Learn how to evaluate memory care communities with tips from Seniorly. Ask the right questions and know what to look for on your memory care tours.
If you have a loved one who has been diagnosed with Alzheimer's disease or dementia, you may be considering looking into a memory care community. There are thousands of memory care communities across the United States, and you're likely to have a choice of several within your own hometown.
Finding the right community for your loved one takes a bit of research and legwork. Of course, you want to make the right choice. While your loved one's physician or your friends may have suggestions, don't rush your decision.
You can start with online research, but you'll quickly realize that you need to see the various memory care communities available to make a wise decision. After all, you wouldn't buy a home based on a few photos online.
The following will help you to evaluate memory care communities, along with a comprehensive list of questions to ask as you do your research and make your assessments.
Start with your online research to narrow down your options and make a short list of communities to visit. You should plan on visiting at least three memory care communities, and you may want to take a look at several more.
Once you visit your first memory care community, you'll see immediately how important it is to go in person. Your visits will give you a peek into what it would be like for your loved one to live in the community. Change and transitions are very hard for people with dementia. Making sure the community is a good fit for your senior is very important. Visiting memory care communities and asking detailed questions can minimize the possibility that you might have to move your loved one to a new place later.
Should you bring your loved one on the tour of the memory care community? That probably depends on the stage of the dementia and their fear of transition. If you sense that touring multiple memory care communities would be confusing or frightening to them, you may want to conduct your in-person research on your own.
The vibe of a memory care community can vary greatly depending on when you visit.
Each memory care community is unique, and you'll get a feeling for the personality of each place as you visit. Some key characteristics to look out for are:
As you tour prospective memory care communities, feel free to ask as many questions as you can think of on your tour. You may want to print off a list of questions or carry a list on your phone so you don't forget something important. Here are some valuable questions to get you started.
Are nurses on duty 24/7? If not, what medical staff are on duty during nighttime hours and weekends? Does the community have visiting physicians? How often do they visit? What other types of medical staff are regularly involved with the community (nurse practitioners, podiatrists, physical therapists, etc.)? How are the medical staff trained? Do they receive ongoing training? Do they receive specific training on dealing with residents with Alzheimer's disease and dementia? What is the policy for handling medical emergencies? What onsite medical services are provided? What types of care can your community NOT provide?
At some time in our lives, we're all likely to experience the important role that nurses and nursing staff play in patient health. For patients with memory care issues like dementia or Alzheimer's, this role is even more crucial. In fact, the role that nursing staff play in providing palliative care and spotting changes in health stats is critical for a patient's wellbeing. While touring, make sure to spend time talking to and understanding the credentials of the nursing staff.
Sometimes, Alzheimer's and dementia residents who have always been gentle and calm become unexpectedly aggressive, hostile, or disruptive. When you ask this question, think about it from both sides of the issue. If it's your loved one who becomes aggressive, what steps will the memory care community take to calm them down? Will psychotropic drugs be used? Will their freedom to move about the community be restricted? And think about the issue from the other point of view as well. If other residents become physically aggressive, what steps are taken to protect your loved one?
At times residents may wander or lose sight of where they are. Some questions to think about is does the facility have the doors locked in case your loved one wanders? Is the building standalone or is it attached to another? Are there outside grounds that your loved one can visit safely?
Some memory care communities offer therapy and treatment for specific types of memory loss, such as vascular dementia. They may offer treatment or accommodations for people with other disabling diseases or conditions, such as Parkinson's disease or blindness. If your loved one requires any such specialized care, make sure you ask specific questions about it. You can also ask what level of personal assistance can your loved one expect? Does the facility accommodate special care needs, such as diabetic care, mobility issues, physical aggressiveness, or wandering?
Food is a great source of enjoyment and comfort for just about everyone, so of course it makes a difference for those in a memory care community. Take a look at menus to see if your loved one will be happy with the food served. Can residents eat whenever and wherever they want, or must they come together in a dining hall at specified times? How frequently is the menu changed? Are there options at each meal, or does everyone eat the same thing? What accommodations are made for special diets (kosher, gluten-free, vegetarian, etc.?) What accommodations are made if a resident refuses to eat? What if a resident wants to eat outside standard mealtimes?
Familiarity makes a big difference in the happiness of dementia residents, so find out what lengths you can go to in making your loved one feel comfortable. Can they bring in their own furniture? Hang pictures on the walls? Use their own linens? Are they allowed to bring in a pet? If so, what restrictions are there on the size of the pet (and is there an extra charge?
Do residents have private bathrooms, or do they have to share bathrooms with other residents? Are there TVs in every room, and is cable or satellite service provided? Is there an emergency response system provided in each room?
AARP outlined the benefits that exercise offers for patients with memory care diagnoses. While exercise regimens may look different in a memory care community - for example dancing, chair-based programs or even working with a ball, you'll want to look for the daily programs that support movement.
Daily engagement is one of the most important pieces of programming that a memory care community can provide. This 2021 study illustrates that while building cognitive reserve (CR) is important to preventing Alzheimers and dementia, supporting CR is equally important to slowing the progression of the disease. While on your tour, look for activities like painting, coloring, working with puzzles, or listening to music, as the depth and breadth of this programming will be a litmus test for the quality of care.
Will you be allowed to take your loved one out for the afternoon if you choose? What's involved in arranging for such a visit? Is transportation available for medical appointments? Does anyone from the community accompany residents on these appointments? Are residents ever taken out of the community for other reasons, such as a slow walk around the neighborhood?
The Alzheimer's Association has put together a comprehensive guide to help families understand the stages of Alzheimer's , and the care plan developed for each resident should strongly correspond with the unique stage and experience of each resident. If the memory care staff don't give you an unequivocal answer, maybe it's time to move on to look at other communities. Once you hear the "Yes," don't drop the subject. Ask who puts together this plan. Are physicians involved? Nutritionists? Therapists?
If something should happen to your loved one you need to make sure what the facility is able to do for them. You might also want to find out what the discharge policy is and if your loved one can return to the facility should they require outside rehab. Another good question is what happens if your loved one is no longer ambulatory? Also, can a resident go into hospice in your facility?
Will the memory care community provide you with regular reports (oral or written) on your loved one? Will you have a single contact person who keeps you apprised of your loved one? Will the community contact you in case of emergency? What types of emergencies?
This may sound a bit abstract, but each memory care community's philosophy of care underlies every decision made affecting your loved one. If the philosophy of care stresses kindness and encouragement, you'll see it reflected in the attitudes and actions of the staff. If the philosophy of care is focused on schedules and checklists, you'll see a different set of behaviors from staff. Take a look at the written philosophy of care and ask questions to see if the community is living up to its ideals.
Does the memory care community celebrate a variety of holidays and events? Will the community be able to cook and provide cultural foods for your loved one? Maintaining a sense of familiarity, such as practices and beliefs associated with a cultural identity, will help your loved one adjust to -and feel more comfortable in- their new home at a memory care facility. To learn more about cultural competence in memory care communities, The Crisis Prevention Institute provides an overview of the advantages of personalized care for patients and cultural competence training for staff.
If you decide to tour assisted living, you can find more questions to ask here. Keep adding to your list and keep track of the answers you receive on your tour.
Once you're home from your tours of memory care communities, you have a lot to think about. Try to pick up some printed materials while you're there to help keep different communities straight in your mind. Pick up floor plans, brochures, and activity calendars to make it easy to remember what you saw at each community. In addition, taking photos as your tour can help you evaluate your experience.
Asking the right questions and considering the answers and your own observations carefully can help you make a wise decision when choosing a memory care community for your loved one.
Marlena del Hierro is Vice President of Partnerships and Seniorly’s Lead Gerontologist. Marlena earned her Master of Arts degree in Gerontology from San Francisco State University and her Bachelor of Arts degree in Human Development from California State University. She also serves in an advisory capacity for Jukebox Health. As Seniorly’s first employee, Marlena is a vocal advocate for evolving the aging paradigm, and is a frequent contributor to public discussions about aging. She has served as a resource for media outlets like WGBH, FOX News, CNBC and the Today Show.
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