For people with Alzheimer’s disease or other types of dementia, there may come a time when they need more care than a loved one or other caregiver can provide at home. In those instances, it may be time to move them into a memory care facility.
But what’s life really like in these places? Here, we’ll unpack everything you need to know about living in a memory care facility and what’s typical of this important senior living option.
[READ: Recognizing the Signs and Symptoms of Dementia]
A Person-Centered Approach to Memory Care
Many memory care centers talk about their “person-centered approach to memory care,” but what does that mean?
It means that instead of a cookie-cutter approach to managing residents with dementia, care is tailored to the specific needs of the individual.
Not only do patients all have unique needs, but each community is unique as well, which makes it difficult to generalize what to expect from memory care.
“There are over 100 different kinds of dementia, and memory care should be personalized as well as safe and comfortable,” explains Dwayne Clark, founder, CEO and chairman of Aegis Living, a Seattle-based senior living company with 39 locations in the western United States.
Clark, who has nearly 40 years of experience in the industry and has also lost several family members to dementia, adds that “you really have to understand the disease and where the person is in their stage of the disease.”
For example, someone with early-stage dementia may still be very functional and able to do many things for themselves. But those with later-stage dementia need help with every aspect of daily living. The progression of the disease can vary widely depending on the individual, with some progressing quickly — having just a couple years between diagnosis and death — while others can live with dementia for decades.
Because of these nuances, memory care is “really a personalized journey in terms of where people are on the dementia scale,” Clark says.
What’s more, “individuals find peace and joy in different modes,” says Toni Lynn Davis, executive director of senior services at Monmouth Crossing Assisted Living and The Manor at CentraState Medical Center, part of Atlantic Health System in Freehold, New Jersey.
“Some respond to music, others to touch and others to dance or smell,” she continues. Therefore, “to be truly person-centered means to discover that specific thing that creates joy and peace in each person.”
[READ: Dementia Care Activities]
Developing an Individual Care Plan
Most memory care communities devise individual care plans for their residents based on both their mental and physical health.
“Some people need more physical assistance than others,” explains Jennifer Moses, a full-time faculty of practice professor at Wilkes University in the Adult-Gerontology Primary Care Nurse Practitioner program in Wilkes-Barre, Pennsylvania.
To devise a care plan for a specific person, Clark says memory care centers will use one of a number of assessment tools to determine where the individual is in the progression of their disease. Then, staff will collaborate with the appropriate medical professionals and the person’s family members to develop an individualized care plan.
That plan will necessarily shift over time and as the person’s condition changes, but it’s a road map for care that’s as unique as the individual.
“Sometimes family can help to arrive at a customized care plan,” Davis says. “Other times, we utilize the individual’s background information, what they did for work or their nationality, or we stumble on something that they just click with.”
In finding what works for an individual, Davis says the hands-on caregivers are the best resource, as they can “help us pinpoint the triggers for each resident and what brings them peace.”
Memory care centers make sure that all staff are familiar with their residents’ care plans, so that “all teams throughout the community can use it to benefit the resident and help staff when there are episodes of unease or anger and frustration that can accompany memory issues and cognitive impairment,” Davis adds.
[READ: How to Manage Sibling Conflict Over Care of Elderly Parents]
Memory Care Requirements for Staffing and Training
Staff working in memory care typically have more extensive and specific training than staffers working in assisted living or other eldercare settings. This helps them better support people with dementia and keep themselves and their patients safe.
Memory care facilities are overseen by the state in which they’re located. State regulatory standards dictate many aspects of staffing and training with which these centers must comply, such as:
— How many staff are on duty at once
— The ratio of staff to patients
— The number of training hours staffers must complete before starting work
— Continuing education requirements and refresher courses
— Safety and emergency management protocols
The National Council of Certified Dementia Practitioners, an eldercare training company based in Sparta, New Jersey, reports that regulatory standards often focus on safety measures, protocols for handling medical emergencies, strategies for reducing the risk of infectious disease spread and best practices for mitigating environmental safety concerns.
Memory care staffing policies
The hands-on care rendered in most memory care facilities requires a higher ratio of caregivers to patients than is typical in assisted living facilities that don’t specialize in dementia care.
Memory care training is required for all staff as they will, at some point, encounter residents with dementia or Alzheimer’s and will need to be able to interact with them, Davis notes. Direct care staff typically receive more intensive, dementia-specific training and requirements for ongoing training.
There is also wide variability in how each one manages staffing. Asking what to expect of staffing in memory care facilities is like asking, “What can I expect from a hotel stay in Los Angeles?” Clark says. “OK, well, are you going to stay at the Four Seasons? I can tell you what to expect there, but that’s going to be different from what you find in a small bed and breakfast, which is different again from what you’ll get at a Motel 6.”
Staffing also depends on the severity of the cases, Clark adds. One facility that’s housing seven acute residents with late-stage dementia, for instance, may need more staff on hand than a facility housing 10 residents with less severe symptoms.
“We assess their acuity on a point system, and those points tell us what the staffing pattern needs to be,” he adds.
But as Davis notes, staffing ratios are close to, if not the same as, that of a skilled nursing facility.
Key Skills Among Memory Care Professionals
Memory care professionals must possess several important skills and characteristics to provide quality service to residents. Chief among them:
— Good communication skills
— Good time management skills
— The ability to plan while remaining adaptable
— Good working knowledge of behavioral management techniques and current treatment protocols
— Excellent observational skills and attention to detail
— Knowledge of relevant safety protocols and regulations
— Understanding of the clinical aspects and typical progression of dementia
— A positive mindset and attitude
— Patience and empathy
— An earnest desire to see patients thrive
“Good communication is at the top of the list,” Davis notes, adding that the communication must be clear and comprehensive to ensure trust between the caregivers and the resident.
“Patience is another key skill,” she adds. “Arguing or contradicting will only bring about agitation in residents.”
How to check staff skills and caregiving acumen
To get a sense of whether a facility you’re considering has caregivers with these skills, Clark recommends showing up unannounced and asking for a tour.
“Go there are 7 o’clock at night, not when the administrators and the general managers are there. Walk in and ask for a tour. That’s when you can really see how care is being provided,” he says.
He also recommends asking directly about the qualifications and training of staff members. Ask about the facility’s affiliations — is it connected with a local university that offers dementia training or other medical institutions?
“That will speak to the quality of care and how seriously they take providing good medical care,” he says.
Meals in Memory Care
Getting good nutrition is a cornerstone of health and longevity even for people with dementia, though their ability to feed themselves diminishes as the disease progresses.
Residents in memory care typically eat according to the stage of their disease.
“Their tolerances for chewing and swallowing and ability to hold focus while sitting all play a part in the types of foods they can eat,” Davis says.
Dementia robs individuals of their ability to care for themselves, and over time, using utensils can become especially difficult. For this reason, “many residents in memory care do well with finger foods,” Davis says. “Residents value independence, and picking up food with their hands is much easier than with utensils.”
Meals are typically served in the memory care neighborhood dining room, which provides an opportunity for social engagement. But some residents may take meals in their own rooms.
Treatments for Alzheimer’s Disease or Dementia
There currently is no cure for Alzheimer’s disease and other forms of dementia, but there are some helpful management tools available.
“Some patients may take dementia meds that slow the progression,” Moses notes. “These meds generally keep patients independent longer.”
Nursing and medical care are also part of the picture. Memory care facilities typically provide some form of nursing care to assist with the medical needs of residents, though Clark stresses that assisted living and memory care are different from nursing homes, which have different regulatory requirements.
How facility design impacts patient treatment
Memory care facilities are designed to evoke positive memories, be safe and put residents at ease.
Since connecting with elements of their former life can help people with dementia feel less agitated and less confused about their current situation, memory care facilities can be designed to support that goal.
For example, Aegis recently build a new facility near the campus of the University of Washington in Seattle, where many of the residents have an affinity for or affiliation with the school. In designing the space, Aegis went all in on Huskie pride.
“The Huskies are a big football school, so there’s a goal post in there and a mini football turf,” Clark says.
There’s even an RV that helps simulate the experience of tailgating at a big game.
“When people move in, we want them to be familiar with things. We want things that resonate with them,” Clark says.
Another Aegis property on Mercer Island in Lake Washington houses many people from the local area who grew up boating around their island home, so they put an old Chris-Craft boat in the courtyard that residents can access, Clark says. They can climb aboard and set sail, figuratively, and reminisce about their adventures at sea.
There are very important safety elements that facility design must also address.
“Most memory units are locked facilities that are free-standing or a locked unit within a larger facility,” Moses explains. “Safety is one of the most important concerns as dementia patients often wander.”
Ideally, a memory care unit will be well-lit and use a circular floor plan with “clear, open spaces where residents can walk uninterrupted and navigate with ease. Long corridors and darker spaces can be challenging to navigate and cause frustration,” Davis explains.
Soothing the senses can help keep residents calm.
“Flooring and walls should not have bold patterns that can confuse a resident as they have difficulty perceiving the design as a pattern and are more likely to view them as bugs or holes,” Davis explains, adding they also “tend to steer clear of bright colors that can cause anxiety and opt for more soothing tones.”
Agitation can be a major challenge with dementia, but establishing a safe, navigable place and a routine that has anchors in a senior’s previous life can help soothe the discombobulated feelings that dementia often brings.
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What to Expect From a Memory Care Facility originally appeared on usnews.com
