Memory Care: Specialized Support for People With Alzheimer's or Dementia

Choosing a memory care facility

You can start the search at AARP and the Alzheimer's Association's Community Resource Finder, an online directory of senior care services. Click on "Housing Options," select a type of residence (for example, assisted living or continuing care retirement community) and enter your zip code; the results will include information on whether the facility provides memory care.

Once you've narrowed down your choices, experts recommend visiting each memory care residence on your list several times, including at least one unannounced visit in the evening, when staffing is thinner. Here are some factors to consider during your search.

Layout and physical environment

Is the facility clean and pleasant? Does it have circular hallways, so residents don't get frustrated by dead ends? Are rooms and doors clearly labeled (with words and pictures) to help residents find their way around? Is there an enclosed outdoor area with walking paths? Do residents seem happy?

Staff

The COVID-19 pandemic has left many long-term care facilities nationwide badly short-staffed. Ask about shortages at communities you visit and keep an eye on how staff members interact with residents: Are their needs met quickly? Is there a nurse who works in the building? What kind of dementia-specific training do employees receive?

“Ask how they manage a person who becomes aggressive,” suggests Laura Gitlin, dean of the College of Nursing and Health Professions at Drexel University and coauthor of the book Better Living With Dementia. “They shouldn't be relying on antipsychotic medications.”

COVID-19 policies

Long-term care facilities were particularly hard-hit by the pandemic, and many memory care patients struggled with isolation and loneliness during lockdowns. Studies show the social restrictions created a spike in mental health problems, agitation and severe behavioral disturbances among people with dementia.

“They couldn’t remember why they had to wear a mask or why they couldn’t see their family members, so of course that was upsetting,” Carnarius says.

When considering a center, ask what rules will go into effect if there’s an outbreak. Will visitation be allowed and in what form? How will the staff communicate with families? Which residents will be quarantined and what does that look like?

Food and activities

Does the facility offer activities that would keep your loved one engaged? What strategies does the staff use to encourage residents to eat? Carnarius recommends having at least one meal and participating in an activity at any residence you're considering.

“Watch to see how staff engages residents during the activities,” she says. “Do they seem to know residents personally?”

Availability of continuing care

Some assisted living memory care units can't provide complex medical care. Find out what health conditions or behaviors might require your loved one to leave or to be moved to a more expensive level of care within the facility.

Also ask if the facility accepts Medicaid. If not, your loved one may have to move when he or she runs out of money.

How much does memory care cost?

Not surprisingly, the higher level of care and supervision in a memory care unit comes at a price.

The average memory care monthly rent is $6,935 in the U.S., according to 2021 NIC statistics. That’s significantly more than assisted living, which averages $5,380 a month, but a lot less than the $10,562 average monthly cost of a nursing home.

Costs vary state to state and are affected by the level of care provided.

Medicare and Medicare Advantage plans generally will not pay for room and board or personal care in an assisted living facility, although they will pay for medical care the facility provides. Veterans benefits typically help cover the cost for eligible veterans and surviving spouses who are over age 65. Once your loved one no longer has any assets, Medicaid may offer some coverage for long-term care, but only if the facility accepts it.

Most families that utilize memory care have to pay out of their own pockets, says Richard Newman, an elder law attorney in Pennsylvania. Long-term care insurance, if your loved one purchased it previously, can be a big help, he says. Families might also sell off personal assets or tap the “living benefits” on a life insurance policy to help cover the cost.

If you think your loved one is going to need memory care, Newman recommends planning if possible. “There are ways to protect some assets and qualify for Medicaid, but it's complicated, so I would recommend talking to an elder law attorney,” he says.

Editor’s note: This article, published Oct. 21, 2019, has been updated with more recent data on the memory care market and the impact of COVID-19.