Many older adults find that some daily activities become harder to manage as the years go by. When extra help is needed, there are several types of senior living communities to consider. Assisted living and memory care are two of the most common options, each offering specific services that support residents’ well-being and day?to?day needs.
While these two options share some similarities, they differ in the level of care, staffing, specialized services they provide and more. Understanding everything you need to know about these two senior living options can help you find the best type of care for your loved one.
[READ: How to Move a Parent With Dementia to Assisted Living]
Assisted Living vs. Memory Care
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What Is Assisted Living?
Assisted living provides a safe space for seniors to live with the support they need to retain what independence they can. These facilities offer safe living spaces and personal care services to support older adults who can no longer manage all of their activities of daily living, such as bathing, dressing and making meals, on their own.
“A good assisted living facility will make sure your loved one is eating right and engaged with other residents. They also manage medications and are there in case of a medical emergency,” says Dr. Elizabeth Landsverk, a geriatrician in the San Francisco area who offers online telemedicine, education and support resources for eldercare professionals, caregivers and families.
[READ: Who Qualifies for Assisted Living: Eligibility Requirements]
What Is Memory Care?
Memory care aims to support older adults who are experiencing cognitive decline. When someone has Alzheimer’s disease or another form of dementia and can no longer take care of themselves, it may be time for them to move into a memory care facility.
Assisted living and memory care are two distinct types of senior living options, and both are different from nursing homes, adds Dwayne Clark, founder, CEO and chairman of Aegis Living, a Seattle-based senior living company with 39 locations in the western United States.
Nursing homes, for example, operate under different regulatory requirements and provide round-the-clock nursing care for chronic conditions or acute illness or injury, which is a little different from memory care.
[READ: What’s the Difference Between Memory Care and Nursing Homes?]
Key Differences Between Assisted Living and Memory Care
There can be some overlap between assisted living and memory care, but there are several key differences:
Care needs and services
Assisted living services typically include:
— Helping residents with bathing, dressing, toileting and other personal care services
— Providing meals and homemaking services, such as laundry and cleaning
— Medication management
— Social and recreational activities
In memory care, all of those same care services are available, plus:
— An added emphasis on safety and security
— More medical support
— Activities designed to support cognitive health
What your loved one needs will depend entirely on their diagnosis and their prognosis.
“Each dementia patient is at a different level of physical and mental health,” 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.
Some need more physical assistance than others, and when your loved one’s care needs exceed what staff at a general assisted living community can provide, they should consider moving into a memory care facility.
Staff training
Staff working in memory care centers, from the top administrator to the janitors, have extra training that caters to people with cognitive impairment.
“You must be trained in how to work with redirection of patients and addressing any behavioral issues,” Moses says.
Most states require ongoing dementia and Alzheimer’s training for all staff, with annual refreshers for direct care staff and activity professionals. The exact frequency and number of training hours can vary depending on state regulations.
More extensive training for direct care staff focuses on developing tools to deescalate, engage and redirect residents to ensure good care, says Toni Lynn Davis, executive director of senior services with Monmouth Crossing Assisted Living and The Manor at CentraState Medical Center, part of Atlantic Health System in Freehold, New Jersey. Ensuring that all staff have some specialized dementia training is a key differentiation between memory care and assisted living communities.
Staff-to-resident ratios in memory care
In addition to requiring more comprehensive and specialized training, memory care centers typically have more staff on site to provide hands-on care and support 24/7. These additional staff are there to assist with the more complicated health care and support needs people with dementia typically have.
Memory care facilities often have a staff member-resident ratio of 1-to-3 or up to 1-to-6, while assisted living facilities tend to have a 1-to-8 or 1-to-15 ratio of staff to residents, depending on the time of day.
These are general guidelines, and each community has its own approach to staffing, so ask about the staff-to-resident ratio at any community you’re considering.
Activities
In assisted living, the emphasis is on socializing, supporting general well-being and boosting physical activity. Activities range from outings and happy hours to book clubs and exercise classes.
“Activities in assisted living communities are vital for keeping residents active, engaged and socially connected,” explains Stacey Eisenberg, a senior care expert and owner of A Place At Home — North Austin home care agency in Round Rock, Texas.
Having many diverse activity options indicates that an assisted living community is committed to the residents’ holistic well-being, which can help prevent issues like social isolation and loneliness, boredom and a decrease in overall life satisfaction among residents, she adds.
In memory care, the focus is on:
— Supporting cognitive health by establishing a dependable routine
— Reducing stress
— Engaging in activities that help preserve cognition
“All residents are treated individually based on their abilities that day,” Davis says. “Some may prefer independent programs, such as art or gardening, while others may benefit from more social engagement like games, discussions or a learning activity.”
The activities a person with dementia accesses also vary depending on the severity of their diagnosis.
“For example, there may be bingo for mild impairment patients and music for advanced cognitive patients for whom bingo may be too much work,” Moses explains.
Therapy services
With therapies, assisted living communities generally focus on personal care rather than direct medical services. In most cases, they do not employ medical professionals to provide health care directly, but many can coordinate with outside clinicians, visiting nurses or home health agencies to deliver basic nursing or therapy services. Regulations and availability of these arrangements vary by state and facility. In contrast, memory care residents often receive more ongoing health monitoring and therapies specifically targeted to support cognition.
Some memory care facilities, like CentraState, are also part of a larger health care system and located on the campus of medical centers, allowing patients and residents to benefit from seamless, coordinated access to clinician expertise and comprehensive health care services.
Safety and security features
“Safety is one of the most important concerns as dementia patients often wander,” Moses notes.
While assisted living facilities may include some safety features, memory care centers almost always have added safety features that aren’t as common in assisted living facilities, such as:
— Locks on doors and wards to prevent residents from leaving their designated area
— Alarms that sound when a resident opens certain doors
— Sensors that alert staff if a resident has left a certain area or is trying to access another part of the building
— Frequent safety checks to ensure all residents are safe and accounted for
Safety features can also be subtler and even incorporated into the design and decor of the building. For example, bright lighting and wide corridors to accommodate stretchers and wheelchairs in a simple, easy-to-navigate layout are best in memory care centers, Davis says, as dark or cramped spaces can be distressing for people with dementia.
Even the paint on the walls and the pattern on the carpeting can make a difference for a resident’s experience, she adds. Bright colors and bold patterns can agitate or confuse residents, as many people with dementia have difficulty perceiving or understanding patterns.
Amenities
Both assisted living and memory care communities offer these basic amenities:
— Housing
— Meals
— Assistance with daily activities and personal care tasks
— Laundry and housekeeping services
— Medication management
— Transportation options
— Activities
— Opportunities for social engagement and connection with others
Where amenities diverge is primarily in their focus. In memory care, the emphasis is on supervising residents very closely to keep them secure. Activities are targeted to support cognitive function and soothe anxiety and agitation. Establishing a set routine is very important, as that brings comfort to many people with dementia.
[Read: What Is Life Like in Assisted Living?]
Can You Stay in Assisted Living With Dementia?
Whether you can continue living in an assisted living community after developing dementia depends on the services and supports the community can provide.
Some assisted living communities are equipped to care for individuals with dementia. Many assisted living communities have a dedicated memory care unit designed for people with cognitive impairments. But other assisted living communities aren’t equipped to care for someone with dementia, and in those cases, you would likely have to move to a specialized memory care facility.
If you’re considering moving a parent or other loved one with a dementia diagnosis into a particular facility, make sure it offers memory care services. If your loved one is likely to need that specialized support down the line, it’s best to select a facility that offers memory care even before it’s absolutely necessary.
Wandering and Safety: The Critical Differentiator
Because wandering is such a common feature of dementia, memory care facilities pay special attention to keeping residents safe on-site while allowing them space to roam as needed so they don’t feel trapped.
To do this, memory care facilities often employ specialized architectural features, such as:
— Circular hallways
— Secured courtyards
— Locked wards
— Keypad exits
— Alarms and security cameras
— Specialized therapy spaces to provide a safe place for wandering
— Bright lighting
— Wide, easy-to-navigate hallways
— Soothing colors and muted or no patterns on carpets or walls
— Sound-absorbing materials
While wandering is a natural part of dementia — and can help soothe an agitated resident — elopement (leaving the safety of the memory care facility) can be very dangerous. Therefore, memory care facilities take extra precautions to prevent elopement.
Do memory care residents have their own apartments?
A memory care resident could have their own apartment in certain communities.
Each community has its own physical structure and layout, and while it’s more common for memory care communities to be set up as dorm-like rooms — sometimes with two or more residents per room — there are some communities that provide an apartment-style living space for memory care residents.
In such settings, however, the apartment would not include any cooktops or other potential fire hazards.
[READ: Assisted Living Communities: Types of Rooms]
Cost of Memory Care vs. Assisted Living
Many people ask: Is memory care more expensive than assisted living? The short answer: Yes, there can be a significant cost difference between assisted living and memory care.
The national monthly median cost of an assisted living community is $6,200, or $74,400 annually, according to CareScout’s Cost of Care Survey.
Compare that to the median cost for memory care in the U.S.: $7,645 monthly, or more than $91,000 annually, according to U.S. News estimates.
As with any senior living situation, cost is highly variable and depends on a number of factors, ranging from services used and geographic location to amenities and size of the living space. However, memory care virtually always costs more than assisted living when all cost-influencing factors are taken into account.
Paying for memory care
There are many ways to pay for memory care, but people often turn to Medicaid and Medicare.
Medicaid
A number of states offer Medicaid waiver programs that use Medicaid money to pay for certain long-term care services, such as assisted living or memory care. The goal of these waivers is to help people qualify for support while living in more home-like, community settings rather than in nursing homes.
When Medicaid isn’t an option, residents or their families must often cover a large portion of these costs, depending on the specific diagnosis and care provided, explains Whitney Stidom, vice president of consumer enablement with eHealth Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California.
Medicare
Medicare covers some forms of inpatient and outpatient care, but there are limitations. For example, Medicare Part A covers hospital stays and skilled nursing care for up to 100 days after a qualifying hospital stay. It also covers an unlimited number of days of hospice care for eligible beneficiaries who have advanced dementia.
Meanwhile, Medicare Part B pays for visits to the doctor, tests to diagnose dementia, outpatient therapies and some preventive services, Stidom notes. This includes cognitive screening and more in-depth testing to diagnose dementia.
But neither Part A nor Part B covers room and board. Medicare also typically does not cover custodial care when a person with dementia is in a nursing home or assisted living facility unless skilled nursing care or therapy is required, she explains.
It can get complicated, so if your loved one is a Medicare beneficiary who needs memory care, it’s important to check what’s covered and understand what their financial liabilities will be when accessing care.
Who Should Choose Assisted Living vs. Memory Care?
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When to Transition From Assisted Living to Memory Care
Cognitive decline isn’t always a linear process, and your loved one may seem able to take care of themselves some days and not so much on others. This can make it tricky to determine the right time to transition from assisted living to memory care.
Keep an eye out for these signs that it may be time to upgrade their care:
— Your loved one starts needing more hands-on care from staff in assisted living.
— Your loved one often seems confused, fearful, uncomfortable or combative.
— Your loved one seems more forgetful, develops personality changes or begins having problems interacting with others.
— Your loved one’s needs aren’t being met appropriately by staff at the assisted living facility.
— Staff at the assisted living community recommend that your loved one move to a higher level of care.
Many families delay the move into memory care for a variety of reasons. But moving earlier is always preferable to waiting too long as you’ll have more time to take advantage of the services and amenities on offer.
Additional Resources
There are many resources available to help families and individuals with cognitive impairment. The following may help as you navigate caring for a parent or other loved one with dementia:
— Start by talking with your loved one’s health care provider. They can often point you in the right direction for community-based resources that are available to help you in supporting a loved one with dementia.
— You can also reach out to local aging-related organizations, such as your town’s senior center. USAging offers online tools to find your local agency.
— The Alzheimer’s Association has a network of local chapters you can search online.
— Government programs can be helpful to families with a dementia diagnosis. Contact the Social Security Administration to find out if your loved one qualifies for disability benefits. Your state’s Medicaid department may also be a resource for assistance.
— If your loved one or their spouse is or was a military veteran, contact your local Department of Veterans Affairs office for information about which programs they might be eligible for.
— Some seniors may also qualify for Indian Health Service programming that supports Native Americans and Alaska Natives.
— The Administration for Community Living provides an online Eldercare Locator that can help with your search.
More from U.S. News
What Is a Long-Term Care Facility? Types and Costs
10 Steps to Plan Ahead for Long-Term Care
7 Myths About Caregiving and Home Care Costs
Assisted Living vs. Memory Care: The Key Differences originally appeared on usnews.com
Update 04/13/26: This story was previously published at an earlier date and has been updated with new information.
