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

The right facility can improve safety and quality of life for a loved one

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If you have a family member or a loved one with Alzheimer’s disease or dementia, you may be considering memory care.

Memory care is a form of residential long-term care that provides intensive, specialized care for people with memory issues. Older adults with Alzheimer’s disease or dementia can benefit from the structured support and specialized 24-hour care offered by a residential memory care facility.

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Memory care is the fastest-growing sector of the senior housing market, with the number of units increasing by nearly 84 percent to 162,100 units from 2013 to 2023 , according to the National Investment Center for Seniors Housing & Care (NIC), a nonprofit that tracks trends in the industry. After a sharp decline in occupancy rates in 2020 due to the COVID-19 pandemic, occupancy has rebounded by 17 percent and is back to pre-pandemic levels, according to NIC’s 2023 figures.

However, many facilities have continued to struggle with staffing in the wake of the pandemic, and the quality of memory care units varies widely, says Megan Carnarius, a registered nurse and memory care consultant in the Denver area.

It’s important to visit and ask questions as you consider whether memory care is the right fit for your loved one.

Is your loved one ready for memory care?

Many people diagnosed with Alzheimer’s can live on their own during the early stages of the disease, especially if a family member or paid caregiver provides regular, in-home support. But there may come a time when your loved one needs more care than you feel you can provide at home. Here are some questions to help you determine if it’s the right time for a move.

  • Is the person with dementia becoming unsafe in their current home?
  • Is the health of the person with dementia or my health as a caregiver at risk?
  • Are the person’s care needs beyond my physical abilities? 
  • Am I becoming a stressed, irritable and impatient caregiver?
  • Am I neglecting work responsibilities, my family and myself?
  • Would the structure and social interaction at a care facility benefit the person with dementia?

Source: Alzheimer’s Association ​

What is memory care?

Memory care is designed to provide a safe, structured environment with set routines to lower stress for people with Alzheimer’s or dementia.

There are stand-alone facilities and many assisted living facilities, continuing care retirement communities and nursing homes have special memory care “neighborhoods” for dementia patients.

Activities at these facilities, for example art and music, are designed to improve cognitive function and engage residents at different stages of the disease.

Because people with dementia are prone to wander (6 in 10 do so, according to the Alzheimer’s Association), memory care facilities have alarmed doors, elevators that require a code and enclosed outdoor spaces to keep residents on site.

Many offer tracking bracelets that give residents the freedom to explore but still allow staff to monitor their location.

Benefits of memory care

Employees in memory care facilities are specially trained to deal with the unique issues that often arise as a result of dementia or Alzheimer’s.

Like staff in assisted living facilities, they provide meals and help residents with personal care tasks. But they also check in with residents frequently and provide extra structure and support to help them navigate their day.

“In regular assisted living, residents are expected to manage their own time; menus and mealtimes are posted, but staff is not checking in on them,” Carnarius says. “In memory care, the staff ensures residents are getting to meals, coming to activities and moving on to the next thing.”

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How to choose the right 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.

“Pay attention to the feeling you get when you walk into a place,” says Tina Sadarangani, a geriatric nurse practitioner and assistant professor at New York University School of Medicine.  

Other factors experts suggest you consider:

1.  What is the 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?

“Make sure people can live to their maximum potential,” Sadarangani says. “Some of the best places have gardens that people are tending. … They don’t serve people [with] plastic utensils on a tray. They have a kitchen that feels like a restaurant where people are served.”

2. How are the staff?

Ask about staff shortages at communities you visit and how much the facility relies on temporary agency employees. What are the staffing ratios, especially at night? How long has the manager been at the facility?

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 emerita 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.”

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3. What food and activities are offered?

Ask for a copy of the activity calendar. Does the facility offer activities that would keep your loved one engaged? Do they incorporate music, art and other activities in the programming? 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?”

4. What is the 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 $8,399 in the U.S., according to 2023 NIC statistics. That’s significantly more than the average monthly cost of assisted living of $6,694, but less than the estimated $12,240 monthly cost of a nursing home, according to NIC.

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 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 when 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.

Alternatives to memory care

If your family member has early dementia, you may want to consider home care as an alternative. It allows your loved one to stay in a familiar environment, and it is less expensive than memory care.

Most communities have adult day care programs that will provide activities and socialization during the day. You can then either hire caregivers or rely on family members to provide support at home.

“Evidence shows that people in [adult day care] programs maintain their cognition and function longer,” Sadarangani says.

As memory problems progress, however, it often becomes too physically and emotionally difficult to care for someone with dementia or Alzheimer’s disease at home. That’s when it is time to consider memory care or a nursing home.

Editor’s note: This article, originally published Oct. 21, 2019, has been updated with new information and statistics.

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