For the vast majority of Alzheimer's caregivers, there comes a time when they can no longer care for the affected individual. They simply do not have the skill, energy, and support to provide round-the-clock supervision and daily activities tailored to the person's increasing needs and remaining abilities. That's the time to take the final step in Alzheimer's care--moving the person into a nursing home. This is often a wrenching decision.

It's natural to feel that no on can take care of your loved one as well as you can because no one feels the way you do about the person. It's true that no one loves the affected individual as you do, but a good nursing home, particularly one that specializes in people with dementia, can provide better care.

It's natural to feel guilty about "abandoning" your loved one. "She raised me, and now it's my turn to care for her." You're not abandoning the person. Chances are you've sacrificed plenty caring for the person. Chances are that you're at your wits end, and know deep down that a nursing home would be best.

It's natural to feel depressed about moving a loved one to a nursing home. Alzheimer's is a very depressing illness, especially as it progresses from moderate to severe. A good nursing home is better equipped to handle people with severe dementia than even the most dedicated, saintly loved one.

It's natural to feel apprehensive about moving a loved one to a nursing home. News stories about abuses at nursing homes--particularly, excessive use of drugs and physical restraints--have tarnished the industry's reputation. But with time, and the right information, you can find a good one. After a while, your loved one will adjust. And so will you.

When To Start Planning: At Diagnosis.

When a loved one is diagnosed with Alzheimer's disease, finding a nursing home is probably not high on the list of things you and the affected person first think about. There's so much else to deal with. But the sooner you begin planning for nursing home care, the better you and your loved one are in the long run.

Barring some medical miracle, Alzheimer's disease follows a relentlessly downward course. Some day--hopefully not soon, but some day--you will probably have to move your loved one into a nursing home. Don't deny this possibility. Face it squarely. Nursing home residence is not inevitable, but it is likely.

Both you and the affected individual should start getting used to the idea early on. Talk about your feelings. Talk with other family members, your clergy, and people who have already placed loved ones in nursing homes. If the affected individual is amenable, visit some facilities together.

There are probably quite a few nursing homes near you. Some are, no doubt, better than others. Top-rated nursing homes usually have waiting lists. In addition, there is a shortage of nursing homes that specialize in people with Alzheimer's disease. The earlier you begin exploring nursing homes, the earlier you're likely to find one whose program, location, and price meet the affected individual's needs and your needs. Get on the waiting list early. That increases the likelihood that a bed will be available when your loved one needs one.

Planning early for nursing home care also saves you the trauma of having to make a hasty decision in a crisis situation. The transition into a nursing home is never easy, but the more reconciled you are to it, the better it is for your loved one. People with Alzheimer's are easy to upset and agitate. The more upset you are, the more upset the affected individual is likely to be.

Finally, planning early is the wisest course financially. It allows other family members to discuss their own budgets and come to a consensus about supporting the affected individual. It also allows time to arrange the affected person's financial affairs to maximize eligibility for government assistance.

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