The Alzheimer’s Association (Alz.org) reports that over 5 million Americans are living with Alzheimer’s disease and related dementias. Further, this number is projected to triple by the year 2060. 

Due to the degenerative stages of Alzheimer’s disease and other dementias, continued care typically transitions from family support to a more appropriate live-in setting where professional, specialized care is provided.

When you start to contemplate residential memory care for your loved one, you’ll have more questions than answers.  But rest assured that there are many resources available to guide you through the process to help find the right care for your loved one.

The purpose of this article is to explore the topic of long-term memory care, with information to help you make decisions and move forward in your search.

First, let’s start with the obvious question:

1.  What is Memory Care?

Memory care is a type of senior living service that specializes in the long-term care of seniors who have memory loss due to Alzheimer’s disease or other forms of dementia. This service is provided by trained caretakers in residential homes, but is more often provided in stand-alone memory care residences or dedicated memory care and dementia special care units of senior homes or assisted living communities.

Cognitively impaired patients have unique daily needs, such as enhanced security, personal care, medication management and memory support therapy, which requires a specialized environment and assistance from a trained professional staff. There can also be behavioral problems related to aggression that memory care homes can address.

Similar to the living arrangements in assisted living communities, memory care residents typically reside in private apartment-type rooms that include private baths. Most communities provide three daily meals and offer additional services as needed, such as laundry and housekeeping. 

The goal of many communities is to support a comprehensive way of life with targeted therapy and planned activities for dementia patients that focus on socialization and relaxation in a safe, nurturing environment.

Key Point #1: Memory care is a type of senior living service that specializes in the long-term care of seniors who have memory loss due to Alzheimer’s disease or other forms of cognitive decline, most often provided in a residential setting in a dedicated memory care or dementia special care unit of a senior assisted living community

2.  When Is It Time to Place a Loved One in Memory Care?

Although a diagnosis of Alzheimer’s disease or dementia is heart-breaking for family members, your loved one may initially live semi-independently at home with guided help from nonprofessional caregivers like family or friends. 

However, due to the progressive stages of dementia-related conditions, it’s important for caregivers to be aware of and recognize signs that their loved one will benefit from professional, attentive care. During this time, it helps to start looking for the right memory care facility before it’s needed while you prepare emotionally, physically and financially to arrive at your decision.

A good relationship with your loved one’s doctor helps to foster open and honest dialogues about the status of your loved one’s condition and ongoing care. Keep a journal of your observations and share your notes during doctor visits.

Key Point # 2: Some common indicators that moving into a live-in memory care community will help your loved one include:

• Caregiver burnout
• Wandering and safety concerns
• Increased agitation or anger (personality changes)
• Personal care and hygiene issues
• Decline in overall health (weight changes, posture, mobility)
• Isolation or limited social engagement with others

3.  What Does Live-In Memory Care Cost?

Many of the services that are provided to residents in assisted living are also offered to those in memory care. However, specialized care by a more highly-trained staff (with a higher staff-to-patient ratio) is the primary factor that impacts memory care’s higher rates. In addition, the added security and supervision, ongoing licensed healthcare services and environmental enhancements contribute to a higher cost.

Rates vary by state and community, but memory care rates are generally 20 to 30% higher than local assisted living monthly rental rates. Average memory care costs range from $2700 to $6000 per month, depending upon your location and services provided.

An assessment of your loved one will identify specific services that he or she will need, and is added to the base monthly rate. Personal care, like help with toileting, bathing or dressing must be funded out-of-pocket because those services are not covered by Medicare.

Anticipate additional one-time fees like application, admission or housing preparation fees which vary by community. To get a general idea of monthly care costs in your area, refer to the Genworth Cost of Care Survey, an annual survey of median costs for long term senior care.

Key Point #3: Average memory care costs range from $2700 to $6000 per month based on your location and exact services provided. 

4.  What is Done to Keep My Loved One Safe in Memory Care?

The Alzheimer’s Association notes symptomatic changes in sense of time and place, judgement, behavior, senses and physical ability that precipitate common safety risks for those with dementia. Due to these physical and cognitive changes caused by dementia, additional safety precautions are needed for residents in memory care.

Wandering and the chance of getting lost is the primary safety risk of a loved one living with dementia. On average, six out of ten memory care residents will exhibit wandering behavior. It’s imperative that memory care centers have security in place (like tracking bracelets) to keep residents from getting in harm’s way. When touring, be sure to ask about the center’s security protocol for entering and exiting the building.

Look for and ask about other safety mitigation strategies such as managing medications, clearing tripping hazards, added bathroom grab bars, water temperature controls and well-lit walkways. Safety precautions should be in place, but shouldn’t suppress residents’ independence and opportunity for social interaction.

Aggression and anger are common behaviors of those with Alzheimer’s or other dementias. Appropriately staffed personnel should be professionally trained in managing aggression in dementia residents to protect other residents (as well as themselves) from verbal or physical harm. Planned positive distractions (more on this in a bit) such as planned activities help reduce agitation and potentially aggressive incidents.

Key Point #4: Additional safety precautions are needed for residents in memory care, For example, enhanced enter and exit security, but it shouldn’t suppress residents’ independence and opportunity for social interaction.

5.  What is a Good Staff-to-Resident Ratio in a Memory Care Community?

According to Dementia Care Central, the larger residential memory care communities house less than 100 people (more than 100 is rare). Smaller communities have less than 10 residents, while medium-sized communities house 11 to 25 people. In assessing a memory care community, consider the comfort level of your loved one around others in regard to the number of residents.

Most important for memory care is the community’s staff-to-patient ratio.  Although there are no national guidelines, the ideal sufficient ratio for memory care units is considered to be one staff member to every five patients, where a 1 to 6 ratio is acceptable and common. (There may be specific regulations in place for your particular state.)

Key Point #5: A good staff-to-resident ratio in a memory care community is five or six-to-one.

6.  What Are the Training Standards for Memory Care Staff? 

Licensing and operation of memory care centers is regulated by each individual state, with requirements for dementia-related training of direct care staff members. However, the amount of required annual training varies significantly by state. (A 2015 Justice in Aging report noted that six states and Puerto Rico do not have dementia training curriculum requirements in place.)

The direct care skilled nursing staff and direct service staff (and their managers) should be trained specifically in effective therapy methods and treatments (pharmacological and behavioral intervention) for cognitively impaired patients.  In addition, continuing education should be encouraged to stay up-to-date on dementia-related care best practices.

Especially diligent communities who provide quality care follow a policy that supports annual dementia-related training for all staff members, including those that have incidental contact with residents, like housekeepers.  Continued training and awareness of securing cleaning agents and effective communication techniques, for example, demonstrates a commitment to its residents’ well-being and safety.     

Key Point #6: Especially diligent communities who provide quality care follow a policy that supports annual dementia-related training for all staff members.

7.  How Do the Physical Accommodations Help Memory Care Patients?

A 2003 study of the relationship between the physical environments of Alzheimer’s special care units and their residents’ behavior found direct associations between particular design features and certain behavioral health measures (like verbal agitation or aggressive behavior), suggesting that environment plays a role in the management of Alzheimer’s symptoms.

Findings of similar studies have impacted the design of memory care units to better support the residents’ emotional and physical needs. To limit overwhelm and confusion and minimize overstimulation, newer designs focus on grouping a smaller number of residents together. “Households”, as they’re called, are living areas that group a smaller number of private bedrooms with their adjoining common areas, including a kitchen and dining area.  Exteriors of newer memory care facilities have a residential presentation instead of a clinical appearance.

Other design recommendations for memory care units include:

• Clear sightlines and nighttime lighting from bedroom to bathroom
• Distinct spaces and landmarks to help with orientation
• Areas for family visitation and involvement
• Private, quiet spaces
• Views of the outdoors
• Unrestricted access to secure outdoor spaces
• Special consideration for secure entry and egress
• Slip resistant flooring
• Glare-free, residential-style lighting

The ideal physical environment in memory care maintains the autonomy of each resident, while providing a safe, stress-free home-like setting that supports their general well-being and social opportunities.

Key Point #7: Thoughtful, planned design elements of memory care units will contribute to the well-being of its residents. For example, good views of the outdoors while still being a secure area. 

8.  What Does a “Day in the Life” of a Memory Care Resident Entail?  

The optimal approach for care of cognitively impaired individuals is to take a person-centered perspective, which focuses on maximizing the quality of life for the resident. With that in mind, a typical “day in the life” of a memory care resident varies, depending on his or her individual needs.

However, there are commonalities. Memory care residents typically benefit from a rigid schedule, which avoids confusion or irritation caused by a change in routine. For example, mealtimes, exercise sessions, and preparation for bedtime are scheduled consistently in order to maintain the predictability of an activity.

Based on regular and thorough needs assessments of each resident, individualized care includes appropriate management of dementia-related symptoms and other physical conditions. Complete care differs among residents, but include combinations of prescribed medications, physical therapy, alternative intervention therapies (like music therapy or aromatherapy), and assistance with activities of daily life (ADLs). Opportunities for social interaction and other creative and meaningful activities provide healthy positive distractions like singing, cooking or crafting that help defuse dementia-related stress and agitation.

Key Point #8: Memory care residents typically benefit from a rigid schedule for their activities such as meal times, exercise schedules, and bedtime routines which are individualized based on their cognitive, physical and social needs.

9.  What Support is Provided for Families of a Memory Care Resident?

Families with cognitively impaired loved ones often feel a range of emotions from guilt to stress and isolation. There are a variety of support groups specifically organized to help caregivers and family members find peace and a better quality of life for their loved one.  

Memory care centers commonly host private support groups for the families of their residents. Members benefit from open dialog and educational opportunities when staff or memory care experts discuss topics related to their loved one’s care. These groups also foster a supportive community among residents’ family members, providing an often-needed sense of belonging and empowerment. 

Beyond the center’s support group, there are many dementia care-related private Facebook groups or other online support groups.  Specifically, the Alzheimer’s Association recognizes that their expertise provided through in-person or online support groups can benefit caregivers and families affected by Alzheimer’s or another dementia.

Key Point #9: Memory care centers commonly host private support groups for the families of their residents.

10. What Can I Do to Help My Parent or Spouse Transition to Memory Care?

First of all, recognize that the transition will be challenging for both you and your parent. Take care of yourself physically and mentally. Your initial emotions of the transition will pass, and you will adjust as time passes.

Your practical experience with his schedule and habits and knowledge of his hobbies and interests are valuable pieces of information to share with the direct care staff. A comforting perspective is to realize that you’re handing over his care to experts, and that he’s in excellent hands.

Experts advise not to discuss the move with your loved one, but to visit the community with him prior to his move-in day for a “soft” introduction. Discreetly pack a limited amount of clothing and a few items that are familiar to him, then move him into the community at his best time of the day. Called “compassionate deception”, tell him the stay is only for a week, then stretch it to two and three until he’s fully adjusted.

After he’s moved in, balance your desire to visit with the need for him to adjust to his new routine and surroundings. It’s ultimately the best change for both of you!

Key Point #10:  Ease your loved one’s transition to live-in memory care by sharing their schedule, habits and a list of their hobbies and interests with the direct care staff.

Memory Care: Key Points for Families to Know

The decision to move your loved one to a memory care community shouldn’t be taken lightly. Ideally, educate yourself, research your options, tour communities and decide on the most appropriate memory care community for her.

You already have a start with these key points for families to know about Memory Care:

Top 10 Takeaways:  Things to Know About Memory Care

1. Memory care is a type of senior living service that specializes in the long-term care of seniors who have memory loss due to Alzheimer’s disease or other forms of cognitive decline, most often provided in a residential setting in a dedicated memory care or dementia special care unit of a senior assisted living community.

2. Common reasons to place a loved on in memory care include:

• Caregiver burnout
• Wandering and safety concerns
• Increased agitation or anger (personality changes)
• Personal care and hygiene issues
• Decline in overall health (weight changes, posture, mobility)

3. Average memory care costs range from $2700 to $6000 per month.

4. Additional safety precautions are needed for residents in memory care, For example, enhanced enter and exit security, but it shouldn’t suppress residents’ independence and opportunity for social interaction.

5. A good staff-to-resident ratio in a memory care community is five or six-to-one.

6. Especially diligent communities who provide quality care follow a policy that supports annual dementia-related training for all staff members. 

7. Thoughtful, planned design elements of memory care units will contribute to the well-being of its residents. For example, good views of the outdoors while still being a secure area. 

8.  Memory care residents typically benefit from a rigid schedule for their activities such as meal times, exercise schedules, and bedtime routines which are individualized based on their cognitive, physical and social needs.

9. Memory care centers commonly host private support groups for the families of their residents.

10. Ease your loved one’s transition to live-in memory care by sharing their schedule, habits and a list of their hobbies and interests with the direct care staff.