There comes a moment when love alone isn’t enough. Maybe it happens when your mother wanders out the front door in the middle of the night, unaware of the danger. Or when your father, once gentle and kind, no longer recognizes you and lashes out in confusion. Maybe it’s the exhaustion—the endless nights of broken sleep, the stress of managing medications, appointments, and basic care while juggling the rest of your life.
For many families, the decision to move a loved one with dementia into long-term care is one of the hardest they will ever face. Guilt seeps in—Should I be doing more? Am I giving up on them?—while family members struggle to agree. One sibling insists Mom is fine at home, while another is drowning in caregiving responsibilities. A devoted spouse, exhausted but unwilling to break a promise made decades ago—“I’ll never put you in a home”—finds themselves at a breaking point.
No one wants to make this decision. But when safety, well-being, and quality of life are at risk, avoiding it only prolongs the inevitable. So how do you know when it’s time? And what steps can you take to ensure your loved one gets the care they need while navigating your own emotions in the process?
This article will help guide you through one of life’s most difficult transitions, offering clarity, reassurance, and practical steps forward.
Signs that Long-Term Care for Dementia Might Be Necessary
Consider long-term care when your loved one’s safety is at risk, their needs become too complex for home care, or if you, as a caregiver, are struggling to cope with the demands of their care.
Here’s a more detailed breakdown of factors to consider when weighing this important decision.
Safety Concerns
Wandering or getting lost: If your loved one frequently wanders off or gets disoriented, especially outside, this can be a serious safety risk.
Falls: Increased risk of falls, especially if they have difficulty walking or standing, can indicate a need for more supervision.
Difficulty with daily tasks: If they are struggling with basic tasks like bathing, dressing, eating, or using the toilet, it may be time to consider long-term care.
Neglect of personal hygiene: If they are neglecting their personal hygiene, this can lead to health problems and make it difficult to care for them at home.
Increased Care Needs
Complex medical needs: If your loved one has multiple health conditions that require specialized care, a long-term care facility may be better equipped to handle them.
Incontinence: Difficulty controlling their bladder or bowels can be challenging for caregivers and may require specialized care.
Agitation or aggression: If your loved one is experiencing frequent episodes of agitation or aggression, it can be difficult for caregivers to manage safely at home.
Changes in sleep patterns: If they are experiencing changes in sleep patterns, such as sleeping during the day and becoming restless at night, this can make it difficult to care for them at home.
Caregiver Strain
Burnout or exhaustion: If you are feeling overwhelmed, stressed, or exhausted by the demands of caregiving, it’s important to consider seeking outside support.
Neglecting your own health: If your own health is suffering because of the demands of caregiving, it’s time to seek help.
Difficulty managing the care: If you are struggling to provide the level of care your loved one needs, it may be time to consider long-term care.
Other Considerations
The person’s wishes: It’s important to consider your loved one’s wishes and preferences regarding their care.
Family support: If you have a strong support network, you may be able to continue providing care at home for longer. However, if your family is unable to provide the necessary support, it may be time to consider long-term care.
Financial considerations: Long-term care can be expensive, so it’s important to consider the financial implications of your decision.
Take this helpful Caregiver Stress Assessment Checklist from The Alzheimer Society of Canada to help you manage your stress as a caregiver.
What to do When Considering Long-Term Care:
Keep an open dialogue going with your loved one’s doctor. Don’t leave discussing moving your loved one to memory care to the last minute. The process takes time, and it’s best to start before you’re dealing with an urgent situation which can reduce your options for long-term care facilities. Your doctor can provide guidance and recommendations based on your loved one’s specific needs.
Contact your local Alzheimer Society or other dementia support organizations. They can provide information and resources about long-term care options in your area. Ask friends who have gone through something similar about the care facilities in your area. If they have experience with them, ask for details and how they would rate them.
Visit potential long-term care facilities. Tour several facilities to get a feel for the environment and the care they provide. Many facilities will provide basic memory care, but may not provide advanced care, so don’t hesitate to ask questions about the facility’s staff, activities, memory care facilities and levels of support.
Choose a facility that is a good fit for your loved one’s needs and personality, however make sure that you thoroughly research the LTC home you are considering through the health agency that oversees long-term care facilities in your province or territory. Contact your provincial health agency for information on facilities in your area.
Get Support for Yourself. This is a tough transition, so take the time to give yourself some extra TLC. If you can find time for self-care, make sure you take advantage. Find a support group near you to talk to people who have gone through what you’re going through. The Alzheimer Society is a great place to find resources and support near you.
Use this checklist from Canada’s Alzheimer Society to make sure the facility is able to provide the care your loved one needs.
You can’t predict how the future will go. As your loved one’s needs change, you will need to adjust your care plans, so make sure you earmark time for review.
There is no single “right” time to move a loved one into long-term care—only the time when it becomes necessary. And even then, the decision is never easy. You may wrestle with guilt, grief, and uncertainty, wondering if you’ve done enough, if they will be cared for, if you’ve made the right choice. But love is not measured by keeping someone home at all costs. Love is ensuring they are safe, comfortable, and receiving the care they need—even if that means letting go of the role you’ve held for so long.
You are not failing them. You are making an incredibly difficult, selfless choice in their best interest. And even after the move, your role as their advocate, their family, and their source of love does not end. You will still hold their hand, share stories, play their favorite music, and remind them, in every way possible, that they are cherished.
This journey is not one you have to walk alone. Support exists—in community, in professionals, in others who have faced this same crossroads. And in time, though the sadness may not fully fade, there can also be relief, knowing that your loved one is being cared for, and that you, too, are allowed to breathe again.
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The information provided on TheHealthInsider.ca is for educational purposes only and does not substitute for professional medical advice. TheHealthInsider.ca advises consulting a medical professional or healthcare provider when seeking medical advice, diagnoses, or treatment.
