What is Memory Care?

Memory Care in senior living refers to purpose built communities to care for seniors who have Alzheimer's disease or other forms of dementia. Often assisted living communities have special wings that are designed to help residents with memory issues. Residents living in memory care benefits from living in a structured environment that provides plenty of routines to help them feel secure and comfortable. The caregiver-to-resident staffing ratio of 1:6 is much higher in memory care than in assisted living, which typically has 1 staff member for every 15 residents.

If your loved one is having problems with forgetfulness and concentration, you may be wondering what to expect next. Alzheimer's disease and dementia residents go through a slow degenerative process that's typically quite slow, but the stages are predictable. The Reisberg Scale can help you understand where your loved one may be in this process so you can determine what type of care they may need.

The Reisberg Scale

Stage Symptoms Duration
No Decline No memory loss. No dementia. ---
Very Mild Normal forgetfulness linked to aging. ---
Mild Increased forgetfulness. Diminished work performance. Difficulty finding words. 7 years
Moderate Difficulty concentrating. Difficulty managing finances. Difficulty with complex tasks. Denial about symptoms. Difficulty in social situations. 2 years
Moderately Severe Significant memory deficiencies, including memory loss about current details like address or date. 2 years
Severe Assistance needed for daily tasks. Memory loss of recent events. Difficulty counting. Incontinence. Personality changes. Repetition of simple behaviors. Agitation. 2.5 years
Very Severe Loss of ability to speak. Assistance needed for all daily tasks, including eating. 2.5 years

Seniors who need memory care often require more attention than is typically available in an assisted living facility, and they also require extra measures to keep them safe. The well-trained staff in a memory care facility focus on slowing the progression of the Alzheimer's disease or dementia through games and exercises designed to stimulate the brain. They're also available around the clock to care for the unique needs of Alzheimer's and dementia residents, something that home caregivers often can't manage.

Often memory care is provided in a dedicated wing or section of an assisted living facility, making it easy for residents to transition if needed. Memory care facilities typically go out of their way to provide additional security, since Alzheimer's residents are prone to wandering. Understanding the unique needs of dementia residents can help you determine what services your loved one may need.

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Memory Care Services

Memory care facilities are often specially designed to help those with Alzheimer's and dementia feel comfortable and at home. The level of services provided often overlaps with similar services provided in an assisted living community.

Residents in memory care typically receive the following types of services:

  • All meals, either in their rooms or in a shared dining hall
  • Housekeeping services to keep their living space clean and safe
  • Social activities designed to stimulate their minds and keep them connected
  • Transportation to doctor's offices and other appointments
  • Comfortable rooms, which may be private or shared
  • All laundry services, including fresh linens
  • Exercise programs and physical therapy when needed
  • Cognitive therapy

In addition, memory care residents receive whatever help they need with activities of daily living (ADL), including:

  • Bathing
  • Grooming
  • Toileting
  • Dressing
  • Medication management

The supervised care provided to these seniors with progressive cognitive disorders is available 24/7 in a memory care facility. To prevent residents from wandering away, exits at these facilities are typically locked and alarmed so that everyone knows if one of the residents inadvertently tries to leave. In addition, the staff at a memory care facility are specially trained to handle the unique needs of Alzheimer's disease and dementia residents.

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Medical Care and Staffing

Most memory care facilities are staffed with registered nurses, licensed vocational nurses, and certified nurse assistants in numbers great enough to care for residents' needs and maintain resident safety. It's optimal if staff have been at the facility for a long time and work consistent shifts, since residents with Alzheimer's disease and dementia respond best to familiar faces.

Medical and non-medical staff in a memory care facility typically receive specialized training that helps them understand how to relate to residents who may have limited ability to communicate. Best practices in Alzheimer's and dementia care include training in the progressive symptoms of dementia and in understanding what seniors are trying to communicate through behavior when verbal communication abilities start to lag.

Part of medical care at an excellent memory care facility is the creation of a written plan for each resident's treatment. The facility's medical director, the attending physician and other medical staff are typically involved with the development of this plan, and family members also get to contribute to it. The written plan for your loved one should reflect their personal preferences and long-term interest, and it should provide as much freedom of choice is as possible and safe.

Among the issues covered in the written plan for any resident's medical care are typically:

  • A customized approach to expression of unmet needs
  • Minimal use of psychotropic medications
  • Flexible care based on the resident's personal sleeping and waking patterns
  • Provision of care for optimal physical functioning
  • Activities that promote quality of life and enjoyment
  • Meeting of all nutrition and hydration needs
  • Minimizing of any distress
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How Does Memory Care Differ From Assisted Living?

If your loved one has already been residing in an assisted living community, or if you're trying to decide which type of senior care would be most appropriate, then it's helpful to understand the differences between the two types of senior care. Although many assisted living communities incorporate memory care units in their facilities, there are some significant differences between them.

Both assisted living and memory care offer solutions for seniors who are no longer able to fully care for themselves. Both provide meals in a secure setting, and both offer assistance with the activities of daily living (ADL), such as grooming, bathing, and medication management. However, memory care units are designed to cater specifically to those with memory problems such as Alzheimer's disease and dementia, and they provide skilled nursing to help those residents.

Take a look at this chart that outlines some of the basics in the care provided in an assisted living community compared to that available in memory care.

Services Available in Assisted Living vs. Memory Care
Services Assisted Living Memory Care
Alzheimer's/Dementia Care Sometimes Yes
Diabetes Management Sometimes Sometimes
Housekeeping Yes Yes
Incontinence Care Sometimes Yes
Meals Provided Per Day 3 3
Medication Management Yes Yes
Mobility Assistance Sometimes Yes
Personal Care Yes Yes
Personal Laundry Yes Yes
Transportation Yes Yes
Wheelchairs Accepted Sometimes Yes

In addition, memory care facilities are often specially designed to minimize wandering. For example, many memory care facilities are centered around a circular hallway that's easy to navigate and that allows residents to stroll without ever becoming truly lost.

Memory care units provide a little extra security because of the tendency of those with Alzheimer's and dementia to wander. This often includes a landscaped yet secure outdoor area so residents can enjoy the sunshine and spend time outdoors while remaining safe.

Safety is paramount in other ways in memory care facilities. Toxic items, such as laundry detergent or shampoo, are kept locked up to prevent accidents. In some cases, residents wear bracelets keyed to sound an alarm if they open a door to leave the facility. As another safety precaution, memory care rooms or suites don't include kitchens.

Creating a relaxing environment is a major focus of memory care facilities, since residents with dementia are prone to stress and confusion. Facilities often feature lots of natural light and bright colors, and there are places for residents to gather among familiar faces. Some facilities feature sensory care and other innovative approaches to help residents stay as communicative as possible.

To encourage residents with Alzheimer's to eat, dining rooms often feature fish tanks, since studies show that watching fish swim stimulates the appetite. In addition, meals are designed to be appetizing to the eye as well as to the palate, with care taken to offer dishes that individual residents enjoy.

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Choosing a Memory Care Facility

When you're looking for a memory care facility for your loved one, you probably have a lot of questions. Sure, some of them will be about the costs of memory care — and we deal with that in our next article here. But that's not the only consideration as you're looking for just the right place.

You should feel very free to ask any question that comes to mind as you try to find the best care for your loved ones. Top-flight memory care facilities abound all over the country, and they never shy away from answering questions. To get you started, here are 10 questions you can ask prospective memory care facilities.

  1. What services and level of care does your memory care community offer? Are all of these services included in the basic monthly rate, or are some of them extra?
  2. What personal assistance do residents receive? How often do they receive it?
  3. How many meals are provided each day? What do you do if a resident doesn't want to eat? What personalization is available in meal plans? Can you accommodate special diets (gluten-free, kosher, etc.)?
  4. What special care do you provide for residents who wander? For residents who become physically aggressive? For residents who have mobility issues?
  5. Is it possible to take a resident out of the facility for a day trip or a weekend? What are your visitation rules?
  6. What happens if a resident requires a more intensive level of care than you typically provide?
  7. Are rooms private? Semi-private?
  8. What housekeeping, maintenance, and laundry/linen services do you provide? How often do you provide them?
  9. Do you offer exercise programs or equipment? What about physical therapy?
  10. What is the staff-to-resident ratio during the day? Does that change at night?
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A thought while you wait ...

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