Erin Schneider, a St. Louis-based care guide supervisor at Homethrive, witnessed firsthand the progression of dementia and its ripple effects to caregivers.
“My mother-in-law was the primary caregiver for her husband, who passed away from vascular dementia. She never seemed to recover after his death,” she recalls. “As the years went by, it became more apparent to us that she was experiencing cognitive decline.
“We decided to move her into the independent living side of a continuing care retirement community, also known as a CCRC. After a few months, we moved her into a dedicated memory care facility, where she has lived for the past three years. She is in the best place to meet her needs.”
If you’re thinking about memory care for a family member, here’s what to consider.
What Is Memory Care?
Memory care refers to a specialized facility or unit that provides residential care for people living with Alzheimer’s disease and other forms of dementia. Memory care facilities provide around-the-clock care and supervision to create a safe and secure environment for residents.
Memory care vs. dementia care: Is there a difference?
You may find the terms “memory care” and “dementia care” are frequently used interchangeably. Most often, residents who need memory care have some type of dementia diagnosis. Individual facilities may choose to define memory care and dementia care slightly differently, so ask potential memory care units if they differentiate them as individual levels of care.
How to Know When It’s Time for Memory Care
If your loved one’s memory loss or dementia prevents them from living safely on their own, it’s time for memory care.
A few examples of behavior needing memory care include:
— Changes in behavior, like increased agitation
— Unsafe confusion and disorientation, like wandering leading to safety concerns
— Decline in physical health or hygiene, like your loved one being unable to bathe themselves or care for their diabetes
— Disruption in caregiving or family dynamics
— Nonsensical communications by your loved one, like repeating stories or sending confusing emails
[Read: 11 Signs Your Aging Parent Needs Senior Care]
Memory Care Services in Different Types of Facilities
Memory care facilities can be stand-alone, or they may be part of a larger senior living community, shares Heidi Royter, president and chief operating officer of Solterra Companies in Scottsdale, Arizona.
You may opt for memory care in:
— A stand-alone memory care facility or memory care unit
— An assisted living community
— A nursing home
“The decision on whether a memory care unit is stand-alone or integrated depends on the facility’s design and philosophy,” Royter adds.
Whether the facility is a stand-alone memory care unit or has memory care integration, research shows specialized dementia care leads to better outcomes. In September 2023, the National Institute on Aging reported that nursing homes provided better dementia care when more than 90% of the residents had dementia than when they had a lower proportion of residents with dementia.
[SEE: Early Signs of Dementia.]
Memory care facilities
A stand-alone memory care unit or facility is dedicated to residents with memory impairment.
“Everything is designed to provide this specialized care,” says Dr. Lindsey Ulin, a palliative care physician at Massachusetts General Hospital and the Dana-Farber Cancer Institute in Boston.
These communities are built with both safety and comfort in mind. For example, walking paths and neighborhoods are built to mimic spaces your loved one would encounter at home, explains Lynne Katzmann, a Bloomfield, New Jersey-based founder and CEO of Juniper Communities. Residents are still able to roam in a familiar feeling space, but the environment has secure boundaries with 24/7 supervision.
“A secure memory care community can protect those who wander,” Katzmann adds.
Memory care in assisted living facilities
Assisted living may be more appropriate for those who are more independent and may not need as much help or for those at earlier stages of dementia.
“While you can receive memory care in assisted living, this is best suited for people with mild memory loss. Most people living with severe memory impairment need more help with daily activities than assisted living provides,” Ulin explains.
Memory care in nursing homes
The key difference between the care in assisted living facilities and nursing homes is that nursing homes offer more assistance with daily activities and more medical care.
“At the later stages of the disease, individuals need considerably more care and assistance,” Katzmann says. “Many require help eating and, in the very late stages, may become bedbound.”
Ulin adds, “Some of this additional care may include needing wound care, intravenous medications or physical rehabilitation.”
She also notes that because more nursing care is needed, memory care in nursing homes is also the most expensive option.
[READ Long-Term Care Facilities: Types and Costs]
Benefits of Memory Care
Specialized memory care offers several benefits, including:
— Safety and room to move
— Specially trained staff
— Around-the-clock care
— Tailored activities and therapies
1. Safety and room to move
With dementia comes heightened safety concerns.
Seniors with dementia have a greater risk of:
— Falling. Research at Drexel University concluded that older adults with dementia are twice as likely to fall and three times more likely to have serious fall-related injuries compared to those without dementia.
— Wandering. According to the Alzheimer’s Association, about 60% of those with dementia will wander at least once, but many do repeatedly.
— Eloping. Trying to leave their residence or care facility creates potential scenarios for injuries or death.
Reliable memory care facilities will have safety plans in place to prevent injuries and accidents with their residents, including:
— Welcoming, airy common areas to encourage moving in a safe way
— Walking paths
— Locked units with security codes or guards
— Enclosed outdoor space
— Bed alarms
— Nonslip, easy-to-navigate floors
2. Specially trained staff
One of the benefits of memory care is the trained staff available to care for your loved one. These staff members have additional training on how to care for those with memory impairment.
Some of the specially trained memory care personnel may include:
— Nurses, including RNs and LPNs
— Caregivers, who may be referred to as nursing assistants or unlicensed assistive personnel
— Ancillary staff, including housekeepers, hospitality personnel and activities directors
— Therapists, such as music therapists, physical therapists, occupational therapists and speech-language therapists
“People with memory impairment have unique needs and challenges, like experiencing agitation, wandering and difficulty communicating,” Ulin shares. “Having staff who receive special training to care for them can make a big difference in both the residents’ experience and families’ peace of mind.”
Supportive memory care facilities train their staff to de-escalate these situations and avoid using excessive medications as a means of behavior control.
Adequate staffing ratios are critically important for good memory care. Minimum staffing ratios are state-dependent, as there are currently no federally mandated staffing ratios set by the Centers for Medicare & Medicaid Services.
3. Around-the-clock care
Memory care at night is especially crucial, as many seniors with dementia struggle with sundowning, when behavioral disturbances and confusion peak in the evening hours.
To prevent sundowning, memory care facilities may:
— Hold activities in the afternoons to prevent late napping
— Incorporate gentle, natural light throughout the living spaces during the day and use blackout curtains at night
— Employ distraction techniques during the evening hours when sundowning typically sets in
Memory care staff also receive special training in caring for individuals with sundowning syndrome. This includes de-escalation techniques, cementing typical daily routines and giving reassurance.
4. Tailored activities and therapies
There are a variety of activities and therapies that memory care uses, says Liz Plozner Chalfa, a Blanchard, Pennsylvania-based certified dementia practitioner and executive director at Juniper Village at Brookline Senior Living.
Chalfa says some tenets of dementia-tailored activities include:
— Repetitive, habitual and rhythmic activities, which can be comforting for dementia-affected individuals. These include kneading, winding yarn, clapping to music or shuffling cards.
— Social skills, like greeting one another, shaking hands or gathering for a meal
— Gross motor skills, such as walking, dancing or playing catch
— Humor, such as reaction to novelty, the unusual and unexpected
How Much Does Memory Care Cost?
Memory care costs more than standard assisted living care. Dementia Care Central estimates memory care may cost about $1,200 more per month than assisted living. (Assisted living averages $5,350 per month, according to Genworth Financial’s 2023 Cost of Care Survey). SeniorHomes.com has compiled a state-by-state list of costs, with monthly medians ranging from a low of $3,233 in Mississippi to a high of $5,800 in Maine.
Memory care costs may vary based on several factors, explains Lucinda “Cindy” Baier, president and CEO of Brookdale Senior Living. These include:
— Geographical location
— Size of dwelling space
— Services offered
— Amenities provided, like enrichment programs or specially designed common spaces
— Level of care needed, like how much medical supervision or treatment is offered
Baier adds that some memory care programs offer services a la carte, by care level or with all-inclusive pricing.
For those who qualify, Medicaid may cover dementia care costs. Medicare typically does not cover some long-term care that’s considered custodial care — meaning it involves assisting with daily activities rather than providing medical treatment. However, Medicare Special Needs Plans may offer some benefits for people with dementia, and Medicare may cover some services rendered in memory care, like medications or physical therapy.
How to Find the Best Memory Care Facility Near You
“Every care facility is different, so visiting and meeting with staff to understand what care they provide is critical,” Ulin advises.
When touring a memory care facility, you may want to contemplate:
— The amount of care your loved one needs, based on their cognitive levels
— Any input from your loved one’s medical providers
— The types of activities or amenities your loved one would be interested in
— If the memory care facility maintains a positive and engaging attitude
Some memory care green flags include:
— Staff who treat residents with privacy, dignity and respect
— Positive and clear communication with residents and their family members
— Eagerness to accommodate the needs of each resident. For example, they make sure a resident can play their favorite card game during activity hours.
On the contrary, some nursing home red flags include:
— Too much reliance on television or electronics as entertainment
— Staff seems overworked or distracted. For example, you ask them a quick question about your loved one, and they don’t get back to you for hours or they seem annoyed by your question.
— Unpleasant smells, sometimes masked by the smells of cleaning supplies
Explore Top-Rated Memory Care Facilities With U.S. News
When considering memory care, make sure to understand your loved one’s needs and preferences. Start the process today to find the right memory care facility. To find the best memory care near you, explore the U.S. News & World Report Best Memory Care Communities 2024.
U.S. News analyzed data from nearly 400,000 resident and family survey responses at more than 3,500 senior living communities across the country in 2024. The senior living survey covers residents and family members’ satisfaction with all aspects of senior care, and scores for memory care communities were derived from family responses.
More from U.S. News
How Much Assisted Living Costs and How to Pay For It
The Best and Most Unique Nursing Home Activities for Seniors
Anosognosia vs. Alzheimer’s: Understanding the Key Differences
What Is Memory Care? originally appeared on usnews.com
Update 08/21/24: This story was previously published at an earlier date and has been updated with new information.
