Risk Factors

• Your care receiver is falling frequently.

• You are becoming physically and emotionally worn out with the lifting, toileting and incontinence, feeding tube, and being awakened all night.

• Your care receiver is wandering dangerously. See "How to Deal with Wandering" in the More Tips and Resources section.

• You are having many symptoms of physical illness yourself. Your health is suffering. You may even need hospitalization.

• You have the symptoms of caregiver burnout or need medications for depression and stress. See Stage Three, section 1: "Preventing Caregiver Burnout".

• You are short-tempered with your care receiver and are afraid you may be on the verge of elder abuse. See "Stop Elder Abuse" and Stage Three, section 2:"Protecting Your Care Receiver".

• You have tried but have not been able to get enough in-home services and respite care to give you the relief you need to keep going. See Stage Two, section 5: Formal Support Services.

Facility based care may also be appropriate when:

• You and your care receiver planned in advance to use facilities to provide needed care.

• He or she prefers going to an assisted living facility or nursing home rather than having you responsible for activities of daily living such as bathing and toileting.

• You did not agree to be a hands-on heavy-duty caregiver, at least not to the extent required now.

• You are an employed caregiver who cannot get a flexible schedule, the unpaid leave under the Family Medical Leave Act is not available to you or has already been used this year, and you cannot afford to give up your job in order to put in the hours of service required for heavy care. See Stage Two, section 4: Help for Employed Caregivers.

• You are a long-distance caregiver, the services you set up with a care manager during your last visit are no longer adequate, and even a revised care plan cannot provide enough support services to keep your care receiver safely in the home.

• Physicians and other professionals are recommending an assisted living facility or nursing home.

• Caregiving in the home has become ineffective, your relationship with your care receiver is strained, and it seems likely that placement in a facility might be positive for both of you.

• Your care recipient needs ALF or nursing care and you are financially able to provide this because he or she has adequate private funds, qualifies for insurance, or meets the eligibility requirements for government funding to cover the costs of facility care.

Next: Caregiver's Role