home" and leave her. It's awful when it's done to an animal, doing it to my mom is heart breaking.
Always in tears.

Karen avatar


Connie Sue,
I believe that your dad is very proud of all the love and support you give to your mom. He could not know what type of care your mom would need at this stage in her life. And, I believe he wouldn't want you in tears.

If you can find a quality memory care center for your mom, she will have time to get comfortable in a new environment made especially for her needs. You are not leaving her, you are making sure she is safe and has 24/7 care. I think it will be a relief and bring you joy once she gets adjusted after the first few weeks. If you can find a location that is nearby so you can easily visit once she is settled, I think you will find it will be a positive move after the initial transition. There are free resources through the Alzheimer's Association that may be helpful. I wish you the best of luck with whatever you do.

Jerry Thomas, Sr avatar

Jerry Thomas, Sr

In the current process of placing my wife of 46-Years into a long term care facility under the Nevada medicaid program. With that said: My wife & I use to live in Nevada till my Dr. mandated me to move to a low altitude for my severe COPD.... (Was passing out in higher altitude). We moved to California - wife developed Alzheimer's Dementia - Tried placing her into a care facility (California Medicaid Approved) Never Happen.... 6,000 people in line for each bed Medicaid Paid).
Hence my wife is now in Nevada establishing state residency (living at my daughters home) & should qualify for placement into their state medicaid program for long term placement care very soon. She is now in Nevada & I'm stuck in California & can never see her again, Due to my own health issues. I learned as a child to stand & walk forward - Yet, This journey In One I never fathomed I would have to walk alone going forward. I took care of her for most of 4-years till I could no longer do so..... Yet the immense feelings that I've abandoned her is beyond reproach. Hardiest thing in my life I have ever done or had to do. My god hold & guide her on the forward journey that no other can walk for her. I love her dearly.

mac johnson avatar

mac johnson

Connie: Alzheimers patients at some point do not realize where home is located. Whether they are home or move to somewhere else they always want to " go home". From my expenience I think my wife wants to be back to normal and by that means she wants to "go home". Just remember to love her and tell her she is loved and safe.

Jessie Holloway avatar

Jessie Holloway

Thanks so much for the list of signs your loved one needs more care than just at home. My great aunt has dementia and her kids cant take care of her everyday like they used to. They've been looking for a nursing home or care facility that can take and care for her as her dementia gets worse.


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