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 and require people to give up their independence and move into assisted living communities.
“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.
[READ: Taking Over Affairs for an Aging Parent in Mental Decline.]
What Is Memory Care?
With more than 30,000 locations throughout the country, assisted living communities offer older Americans various advantages, including providing them with a safe place to live when they can no longer live independently and need help with activities like cooking, bathing or dressing. These communities usually provide residents with their own apartments or rooms, 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 communities do not provide 24/7 care like nursing homes, and they encourage residents to remain as independent as possible.
Within assisted living communities, there’s a variety of services, programs and care offered. Some communities are designed specifically for those living with memory impairments, such as dementia or Alzheimer’s disease.
Memory care units are types of communities that 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 keeps 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. About 14% of assisted living communities offer memory care or dementia units, according to the American Health Care Association and the National Center for Assisted Living.
“These communities typically have a higher staff-to-resident ratio, and staff have extensive training in supporting someone with memory challenges,” says Kate Granigan, CEO of LifeCare Advocates in Newton, Massachusetts, and president-elect of the Aging Life Care Association. “These communities are also typically secured with locked doors, which is critical for someone who may wander.”
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 and director of neuropalliative care service at the University of Rochester in New York. “I’ve seen some patients actually thrive and blossom after moving into these types of facilities.”
[READ: Nursing Homes vs. Assisted Living.]
Signs to Look For
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 communities 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, medical and cognitive abilities. The assessments are usually conducted by a staff member at the community, typically a nurse, to determine the best environment for the person to live in.
Experts recommend looking out for these common signs of dementia:
— Aggression.
— Combativeness.
— Diminished interest in joining activities.
— Incontinence.
— Mobility issues.
— Poor hygiene.
— Repeating stories during the same conversation.
— Wandering or getting lost.
[READ: Assisted Living Checklist.]
Moving to Memory Care
When some of these signs start to occur more frequently and a relative needs more hands-on care, that’s when it’s 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 community staff and the person’s primary doctor. While a doctor’s input is recommended, there are no referrals or permissions needed.
Moving relatives away from communities that they have been living in for a while can be disruptive to their daily routines.
“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,” Sorensen says.
For those with dementia, any sort of uprooting from a familiar environment can lead to agitation or frustration and an overall unsettled feeling.
“Unfamiliar environments can lead to potential hazards for falling or even wandering, so it’s important to prepare for a transition period,” Ouslander says.
Choosing a Memory Care Community
Ouslander recommends researching assisting living communities and their memory care units before making the move. That means visiting the unit to learn more about the community’s track record in caring for residents, meeting the staff and learning 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 health and treatment, including medications.
When meeting the community staff, find out about their training process for their teams to ensure they are equipped to care for those living with dementia issues.
“Many facilities are facing staffing shortages, and the question becomes: ‘Are the new staff members receiving proper training in dementia care?'” Sorensen explains.
Families should ask about the tenure of the staff since high turnover can impact the quality and coordination of care.
In addition, it’s 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 community.
“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,” Ouslander says.
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When to Move From Assisted Living to Memory Care originally appeared on usnews.com
Update 09/15/23: This story was published at an earlier date and has been updated with new information.
