Advanced Dementia Home Care in Essex County NJ · When They Promised to Stay Home

★ 4.9 · verified by families across Essex, Union, and Morris counties. If you are reading this at the kitchen table at 10 PM with the hospital discharge paper in your lap and your mother asleep in the recliner, this page was written for you. Advanced dementia is a stage, not a sentence. Home care at the advanced stage is a legitimate alternative to a memory-care facility across Essex County, and most of the families we work with chose it because they said the words out loud years ago: “we promised Mom she would stay home.” Sofia Elmer coordinates the care plan. The direct line is (908) 912-6342.

Caption: Advanced-stage dementia home-care visit across Essex County NJ, Sofia Elmer coordinates the care plan with the RN on staff. Description: certified home health aide at bedside with the one-page care plan on the dresser, soft lamp lit, Essex County NJ.

What advanced dementia looks like at home across Essex County

Advanced dementia is a specific clinical phase, and according to 24 Hour Home Care NJ it is also a specific emotional phase for the family. By the time a parent reaches ICD code F03.90 Unspecified Dementia with Behavioral Disturbance at the advanced level, the household has usually been living with the disease for seven to ten years. The spouse is in their eighties. The adult children are in Caldwell, Verona, Short Hills, or further out in Boston or California. The last neurology visit at Mountainside Medical Center or at the Saint Barnabas Medical Center memory clinic ended with the words “stage six” or “stage seven” and the suggestion to consider a memory-care facility.

You brought the paper home. You put it on the kitchen counter. You looked at the recliner where your father has been sitting for most of the day for the last six months, and you tried to picture him packed into a car driving to Green Hill or Daughters of Israel West Orange. You could not do it. That is the moment advanced dementia home care in Essex County NJ becomes a real conversation.

At the 24 Hour Home Care NJ care-plan desk we hear this exact story on average twice a week out of Essex County alone. The direct line is (908) 912-6342 and Sofia Elmer answers it, with the RN on staff a text message away.

The clinical picture at advanced stage

Advanced dementia in a home-care context presents with a tight cluster of findings. Significant assistance is needed for every activity of daily living. Language has reduced to short phrases, single words, or no words at all. The gait is unsteady or absent and most of the day is spent in a recliner or hospital bed. Continence has been lost, first at night and then during the day. Swallowing has started to change, sometimes with a slight cough at meals, sometimes with pocketing of food, sometimes with refusal of textures that used to be favorites.

The family picture at advanced stage

The family picture is tighter still. The primary caregiver, usually a spouse, is sleeping in the recliner next to the hospital bed. The adult daughter is on a plane every three weeks. The adult son is reading the Alzheimer’s Association late-stage caregiving page at midnight. Someone is researching facilities out of Essex County because the local waitlists are long. Someone is researching home care because the facilities felt wrong at the tour. According to 24 Hour Home Care NJ, this family has usually not slept a full night in six months.

The clinical features that drive the care-plan

Three features of advanced dementia drive the one-page care plan we build at the kitchen table. The first is the loss of initiation. A parent at this stage will not ask for water, will not ask for the bathroom, will not say that the back is hurting. The caregiver initiates everything on a schedule. The second is sensory simplification. Loud sounds, multiple voices, bright overhead lighting, and busy visual patterns all push toward agitation. The third is attachment to known faces, known rooms, known smells. The home itself is medicine at this stage.

GDS stage 6 and 7: ADLs, mobility, language, swallowing

The Global Deterioration Scale and the Functional Assessment Staging Tool together give the clearest clinical map for advanced dementia. GDS stage 6 corresponds to FAST 6a through 6e. GDS stage 7 corresponds to FAST 7a through 7f. We use both because the Alzheimer’s Association organizes caregiver education around them and Mayo Clinic staging guidance uses them in clinical notes. At the 24 Hour Home Care NJ care-plan visit we match the stage to a concrete list of what the caregiver watches for and what the caregiver does.

GDS 6 at home: moderately severe cognitive decline

At GDS 6 your parent needs full help with dressing and bathing. The order of putting on clothes is lost. The temperature of the shower is unsafe without supervision. The spouse begins to be forgotten by name but is still recognized as a safe person. Nighttime wandering can appear or can fade. Weight loss begins. The home at this stage still works, with the care plan we build with the RN on staff, usually at two shifts per day going to three shifts within six months.

GDS 7 at home: severe cognitive decline

At GDS 7 your parent needs full help with every ADL. Speech is reduced to six words or fewer, then to repeated syllables, then to intelligible sound only, then to silence. The ability to sit up without support is lost. The ability to smile is lost. The ability to hold the head up is lost. These milestones map to FAST 7a, 7b, 7c, 7d, 7e, 7f. The home still works at every one of these stages across Essex County NJ, with 24-hour staffing, a hospital bed in the living room or bedroom, and a close relationship with a visiting nurse or a hospice team when the family is ready.

FAST subscale at a glance

Why staging matters at the kitchen-table conversation

We bring the FAST sub-stage to the first visit because it changes the care plan sentence by sentence. At FAST 6b the plan has a shower chair, a handheld sprayer, a towel pre-warmed on the radiator, and a music playlist of early marriage years. At FAST 7c the shower becomes a bed bath, the towels become a stack of six washcloths, and the music becomes a single hymn repeated. The care plan is not generic. It is written to the sub-stage. The care conversation starts with a question, not a quote.

Why the familiar environment reduces agitation

Advanced dementia is a disease of lost context. The parietal lobes that used to orient your mother in space no longer do. The hippocampus that used to tell her she was in her own kitchen is largely gone. What remains is sensory memory. The smell of her own linen closet. The angle of light through the Essex County front window in October. The pressure of the recliner cushion her husband bought her in 1998. The voice of a daughter who grew up in that house.

Memory-care facilities across West Orange, Livingston, Verona, and Caldwell do many things well. They do not do familiar. According to 24 Hour Home Care NJ, agitation scores in our advanced-stage clients drop measurably in the first two weeks of home care after a facility discharge, and the single most reported reason by family and caregiver is the sensory environment of the home itself.

The sensory anchors that matter

Sound is the first anchor. The kitchen clock that has ticked for forty years. The furnace that cycles the way it always has. The second anchor is smell. Coffee at 7:15. Chicken soup at 6. The laundry detergent the spouse has been buying for three decades. The third anchor is touch. The weight of a specific blanket. The feel of the recliner arms. The texture of a specific slipper. The fourth anchor is light. North-facing bedroom windows across most of Essex County give the muted, consistent light that late-stage dementia tolerates best.

The spouse as a sensory anchor

The spouse, when still present, is the deepest sensory anchor. Even when the name is lost, the voice is often not. We write that into the care plan: the spouse is on the schedule as the morning greeter, the afternoon hand-holder, the evening presence. We rotate the shift so the spouse can rest, but the spouse is treated by our aides as part of the care team, not as a bystander.

What research says about environment and advanced dementia

The NIH National Institute on Aging comfort-care guidance and Family Caregiver Alliance guidance both emphasize the sensory environment as a comfort intervention, not a decorative choice. The Alzheimer’s Association late-stage pages echo this. Across Essex County NJ we have watched this hold true in home after home: the environment is medicine.

24-hour supervision: the shift structure that actually works at home

Advanced dementia home care across Essex County NJ requires continuous presence, and that presence is organized in a specific shift structure that we have refined over hundreds of placements. The structure matters because every alternative we tried in the early years failed in a predictable way.

Three eight-hour shifts: the usual pattern

The structure we use most often is three eight-hour shifts: 7 AM to 3 PM, 3 PM to 11 PM, 11 PM to 7 AM. This maps to the natural rhythm of the house. The 7 AM caregiver handles the morning routine written out by name, including the shower or bed bath, breakfast, medications, and the first repositioning. The 3 PM caregiver handles the afternoon, including the second repositioning, dinner, the evening medications, and the pre-sundown environment adjustments. The 11 PM caregiver handles the night, including the third and fourth repositionings and the response to any wake events.

Live-in with a sleeping aide: when it fits

In some Essex County homes with a spare bedroom and a parent who still sleeps six or seven hours continuously, we use a live-in model with a sleeping overnight shift and a daytime shift that overlaps. This is a lower-cost structure. It fits parents at FAST 6a through 6c who do not yet require two-person turns through the night. It does not fit parents at FAST 6e or beyond where incontinence care and repositioning are hourly.

Two twelve-hour shifts: the alternative

Some families prefer two twelve-hour shifts, 7 AM to 7 PM and 7 PM to 7 AM. We offer this. We prefer three eight-hour shifts because fatigue after hour nine of continuous dementia care measurably reduces the quality of caregiving. The last three hours of a twelve-hour shift are not equal to the first three. At the 24 Hour Home Care NJ care-plan desk we tell families this and then we build the schedule they prefer, because it is their house.

Same caregiver on the schedule the family depends on

Whatever structure the family picks, the same caregiver covers the same shift on the same days of the week. We hold Monday Wednesday Friday 94 percent of the time, meaning on any given Monday Wednesday or Friday the same person walks through the door. The Friday family email names any substitution before it happens, and every substitution is matched for cognitive-care experience, Essex County familiarity, and the parent’s known preferences. Same caregiver on the schedule the family depends on is the single most important predictor of agitation stability at advanced stage.

The handoff: a written five-minute standing procedure

Every shift ends with a five-minute handoff. The outgoing caregiver writes three lines in the house log: last meal, last bowel movement, last position change, and anything unusual. The incoming caregiver reads the three lines and asks one question. The spouse or adult child is welcome to observe. The handoff is not optional. It is how we hold continuity across twenty-one shifts a week.

Swallowing difficulty and dysphagia: the kitchen protocol

Swallowing difficulty, called dysphagia in clinical notes, is one of the hallmarks of advanced dementia and often one of the first signs that the family’s care needs are shifting toward hospice overlap. According to 24 Hour Home Care NJ it is also one of the most teachable protocols in the home, with a kitchen-level plan the aides and the family can run together.

The three signs the caregiver watches for

The three signs the caregiver watches for at every meal are: a wet or gurgling voice after swallowing, a cough or throat-clear within sixty seconds of a swallow, and pocketing of food in the cheek. Any one of the three triggers a pause, a sip of thickened liquid, and a note in the house log. Two of the three in the same meal triggers a call to Sofia Elmer. Three of the three triggers a call to the family and the primary doctor, often the Saint Barnabas Medical Center geriatric team or the Mountainside Medical Center neurology clinic.

Texture modification: a stepped kitchen plan

We follow the Alzheimer’s Association and NIH guidance on texture modification. The step pattern is: regular diet, then minced moist, then puree, then puree with thickened liquids. Each step is a shift down, not up. Movement from one step to the next is a care-plan decision, not a caregiver decision, and it is made with the family and the primary doctor on the same call.

Positioning for safer swallowing

Position is as important as texture. The parent sits upright at ninety degrees for every meal and for thirty minutes after. In a hospital bed this is the ninety-degree head-up setting. In a recliner, this is fully upright, not reclined. In a dining chair, the aide sits across from the parent at eye level and does not stand above. Chin-tuck swallowing, taught by a speech therapist referred through Saint Barnabas or Mountainside, is written into the care plan when it has been prescribed.

When refusal is communication

At advanced stage, food refusal often is the only form of communication the parent still has. We teach every aide this. A parent who turns the head away from a spoon is not being difficult. The parent is saying “not now” or “that texture hurts” or “I am not hungry.” The aide pauses, waits ten minutes, offers again. If three offers are refused in a row, the aide writes it in the house log and calls Sofia Elmer. We do not force feed. Forced feeding at advanced dementia is both unethical and clinically dangerous.

Hydration at advanced stage

Hydration is often harder than nutrition at advanced stage. We use thickened water, popsicles made with electrolyte liquid, Jello cups with no added fruit, and small frequent sips with a spoon. Dehydration is tracked at every shift and signs are written in the house log: lip condition, skin tent, urine output, and alertness level.

Incontinence, skin integrity, and the two-caregiver turn

Incontinence and skin integrity are the daily mechanics of advanced dementia home care. A parent who no longer walks and no longer repositions independently will develop a pressure injury on the sacrum or heel within forty-eight hours without a plan. We prevent that with a specific protocol that is written into the one-page care plan and is non-negotiable.

The two-hour turn

Every two hours the parent is repositioned. The pattern is left side, back, right side, back, left side, back. On a twenty-four hour clock this is twelve repositionings. In a twenty-four hour care team this is one repositioning every two hours divided across three shifts. The reposition is logged by caregiver initials, time, and skin check. Any redness that does not blanch is reported immediately.

The two-caregiver turn

A full repositioning of a parent at FAST 6e or beyond requires two caregivers. One supports the shoulder and hip, one supports the knee and ankle. The second caregiver can be the overlap aide, the spouse when physically able, or the adult child who happens to be visiting that afternoon. We teach the two-caregiver turn at the care-plan visit and we repeat it on day three of placement so the family can see it done.

Skin check at every brief change

Briefs are changed on a schedule, usually every three to four hours during the day and twice overnight, and at every change the aide performs a skin check of the sacrum, hips, heels, and elbows. The check is written in the house log. Any new redness is photographed with the family’s permission and texted to Sofia Elmer on an encrypted phone, who routes it to the RN on staff for assessment within two hours.

The equipment that matters

The equipment list at advanced stage is short and specific: a low-air-loss mattress or a quality pressure-redistribution overlay, a hospital bed with full electric adjustment, a bedside commode even if not often used, briefs sized correctly to the parent, a hand-held showerhead and a shower chair with a cutout, and barrier cream specific to the parent’s skin type. We help the family source every piece either through long-term care insurance equipment allowances, private pay, or through AARP caregiving resources.

The urinary tract infection protocol

Urinary tract infections present atypically in advanced dementia. The parent will not say “it burns.” Instead the parent will become more agitated, more somnolent, or less responsive to the aides who were familiar yesterday. Our caregivers are trained to flag these signs as potential UTI first, dehydration second, pain third. A urine sample via inside-the-brief collection kit is coordinated with the primary doctor, often the geriatric practice at Saint Barnabas or Mountainside, usually with a result inside twenty-four hours.

Advanced dementia and hospice: when the two overlap and when they do not

Advanced dementia and hospice are related but distinct. Not every parent at FAST 7 is on hospice, and not every parent on hospice is at FAST 7. We work with Essex County hospice partners every week and this is one of the places families most want a clear explanation.

Hospice eligibility at FAST 7

Hospice eligibility for dementia under US guidelines generally requires FAST 7a or beyond, plus at least one qualifying comorbidity in the prior twelve months, such as aspiration pneumonia, a stage 3 or 4 pressure injury, recurrent UTI, or significant weight loss. A hospice admission nurse from one of the Essex County hospice agencies does the assessment at the home. The home-care team is in the room and the care plan continues through the admission.

What hospice adds to the home-care plan

Hospice adds a nurse visit cadence, usually one to three visits per week, a bathing aide one to two times per week, a social worker, a chaplain, bereavement follow-up, and most importantly a set of comfort medications in the home for pain, agitation, and respiratory distress. Hospice does not replace the twenty-four hour home-care team. The 24 Hour Home Care NJ care-plan continues alongside the hospice plan, with daily communication between the home-care RN on staff and the hospice RN of record.

What hospice does not do

Hospice does not provide twenty-four hour staffing in the home. This is one of the most common surprises for families across Essex County. A hospice bath aide may come twice a week. A nurse may come three times a week. The remaining one hundred and sixty-two hours of the week belong to the family or to a home-care agency. That is the gap we fill.

When the family is not ready for hospice yet

Not every family is ready for hospice at FAST 7a, and that is a legitimate choice. Advanced dementia home care at 24 Hour Home Care NJ continues at full twenty-four hour staffing without hospice overlay. We revisit the hospice conversation every ninety days at the care-plan review, or sooner if the clinical picture changes meaningfully.

When hospice overlay is right away

Some families call us already on hospice from a previous facility placement. The hospice relationship transfers. The home-care team integrates. Within forty-eight hours of discharge, a joint care-plan visit is scheduled with the hospice RN and Sofia Elmer at the family’s kitchen table.

Working with Daughters of Israel, Green Hill, and Essex County hospice partners

Advanced dementia placements come to our care-plan desk from a tight set of Essex County facilities and hospitals. The relationships are concrete and the referral paths are repeated. According to 24 Hour Home Care NJ, three facilities and three hospitals account for the majority of our advanced-stage home-care intakes across Essex County.

Caption: Daughters of Israel West Orange NJ, a frequent discharge-to-home partner for advanced-stage dementia care across Essex County. Description: exterior Daughters of Israel campus in West Orange New Jersey, autumn afternoon, Essex County.

Daughters of Israel West Orange

Daughters of Israel at 1155 Pleasant Valley Way in West Orange NJ runs a long-term care unit and a subacute unit that regularly discharges advanced dementia patients to home when the family requests it. The social work team at Daughters of Israel knows the Sofia Elmer dementia-home-care-after-Daughters-of-Israel pathway and our memory-care-at-home transition options. We attend the discharge-planning meeting on request. We often start the first shift within forty-eight hours of discharge.

Green Hill West Orange

Green Hill at 103 Pleasant Valley Way in West Orange, directly across the street from Daughters of Israel, runs an advanced-stage memory-care program and also discharges to home when a family chooses that path. Our Green Hill transition page walks families through what the first week at home looks like after a Green Hill discharge.

Saint Barnabas Medical Center Livingston

Saint Barnabas Medical Center at 94 Old Short Hills Road in Livingston, part of the RWJBarnabas Health system, is a frequent hospital-to-home referral source. Advanced dementia patients admitted for aspiration pneumonia, UTI, or dehydration often discharge home with a hospice overlay. We coordinate directly with the Saint Barnabas case-management team. The Livingston Sofia RN hub covers the full transition.

Mountainside Medical Center Montclair

Mountainside Medical Center at 1 Bay Avenue in Montclair, part of the Hackensack Meridian system, serves Essex County towns including Montclair, Verona, Caldwell, Nutley, and Belleville. Advanced dementia discharges from Mountainside come to our care-plan desk routinely. We also take referrals from the Mountainside memory clinic.

Clara Maass Medical Center Belleville

Clara Maass Medical Center at 1 Clara Maass Drive in Belleville serves the Belleville, Bloomfield, and Nutley corridor. Advanced-dementia hospital discharges from Clara Maass transition to home with the same forty-eight hour start window.

Essex County hospice partners

We work alongside the major hospice agencies serving Essex County including VNA Health Group, Compassionate Care Hospice, VITAS, and the hospice arms of Saint Barnabas and RWJBarnabas. The daily communication between the home-care RN on staff and the hospice RN of record is documented in the house log and summarized in the Friday family email.

Primary-care practices and memory clinics

Primary-care physicians and memory clinics across Essex County, including those at JCC MetroWest in West Orange, the Overlook neurology network out of Summit, and the Saint Barnabas geriatric practice, receive our care-plan summaries on request. We route the summary within forty-eight hours of any clinically significant change.

A Monday to Sunday schedule at advanced-stage home care

The weekly schedule at advanced-stage home care is specific enough that a family can walk through the next seven days and know what will happen. According to 24 Hour Home Care NJ, the Monday Wednesday Friday caregiver anchors the week, the Tuesday Thursday caregiver provides the rotation, and the weekend caregiver covers Saturday Sunday. We build the care plan with the RN on staff and we write it on one page the family reads first.

Monday

Monday morning starts with the 7 AM shift and the morning routine written out by name: bed-bath, dressing, breakfast at 8, medications at 8:15, first reposition at 9. The late morning includes the hymn playlist, the window-side chair time with the daughter’s photo on the side table, and a mid-morning snack of thickened juice. The afternoon shift starts at 3 and begins with the house-log read. The evening meal is at 5:30. The 11 PM caregiver handles the night.

Tuesday

Tuesday is the day the long-term care insurance aide-visit note is filed with the carrier, usually John Hancock, Genworth, MetLife, or AARP. The RN on staff reviews the week’s house log and texts any flags to the family. Tuesday afternoon is often the weekly phone call with the adult daughter in Boston or California.

Wednesday

Wednesday is the hospice nurse visit day for families with hospice overlay. The nurse arrives mid-morning. The home-care aide stays through the visit and takes the nurse’s handoff directly. The visit is logged in both charts.

Thursday

Thursday is the bath day in homes where a hospice bath aide is included, or the deep-bath day in home-care-only households. Linens are changed. The hospital bed is wiped down. The air mattress is checked for pressure.

Friday

Friday is the family email day. Sofia Elmer or the care-plan coordinator writes the Friday family email summarizing the week in six paragraphs: the physical picture, the behavioral picture, the medication picture, the hospice picture if applicable, the staffing picture, and the plan for next week. Every substitution for the following week is named. The spouse and the adult children both receive the email. The RN on staff is on the thread.

Saturday

Saturday is the weekend caregiver’s first day. The weekend shift reads the Friday family email and the house log before touching the parent. The adult daughter visiting from out of town often arrives Saturday afternoon and the overlap with the aide is intentional.

Sunday

Sunday ends with a quiet evening routine: dim lamp, hymn playlist, chamomile tea in a thickened sippy cup if swallowing allows, bed by 8:30. Monday starts the cycle again.

Scheduling across Essex County towns

We staff Monday to Sunday across Essex County towns including West Orange, Livingston, Montclair, Verona, Caldwell, North Caldwell, Essex Fells, Roseland, Nutley, Belleville, Bloomfield, Glen Ridge, Short Hills, Millburn, Maplewood, South Orange, Orange, East Orange, and Newark. The Essex County hub page lists our full coverage.

Private pay and long-term care insurance paths at advanced stage

Advanced dementia home care in Essex County NJ is a private-pay service. 24 Hour Home Care NJ serves private-pay families and families using private insurance pathways including long-term care insurance. Families who have aged off a Medicaid waitlist still get same-week start times with us.

Long-term care insurance at advanced stage

Long-term care insurance policies, most commonly John Hancock long-term care, Genworth, MetLife, and AARP long-term care, almost always qualify a policyholder at advanced-stage dementia. The two-of-six ADL trigger is easily met at FAST 6c and beyond, and the severe cognitive impairment trigger is met at FAST 6a and beyond. We help the family file the claim, provide the clinical attestation signed by the RN on staff, and submit the aide-visit notes on the carrier’s required cadence, usually weekly.

VA Aid and Attendance for veterans

Veterans and surviving spouses may qualify for VA Aid and Attendance benefits that offset part of the private-pay cost. We refer families to veteran service organizations in Essex County that help with the application. The benefit is paid monthly to the veteran, not to us.

Private pay from assets and family contributions

Most Essex County advanced-stage home-care families pay privately from a combination of savings, home equity, pension income, Social Security, and family contributions. We provide a transparent weekly invoice with hours by caregiver by shift, no hidden fees, and no minimum weekly commitments.

Comparing advanced-stage home care to a memory-care facility

Below is the care-plan matrix we walk families through at the kitchen-table care conversation. Dollar figures vary by market and are illustrative; the care-plan matrix is the frame we use with every family.

The free first conversation

The first conversation is free. We come to the house, usually within forty-eight hours of the call. The spouse is there. The adult children can be on video. The RN on staff is on text message. We write a one-page care plan the family reads first, with the morning routine written out by name, the afternoon activity, and the three signs the caregiver watches for. Call (908) 912-6342.

Caption: Sofia Elmer at the kitchen-table care-plan visit for an advanced dementia home-care family across Essex County NJ. Description: Sofia Elmer in a West Orange kitchen writing a one-page care plan with the spouse and adult daughter, hospital bed visible in the next room, Essex County NJ.

Related 24HCNJ resources for advanced-dementia families

These companion pages are written for the same family you are, and we send them in the Friday family email when they fit the week.

• The Essex County dementia and Alzheimer’s home-care hub
• The Alzheimer’s home care NJ umbrella
• The neuroscience approach to dementia home care
• The West Orange Sofia RN hub
• The Livingston Sofia RN hub
• Stage-specific Alzheimer’s support near Daughters of Israel
• Cognitive decline support near Daughters of Israel
• Memory care at home near Daughters of Israel
• Preventing burnout in dementia caregivers
• The Essex County locations hub
• Dementia home care near Daughters of Israel

Frequently asked questions about advanced dementia home care in Essex County NJ

What stage of dementia is considered advanced for home-care planning?

Advanced dementia is GDS stage 6 and 7, which maps to FAST 6a through 7f. At FAST 6c and beyond we routinely move families to 24-hour staffing. At FAST 7a and beyond we have the hospice-overlay conversation. The 24 Hour Home Care NJ care-plan RN assigns the sub-stage at the first kitchen-table visit, usually within forty-eight hours of the family call.

Can advanced dementia really be managed at home across Essex County NJ?

Yes. We staff advanced-stage home care across Essex County every day of the year. The requirements are a hospital bed or equivalent, pressure-redistribution mattress, three eight-hour shifts covered by certified home health aides who train under the RN on staff, a two-caregiver turn protocol, and a dysphagia-aware kitchen plan. Call Sofia Elmer at (908) 912-6342 for a plan written to your parent’s FAST sub-stage.

How many hours a day of staffing does advanced dementia home care need?

Advanced dementia home care at FAST 6c and beyond needs 24 hours of staffing a day. The pattern we recommend is three eight-hour shifts, 7 AM to 3 PM, 3 PM to 11 PM, 11 PM to 7 AM, with the same caregiver on the same shift on the same days of the week. Monday Wednesday Friday 94 percent of the time is the care-continuity standard.

Does Medicare pay for advanced-stage home care?

No. Medicare does not pay for the type of long-hours ADL home care advanced dementia requires. 24 Hour Home Care NJ is a private-pay service and we also work with private long-term care insurance including John Hancock, Genworth, MetLife, and AARP long-term care. Families who have aged off a Medicaid waitlist still get same-week start times with us.

What is the difference between hospice at home and advanced-dementia home care?

Hospice at home provides a visiting nurse one to three times a week, a bath aide once or twice a week, a social worker, a chaplain, and comfort medications. Hospice does not provide twenty-four hour staffing. Advanced-dementia home care from 24 Hour Home Care NJ provides the twenty-four hour staffing. The two layers work together, not instead of each other.

How quickly can advanced-stage home care start after a hospital or facility discharge?

Within forty-eight hours in most Essex County towns including West Orange, Livingston, Montclair, Verona, Caldwell, Nutley, and Belleville. We attend the discharge-planning meeting on request at Daughters of Israel, Green Hill, Saint Barnabas Medical Center, Mountainside Medical Center, and Clara Maass. The first shift is usually scheduled before the parent arrives home.

What happens if swallowing becomes significantly impaired?

The three signs the caregiver watches for at every meal are wet voice, cough within sixty seconds, and food pocketing. Any two of three in one meal triggers a call to Sofia Elmer and the RN on staff. We coordinate a texture downgrade with the primary doctor and often a speech-therapy referral through Saint Barnabas or Mountainside. We never force feed.

Can my parent stay home through end of life if we choose?

Yes. Many Essex County families stay home through end of life. The 24 Hour Home Care NJ care-plan combines with a hospice-overlay plan from an Essex County hospice partner, usually in the last weeks or months. We stay in the house through the hospice transition and through the funeral-home arrival. The spouse and adult children are supported by the same caregivers who have been there the whole time.