Alzheimer's Care at Home in Preston Hollow and the Park Cities: How Families Set It Up

Most families in Preston Hollow and the Park Cities who call us about Alzheimer’s want the same thing: for a parent to stay in the house they know, with the neighbors, the church and the routines that still make sense to them. That is possible for a long time if the care is set up well. Alzheimer’s care at home means a trained, non-medical caregiver who comes to the house on a steady schedule, keeps the day predictable, helps with bathing, dressing and meals, gives medication reminders and keeps your parent safe and engaged. This guide walks through how families here usually set it up, and what to watch for along the way.

Can someone with Alzheimer’s really stay at home?

Often, yes, for longer than families expect. In the early and middle stages, a person with Alzheimer’s usually does best in familiar surroundings. The kitchen they have cooked in for decades, the chair by the window, the walk to the mailbox: these are anchors when short-term memory is slipping. Moving to a new building can bring confusion and distress, and familiar rooms help keep it at bay.

Home stops being the right answer when it stops being safe. That point is different for every family. It may come when a parent leaves the house at night and cannot be kept in, when care needs two people for every transfer, or when the caregiver at home is so exhausted that their own health is failing. We talk about those signs openly at the first visit, because a plan that pretends they will never come is not a plan. Our guide on dementia care at home versus a facility covers that decision in more depth.

What does the house need before care starts?

Many homes in Preston Hollow are larger single-story houses on wide lots. Many in Highland Park and University Park are older two-story homes with stairs, several doors and a detached garage. Both can work well for dementia care, but each brings specific risks. Before a caregiver starts, walk the house with these in mind:

• Exterior doors. Count them, including the garage, the side gate and any door to a pool or patio. Each one is a way out. Simple chimes or door alarms tell the caregiver when a door opens.
• The pool. If the house has one, it needs a fence or a locked gate your parent cannot open, and a door alarm on any door that leads straight to it. Water is one of the most serious risks for someone who wanders.
• The driveway and the cars. Keys left in a bowl by the back door are an invitation. Decide early where keys live, especially if driving has become a question.
• Stairs and second floors. If the bedroom is upstairs, think about moving it down before a fall forces the move. Our guide to stairs and safety in older homes goes room by room.
• The kitchen. Stove knob covers or an automatic shutoff matter once a parent starts forgetting a burner. The kitchen safety guide lists the changes that help most.
• Rooms nobody uses. In a large house, a parent can be in a formal living room or a guest suite without anyone noticing for an hour. Close or lock rooms that are not part of the daily routine.

None of this needs to happen in one weekend. Start with the doors, the pool and the keys, because those are the risks that cannot wait.

Why does one consistent caregiver matter so much?

For a person with Alzheimer’s, a new face every few days is a new stranger every few days. Each stranger has to be met, judged and trusted again, and that costs a person with memory loss real effort and often real anxiety. A consistent caregiver becomes familiar even when your parent can no longer say her name. Bathing goes better. Meals go better. The afternoon restlessness families call sundowning is often easier to manage when the person in the room is someone your parent already feels safe with.

That is why memory care at home is built around a steady match. We match a caregiver to your parent’s temperament and needs, introduce them before or on the first visit, and keep that person on the schedule. If the match is not right, you can ask for a different caregiver at any time, and we will make the change.

What does a caregiver actually do during a visit?

A typical four-hour morning in a Park Cities home might look like this. Picture a common situation: a mother in her eighties with mid-stage Alzheimer’s, a husband who is still at home but tired, and a daughter who lives a few streets away.

1. Arrival and breakfast. The caregiver arrives at the same time every day, greets her by name, and makes breakfast in her own kitchen.
2. Medication reminder. The caregiver reminds her to take the morning pills from the organizer the family or pharmacy has filled. Reminding is allowed; giving medication is a medical task we do not perform.
3. Bathing and dressing. Help with a shower on the days it is scheduled, done calmly and at her pace, then clothes she chooses from two or three options.
4. Something to do. A walk around the block, folding laundry together, looking at photo albums, a drive to Snider Plaza or Highland Park Village for a coffee and a short errand.
5. Lunch and a quiet hour. Lunch, then a rest, while the caregiver tidies the kitchen and makes notes for the family.

Meanwhile her husband gets four hours to rest, see his own doctor or simply sit in another room without being on duty. That break is a large part of what keeps a home plan going. Rides to appointments are part of the service too; families here are often going to neurology visits at UT Southwestern or appointments near Presbyterian Hospital on Walnut Hill, and transportation and errands can be built into the schedule.

When do families add nights or 24-hour care?

Nights usually change before days do. A parent who sleeps through in the early stage may start getting up at 2 a.m., trying to dress for work or looking for someone who died years ago. The spouse at home stops sleeping. That is the moment to talk about overnight care, ideally before an accident forces the conversation.

Overnight care means an awake caregiver in the house from evening to morning, watching the doors, helping your parent back to bed and keeping the night calm. When needs grow further, 24-hour care uses a small team of caregivers who rotate shifts so someone awake is always on duty. We do not offer live-in care, where one person sleeps in the home; with dementia, a caregiver who is asleep cannot respond to a 3 a.m. wandering attempt. Every hour, day or night, bills at the same flat rate.

What does Alzheimer’s care at home cost here?

Our rate is one flat hourly rate of $30–34, the same for days, evenings, weekends and overnights. Major holidays are billed at time and a half. The minimum visit is four hours. There are no “levels of care” tiers, so the rate does not rise as the disease progresses, and there is no long-term contract.

The monthly total depends on the hours, and the hours depend on the stage. The cost of in-home care page shows how the numbers add up for common schedules. If both parents need help in the same house, a couples discount applies when one caregiver cares for both.

How do families share the load?

In many Park Cities families, the work falls on one person: the spouse at home or the daughter who lives closest. Siblings in other cities help by phone, and the person on site slowly burns out. A few habits help:

• Name one point of contact who talks to the caregiver and the agency, so instructions do not conflict.
• Keep a shared notebook or note thread where the caregiver records meals, mood, sleep and anything unusual.
• Schedule real breaks for the main family caregiver. Respite care can cover an afternoon each week or a full week while someone travels.
• Revisit the plan every few months. Alzheimer’s changes, and the schedule should change with it.

For families getting started, the first month of dementia care at home guide lays out a week-by-week plan, and the wandering prevention guide covers doors, alarms and identification in detail.

How do we start?

Care starts with a free in-home assessment. Ryan Berry, who co-owns Senior Care of North Texas, does those visits himself. He meets your parent and family at the house, or at the hospital or rehab if that is where things stand, walks through the routine and the risks, and helps you decide how many hours make sense now. Care can often begin within 24 hours. See how it works for the steps, or read about care in Preston Hollow, Highland Park and University Park.

This guide is educational and is not medical advice. Questions about diagnosis, medication or changes in behavior belong with your parent’s physician.