What Are Memory Care Facilities? And How Do They Work?

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

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If you are deciding to put a loved one in a memory care facility, you may be dealing with a complex situation that requires some more care that you are unable to provide on your own.

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You might be a family caregiver who can no longer care for your loved one or have tried piecing together care in the home. Or you may have encountered a situation where your aging parent’s symptoms have gotten worse over a short time frame.

Most people in memory care units have some kind of dementia, often Alzheimer’s type of dementia. Since there is no cure for Alzheimer’s, symptoms tend to get worse over time. At some point, there may be no other option but to consider the safety and structure that only memory care can provide.

But how can you look for the appropriate memory care facility that will give you ease of mind and enable you to worry less about your loved one? If you’re starting the search now and doing some long-term care planning, here are some things to keep in mind.

What’s a Memory Care Facility?

A memory care facility is a specialized community for people who have memory problems. These memory problems could be related to Alzheimer’s dementia or other types of dementia, which may occur in tandem with other disorders such as mental health problems, head trauma, or neurological conditions such as Parkinson’s or Lou Gehrig’s Disease. 

Memory care facilities tend to differ from other assisted living or care facilities in the following ways:

  • Higher staff to resident ratio.
  • More intensive supervision of residents.
  • Activities that are tailored to people with dementia.
  • Units are locked and secure to prevent wandering, with a code required to get in and out of the unit.
  • The daytime routine is very structured with meals and activities at certain times.
  • Staff check on residents frequently.
  • Staff is trained to deal with behaviors specific to dementia such as agitation, confusion, disorientation, anxiety, and depression.

Difference between assisted living and memory care

There are many similarities between assisted living and memory care facilities. Both have nursing, aide services, and medication management (except in states that allow residents to manage their own medications).  Meals and housekeeping are provided, as well as transportation to medical appointments. 

There are distinct differences between assisted living and memory care, with assisted living communities featuring the following:

  • Residents are free to come and go as they please. 
  • Apartments may have full kitchens, while memory care units will not.
  • Mealtimes can be flexible depending upon the resident’s preferences.
  • There will be a wide range of activities, from games to cultural events and trips.
  • Many assisted living communities are large, with hundreds of apartments. Memory care units are usually smaller. There are stand-alone memory care communities, but most are separate units within assisted living. 

Cost and paying for care

Medicare and Medicare Advantage plans do not pay for memory care. The cost of memory care is determined by the state you live in, rural versus urban regions, and the amount of care your loved one needs. 

According to Dementia Care Central, the median monthly cost of assisted living in 2019 was $4,050. The additional cost of memory care can bring to an average $1,250 or more per month, depending on the region where you reside.

Unless you have a long-term care insurance policy, costs will have to be covered by your income and savings. Some people sell their primary residence to fund the cost of memory care. 

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What Should You Consider Before Moving to a Memory Care Facility?

Moving into memory care can present some challenges. Dementia is a progressive disease and can be highly stressful for families to deal with.

According to the Mayo Clinic, the hallmark symptoms of dementia are memory loss, confusion, difficulty communicating, problems with reasoning and problem solving, wandering, and eventually physical decline. 

Before deciding on memory care, there are some things to consider:

  • Your loved one or aging parent may refuse help. You and your family may need to strategize the best way to handle a sensitive situation. 
  • Could your loved one manage in assisted living augmented by private duty care?
  • Is it possible to arrange for enough in-home care to keep your family member at home?
  • What is the progression of your loved one’s dementia? If the disease has accelerated, time might be of the essence since a decline is imminent. 
  • If residents are not grouped by cognitive level, will your loved one fit in or be intimidated by people who are more impaired than they are?

How Do You Pick the Best Memory Care Facility?

Picking the best memory care unit is a combination of commitment and luck. Your job might be easier if you don’t have many to choose from.

For people who live in larger urban areas, there could be lots of choices. Here are some tips to get started with your search.

Visit more than once

There are few things more critical to picking a memory care facility than personal visits. Since memory care units are locked and secure, you will need to schedule a tour. Staying focused on what is important can help you make a fair evaluation of the community.

  • Observe the atmosphere. Is it stressful and chaotic or calm and organized?
  • How do the staff interact with the residents? Are they patient and kind?
  • Is the place clean?
  • Ask about meals and the ability to accommodate meal preferences. 

Ask about staff training

Each state can dictate the minimum amount required of staff training. That doesn’t mean that training should stop there. Ask to look at the training schedule. Are there dedicated staff for memory care, or do staff rotate between assisted living and memory care?

Inquire about how many Certified Nursing Assistants (CNAs) there are. CNAs are trained to perform tasks that are permitted by the state.

For example, personal care aides/assistants don’t have any formal training except what is provided by the facility. This doesn’t mean that personal care aides aren’t valuable. They are, but the help they can give is limited to bathing, grooming, and dressing, etc. 

Also, ask about emergency procedures and how the staff is expected to respond to those. 

Ask about staff to resident ratio

There is no national staff to resident ratio requirement in assisted living or memory care. The states will mandate this ratio, but some states may have no requirement at all.  You will have to trust that the information you receive on staffing is correct. 

Some memory care units flex staff according to the cognitive level of the residents. There might be times when many of the residents require more supervision or help, so staff is increased. 

Ask about nursing

Find out what the scope of practice is for nursing service. If a nurse is not available 24 hours a day and seven days a week, how are emergencies handled?

You may also want to find out if physician services are offered on-site.

Consider the size of the community

You may wonder why this is important. If your loved one is the anxious and/or confused type, a smaller place may be less overwhelming. Some residents prefer the structure and comfort that a more confined space offers.

Some people with dementia have lots of energy. Being in a confined space may lead to agitation and increased anxiety. A larger community will give someone like this plenty of room to roam.

Activities

Activities are a vital and essential part of memory care life. People with dementia need stimulation, distraction, and emotional regulation. Activities keep people engaged, help them stay calm, and allow for social interaction.

Asking about the types and frequency of activities will give you an idea of what you can expect for your loved one. Many memory care communities also offer one-on-one activities for people who aren’t able to tolerate groups. 

Discharge policy

The sad fact is that on occasion, people are asked to leave memory care. Reasons could include behavioral problems that endanger other residents' safety or complex medical needs that can’t be handled by the nursing staff.

If a memory care community is going to ask your loved one to leave, what criteria do they use and how much notice do they give? Do they assist with finding other more appropriate placement? Knowing what the requirements are will help you mitigate any potential issues before they become a problem for the community.

Check with the Ombudsman Program

The States’ Long Term Care Ombudsman investigates complaints about assisted living, memory care, and nursing homes.

The Ombudsman “works to resolve problems related to the health, safety, welfare, and rights of individuals who live in LTC facilities, such as nursing homes, board, and care and assisted living facilities, and other residential care communities.” If there have been multiple complaints about a community, this would be cause for concern.

Ask others for referrals

Check with friends and health providers on their experience with memory care. Often home health companies have a unique perspective because they go into memory care communities every week.

You can ask the memory care facility under consideration which companies service the building. Give the home health company a call to ask their opinion. 

Physicians can offer suggestions as well. They have patients that go to memory care communities and receive feedback on the experience. Geriatric clinics, in particular, may have close relationships with memory care facilities. Their advice can be invaluable in helping you make a decision. 

Cost

Cost may be a consideration for you. Make sure you find out about any add-on costs for additional care.

If shared rooms are an option, that might reduce the monthly cost. Don’t hesitate to negotiate the price. It can’t hurt and it might help.

Memory Care for Your Loved One

Memory care is a valuable part of the continuum of care for aging adults. You can prepare yourself for this decision with resources like books on aging and long-term care planning. It can provide a secure and safe environment for people who can’t manage under other circumstances. 

Working with your family and loved one ahead of time to make a decision can help ease any stress down the line, especially with something that can be uniquely distressing such as dementia. Following our guide will help you choose the best place for your loved one.

If you're looking for more resources on finding care for aging adults, read our guides on the best books on dementia care, memory care vs. assisted living, and how to find the best senior care.


Sources

  1. “Alzheimer’s / Dementia Care Costs: Home Care, Adult Day Care, Assisted Living & Nursing Homes.” Dementia Care Central, www.dementiacarecentral.com/assisted-living-home-care-costs
  2. “Dementia.” Mayo Clinic, 19 April 2019, www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013.
  3. “Long Term Care Ombudsman Program.” Administration for Community Living, acl.gov/programs/Protecting-Rights-and-Preventing-Abuse/Long-term-Care-Ombudsman-Program.

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