While an overwhelming majority of older Americans want to remain living in their home, nearly half of those 65 and older report that they either need or receive help with routine daily activities. Even the best plans for independent living can be disrupted by physical and mental challenges that require people to give up some of their independence and move into assisted living facilities.
“Maintaining independence is important for people as they get older, but that’s not the reality for many, which is why assisted living facilities are so common,” says Dr. Joseph Ouslander, professor of geriatric medicine at the Charles E. Schmidt College of Medicine of Florida Atlantic University in Boca Raton, Florida.
Assisted Living Options for Seniors
With nearly 29,000 locations throughout the country, assisted living facilities offer older Americans a safe place to live when they can no longer live independently and need help with activities like cooking, bathing or dressing. These facilities usually provide residents with their own apartments or rooms and general living areas and dining rooms.
They offer a range of activities and services — from meals and laundry services to medication management as well as entertainment and recreational activities. These facilities do not provide 24/7 care like nursing homes and encourage residents to remain as independent as possible.
Within assisted living facilities, there’s a variety of services, programs and care offered. Some facilities are designed specifically for those living with memory impairments such as dementia or Alzheimer’s disease. About 14% of assisted living facilities offer memory care or dementia units, according to the American Health Care Association and the National Center for Assisted Living.
These types of facilities typically offer more tailored care for seniors with Alzheimer’s or dementia than a traditional assisted living community. The units provide round-the-clock supervised care in a separate wing or floor of a facility that keep residents safe and prevents them from getting lost. Staff members are instructed to receive specialized training and coordinate activities designed for those living with memory impairment issues.
Because of the specialized staff training and resources required, memory care units typically cost more than other types of residential care, usually about 20% to 30% more than assisted living.
“Some people who move to memory care units actually do better because there’s more structure and layer of care that they didn’t have in assisted living,” says Dr. Benzi Kluger, professor of neurology and medicine at the University of Rochester in New York. “I’ve seen some patients actually thrive and blossom after moving into these types of facilities.”
Signs That It’s Time for Memory Care
There’s no specific formula as to exactly when a loved one should be moved from assisted living to a memory care unit. There are many individuals with memory impairment or mild dementia who are living in assisted living facilities and able to live semi-independently. “Just because they have dementia doesn’t mean they need to be moved to a memory care unit,” says Roxanne Sorensen, an aging life care specialist and owner of Elder Care Solutions near Buffalo, New York.
The top reason for moving a relative to a memory care unit is to preserve their safety. “If your family member is showing signs of wandering or experiencing sudden falls then it’s time to definitely consider reevaluating their living situation,” Kluger says.
Before an individual is moved, an assessment is usually administered to examine physical, medial and cognitive abilities. The assessments are usually conducted by a staff member at the facility, typically a nurse. “The goal of the assessment is to determine the best environment for the person to live in,” Sorensen explains.
“There are many clues that may indicate someone is becoming cognitively impaired. It could be simple things like they repeat themselves in the same conversation or something more serious like wandering around getting lost within the unit,” Ouslander says. “Poor hygiene is another key sign an individual may need help. When someone isn’t brushing their hair or not washing, it reveals that they’re having cognitive difficulties.”
Experts recommend looking out for these common signs of dementia:
— Mobility issues.
— Poor hygiene.
— Repeating stories during same conversation.
— Sudden falls.
— Wandering or getting lost.
When to Move From Assisted Living to Memory Care
When some of these signs start to occur more frequently, and a relative needs more hands on care, that’s when its usually time to consider a move to a memory care unit, Sorensen says. She adds that it’s important for families to monitor their relatives’ behavior and talk to the care team about any physical, mental or emotional changes that they observe.
The decision to move relatives is always done jointly between families, the facility staff and the individual’s main doctor. While a doctor’s input is recommended, there are no referrals or permissions needed from a doctor.
Moving relatives away from facilities that they have been living in for a while can be disruptive to their daily routines, Sorensen says. “Families need to consider how the transition will affect their loved one. It’s possible that your relative might have favorite friends, aides or therapists that they will miss at their assisted living facility, so it’s important to keep this in mind.”
“For those with dementia, any sort of uprooting from a familiar environment can lead to agitation or frustration and an overall unsettled feeling,” Ouslander says. “Unfamiliar environments can lead to potential hazards for falling or even wandering so it’s important to prepare for a transition period.”
Choosing a Facility
Unless you’re in an urban setting, most areas only have a few memory care units to choose from. In some cases, the assisted living facility where your relative is living may have one of these units in a separate floor or wing.
Ouslander recommends visiting the unit to learn more about the facility’s track record in caring for residents, meet the staff and learn how they care for those living with dementia. Since many older people have other chronic conditions like heart disease, diabetes and respiratory issues, it’s important to find out how the staff will manage their chronic conditions as well.
When meeting the facility staff, find out about their training process for their teams to ensure they are equipped to care for those living with dementia issues, Sorensen explains. “Many facilities are facing staffing shortages, and the question becomes are the new staff members receiving proper training in dementia care.”
It’s also critical to speak to other families who have loved ones living there to get an insider’s perspective about the pros and cons of the facility, Ouslander adds. “You can learn so much about a place by talking to other families or caregivers to make sure it’s a good fit for your loved one.”
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Update 09/08/22: This story was previously published at an earlier date and has been updated with new information.