It’s bittersweet to see your loved ones age. Your mom, once a prolific baker, still makes her way around the kitchen but occasionally mixes up the steps in her favorite recipes. Or, your dad doesn’t notice he’s no longer writing the answers to his daily crossword puzzle neatly inside the boxes. These early signs can progress, until Mom has trouble remembering when it’s time to eat and Dad can’t write at all.
Dementia usually worsens over several years, making it hard to distinguish the exact moment when it’s time for memory care — a type of specialized care and round-the-clock support service for individuals experiencing memory-related issues, particularly dementia or Alzheimer’s disease.
More than 6 million people in the U.S. have Alzheimer’s disease, which is the most common form of dementia, according to the Alzheimer’s Association. More than 11 million family members care for someone with dementia, while others with memory issues live in assisted living communities, nursing homes or memory care units.
Memory care units help people with dementia who exhibit certain behavioral changes that affect their day-to-day living. These units provide specialized care from health care professionals trained to work with such patients, says Dr. Ardeshir Hashmi, enterprise director for the Center for Geriatric Medicine at Cleveland Clinic.
Ask yourself: Are you doing enough to care for your loved ones? Here’s how to tell if it’s the right time for memory care and when to seek professional assistance.
When Is It Time for Memory Care?
It’s hard to know when someone with dementia should transition to a care home. Medical professionals understand several warning signs and subtle signs as potential reasons to seek memory care services.
Here are six behaviors or circumstances that can indicate someone may need to move into residential memory care:
— Changes in behavior.
— Confusion and disorientation that imperils physical safety.
— A decline in physical health.
— Caregiving is a family hardship.
— Incontinence.
— Failed electronic and phone communications.
Changes in behavior
It’s common for those with dementia to have dramatic behavioral changes.
Some of these differences, according to the Alzheimer’s Association, may include:
— Paranoia.
— Difficulty making decisions or concentrating.
— Social withdrawal.
— Lack of initiative.
— Aggression or agitation.
Consult with a medical provider to evaluate these symptoms. More mild symptoms, like difficulty concentrating or forgetting to cook meals, may be appropriate for memory care living, while more severe ones, like difficulty speaking or swallowing, may require a higher level of care, like a nursing home.
“Someone very independent may start to suddenly be apprehensive about driving, decline social invitations and become withdrawn,” says Dr. Elaine Healy, vice president of medical affairs and medical director of United Hebrew of New Rochelle in New York. “Someone meticulous about their appearance may suddenly forget daily hygiene or how to do basic tasks like bathing and hair styling, and (they) are too embarrassed to ask (for help).”
A person may also become more anxious or agitated. Individuals may exhibit agitation through excessive motor activity, restlessness, aggressiveness and emotional distress, according to research published in the journal Frontiers in Neurology in 2021. Agitation can occur in up to 50% of those with Alzheimer’s. Sometimes, the behavior is precipitated by time of day, overstimulating environments or changes in medications.
[READ: Understanding Sundowning: Symptoms, Causes and Coping Strategies]
Confusion and disorientation that imperils physical safety
Dementia can cause confusion and disorientation, which can lead to accidents.
Common examples of physical safety red flags that indicate it’s time for memory care include:
— Wandering.
— Unsafe driving.
— Burning or cutting themselves while cooking.
— Noncompliance with medications or treatments.
“Someone with dementia symptoms may forget where they’ve walked and end up somewhere they don’t recognize,” Healy says. “When your loved ones are putting their physical safety at risk, it’s time to consider memory care.”
Physical safety is a non-negotiable, adds Carrie Ditzel, the director of geropsychology and neuropsychology at Baker Street Behavioral Health in Paramus, New Jersey. If you have any concerns about safety, “give memory care some real consideration.”
[READ Anosognosia vs. Alzheimer’s: Understanding the Key Differences]
A decline in physical health
Physical health changes are often the first noticeable difference in someone with dementia or Alzheimer’s, Healy says.
Healy says to watch for:
— Changes in appearance
— Changes in grooming habits.
— Changes in body composition, like becoming thinner or more frail.
These changes may indicate it’s time for memory care because they may be due to your loved one forgetting to perform activities like grooming or shopping or by not being physically strong enough for the task, Healy adds.
Memory care is an appropriate level of care when a decline in physical health is not related to another chronic disease outside of Alzheimer’s or dementia. If health is also wavering due to conditions like diabetes, heart failure or consistent infections, then it’s worth pursuing a higher level of care, like a skilled nursing facility.
[READ: What Increases Dementia Risk?]
Caregiving is a family hardship
Memory care should not only be in the best interest of the individual, but for the family as a whole, Ditzel says.
There are many reasons memory care living may be the best option for the family unit. Ditzel suggests considering:
— Caregiver deterioration or death.
— Demanding jobs that do not allow family to care for the individual.
— Needing to also care for children.
— Being the sole caregiver without additional family member support to take turns.
— Financial strain on the family.
If there’s potential for any of the above circumstances, it’s time for memory care.
“Many struggle with feelings of guilt when they consider placing a loved one in a facility,” Ditzel says. “However, I encourage those people to look at the situation as a whole. What circumstance is best for their loved one and themselves physically and emotionally?”
Incontinence
Caregivers can handle a lot, but if incontinence gets to the point that adult undergarments are ineffective, it may be time for memory care, says Dr. Clifford Segil, a neurologist at Providence Saint John’s Health Center in Santa Monica, California.
This is because bladder or bowel incontinence can lead to potentially serious, and even fatal, infections. For example, a urinary tract infection can ascend and become a kidney infection or cause blood infections. Such infections can cause subsequent shock and potentially organ failure.
These infections are often the product of neglect and poor care, Segil says. Patients in memory care units receive a level of care to help prevent small and easily treated infections from progressing into life-threatening sicknesses. The higher level of attention provided in memory care could help prevent such infections.
Failed electronic and phone communications
If your loved one starts sending texts, emails or leaving voice messages that don’t make any sense, that may be a sign that it’s time for memory care, Segil says. You might read texts multiple times or listen to a voicemail more than once but still not figure out what your loved one is trying to communicate.
“When you contact them to ask them what they were trying to say, they’re unable to because they’ve forgotten,” Segil adds.
What Is Memory Care?
Memory care, sometimes also referred to as Alzheimer’s care, may be recommended to your loved one by a medical professional, or you may notice the need in your loved one on your own. In either case, you do have a few memory care options available.
Kim Elliott, Nashville, Tennessee-based senior vice president and chief nursing officer at Brookdale Senior Living, says memory care facilities offer the following amenities:
— Specially trained staff available 24/7 to care for individuals with dementia and Alzheimer’s.
— Additional security measures, like doors with keypad entries.
— Enclosed spaces and courtyards to prevent wandering.
— Easy-to-navigate floor plans.
— Activities that are friendly for those with memory difficulty, like sensory activities and listening to music.
Memory Care Options
When it’s time for memory care, there are several options to consider:
Assisted living facilities
Those with mild or moderate stages of Alzheimer’s or dementia who are are able to still care for themselves may benefit from assisted living.
Segil adds that assisted living is able to help those who need some additional help with grooming, feeding and remembering to take medications. Some people who may need support for their memory are already living in a nursing home or assisted living facility. Want to know when to move from assisted living to memory care? If someone needs additional memory support, along with help with daily activities, they might be able to transfer to the memory unit in their facility.
For those concerned with having adequate care on-site, a continuing care retirement community will typically have assisted living where people can live relatively independently in the early stages of dementia. They may also have a memory care unit on campus that individuals can transition to as the disease progresses.
Dedicated memory care and Alzheimer’s facilities
A dedicated memory care community could be another option. This is a specialized type of assisted living that provides comprehensive care in a secure environment. Typically, these are units in which patients are unable to leave without supervision.
In addition, physical spaces within the unit are often designed with visual cues and artwork to help with navigation and ease anxiety. Meal preparation, medication management, assistance with daily life and personal care and enriching activities — outdoor walks, arts and crafts and gardening — are all part of a memory care community designed to meet the health care needs of residents and keep them engaged in the world around them.
Skilled nursing homes
A secure memory care unit in a skilled nursing facility is a good option for people who need more care than they’d likely receive while living at home and who also need moderate or complete assistance with personal care tasks, such as bathing or toileting.
“There will be other people your same age to talk with and hang out with,” Segil adds.
The same assistance with daily activities and personal care that is provided in assisted living communities and dedicated memory care facilities is applied, with a greater emphasis on meeting the medical needs of those with chronic or complex illnesses.
When to Move from Assisted Living to Memory Care
Once you know it’s time for memory care, whether your loved one is still living independently or in an assisted living community, there are several reasons to facilitate a timely transition.
Benefits include:
— Preventing undue stress.
— Preserving a positive relationship between the individual and their family.
— Assistance with needs as the condition progresses.
— Preventing unnecessary medical issues, like infection.
— Ensuring physical safety.
— Providing structured socialization and activities.
Ditzel emphasizes that when the burden of caregiving is on the family, the dynamic suddenly shifts.
“For example, to someone with dementia living at home, suddenly now a spouse or child is telling them what to do or is washing them and taking them to the bathroom,” she says.
Although this is necessary, the change in roles poses a stress to everyone in the household. Trained professionals can prevent any resentment from building on both sides and allow the family to spend time together in a more positive and personal manner, she explains.
“There is a richness in the environment of a facility that is therapeutic to many,” Ditzel shares. “Regular activity, socialization and routines in their care can lead to reduced symptoms and improved outcomes.”
By interacting with staff, they can talk about themselves and their life more frequently than they might at home, which promotes memory recall and self-esteem.
Urgent Placements for Dementia Patients
Sometimes, it’s time for memory care without much warning. An urgent or emergency placement for a dementia patient into memory care may be necessary if your loved one’s condition progresses quickly or if they become a danger to themselves or others.
To start an emergency placement, contact:
— Your loved one’s primary care provider or the health professional managing their memory condition.
— A social worker.
— A senior care placement service or specialist.
Depending on your state, you may need some paperwork, like medical notes and power of attorney documentation. A medical professional can direct you to the necessary resources for your area.
Bottom Line
Caring for a loved one with memory issues is emotionally challenging, but it doesn’t have to be a burden you bear long-term. Recognize when it’s time for memory care, and consider that it may be time to transition for the well-being of your loved one and your family unit.
By seeking help from professional memory care facilities and professionals, you can preserve your relationships and be at peace knowing that your loved one is safe and cared for.
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6 Signs It’s Time for Memory Care originally appeared on usnews.com
Update 04/10/24: This story was previously published at an earlier date and has been updated with new information.
