What is Memory Care?
Time moves in one direction, memory in another—William Gibson
We typically associate old age with the fragility of the physical body: the wrinkling of skin, arthritis in the joints and failing eyesight. Even the mind shows its age with bouts of forgetfulness, whether it is forgetting where glasses were laid or an anniversary date. But what happens when the mind ages in a way that disrupts a person’s personality or memories?
These are the heartbreaking effects of Alzheimer’s or dementia. While it’s easy to prescribe stronger reading classes or medication for arthritis, healing a mind with Alzheimer’s or dementia isn’t possible, leaving families little choice but to adapt to their loved one’s condition.
If, after reading this article, you would like to find out more about memory care communities, or you need to discover a community that may be right for you or your loved one, please give us a call. Our dedicated team will help you find the right community, in the right location, with the right services and at the right price—all for free.
The basics of memory care
Alzheimer’s and dementia are two of the common memory-loss conditions included under the umbrella of memory care. This specialized care spans a spectrum of services depending upon the severity of symptoms exhibited by an individual—from cueing to requiring a secured setting to prevent elopement.
Memory care goes beyond what is traditionally offered in an assisted living setting. Housekeeping, laundry and meal preparation services are provided but the level of assistance with activities of daily living is increased. Often the daily activities are designed specially to allow the individual to reconnect with favorite hobbies or interests.
In recognition of the unique care challenges that Alzheimer’s and dementia pose, communities may only provide memory care, or in the cases of a continuing care community, have a neighborhood solely for residents requiring memory care. Often these communities incorporate design elements that research has shown to lower stress in individuals with Alzheimer’s or dementia. These elements include increased natural lighting, memory boxes outside the room and a circular neighborhood design that allows for safe wandering. Because an estimated six in 10 people with Alzheimer’s will wander, communities are designed to minimize the risk of elopement, whether employing security alarms on doors or performing more frequent safety checks.
Demographics of memory care communities
While there is data available for the demographics of assisted living and nursing homes, the same is not available for memory care communities. The Alzheimer’s Association reports that in 2014, an estimated 5.2 million Americans had Alzheimer’s. Five million of these individuals were 65 or older, and women compose most of these cases with 3.2 million compared to 1.8 million men.
The amenities found at a memory care community may not be as glamorous as those found in an independent living or assisted living community, such as an ice cream parlor or indoor swimming pool, but that is by design rather than oversight. Because research has shown that seniors with Alzheimer’s and dementia can become easily stressed and disoriented, communities are designed to create a relaxing setting.
Communities typically have a secured courtyard that allows residents the opportunity to walk outside or garden without the risk of elopement. Gathering places, such as a TV lounge or library, are also common features. To create a more intimate setting for residents, a memory care community may even be designed around a neighborhood setting, with apartments clustered around shared common areas. Hallways are likely brightly colored, in a variety of colors, to assist residents in finding their way.
Apartment suites are typically available in private or companion options, with some communities offering a one-bedroom apartment floor plan. These suites won’t have the kitchenettes found in assisted living apartments and the amenities are minimal—again, in the effort to reduce stress. To assist in way finding, many communities will place a memory box filled with mementos from the resident’s life outside each apartment.
Dining rooms typically feature family-style dining so residents can gather together for mealtimes. Some memory care providers, such as Autumn Leaves, specially design menus that address the lack of appetite that can accompany Alzheimer’s and dementia. Their dining rooms feature a tropical fish tank, as studies have shown that watching fish can increase appetites, and attention is placed on creating a contrast between the food’s color and the plate so residents can better see the food.
Activities are specially designed around a resident’s past interests so residents may reconnect with their memories; art classes, music and games are usually offered, along with exercise classes. Some communities may also provide escorted outings.
Services offered at memory communities
At a memory care community, staff handle all the responsibilities of life—from housekeeping and laundry to meal preparation and transportation. Assistance with activities of daily living is also a standard service offering.
Advanced healthcare services, such as skilled nursing services, are typically not offered unless the community is part of a larger campus.
The costs of memory care
Because Alzheimer’s and dementia requires a higher level of care, memory care costs are higher than those of assisted living. While the cost assisted living and nursing care have been calculated for each state, the same has not been done for memory care.
In 2012, SeniorHomes.com conducted a cost survey of all communities on our website that offer memory care. Below is a table outlining the monthly rental costs for memory care communities in selected states:
|State||Monthly Average||Monthly Minimum||Monthly Maximum|
The monthly rate for most communities includes the cost of rent and services; utilities may also be included with cable TV and phone often extra. A one-time community fee is standard, and there may also be an assessment fee. How care costs are calculated varies by community. Some communities may offer different care packages, ranging from minimal cueing to hands-on assistance, which allows families to select the care level which meets their loved one’s needs. Other communities assign care points to the level of support a resident requires and charge a fixed amount per care point, in addition to the monthly fee.
How to select a memory care community and what to expect during the assessment process
Given the high costs associated with memory care, some families may seek the less expensive alternative of an assisted living community to care for their loved one. The good news is that more assisted living communities are offering “memory care light” for those who don’t exhibit wandering or require an enhance environment. For those seniors who exhibit wandering or require constant attention, a memory care community is the best option.
However, if may be difficult to find a community, especially in rural areas, that offers memory care. Of the senior living providers that offer memory care services, the National Study of Long-Term Care Providers, 2012 found that only 26 percent serve residents with dementia or have a portion of the community designated as providing dementia care. Some companies, such as Silverado or Autumn Leaves, only provide memory care at their communities while others offer this care type along with assisted living.
Figure 1. Selected characteristics among residential care communities, by community bed size: United States, 2012
Courtesy of NCHS Data Brief Number 170, November 2014. Operating Characteristics of Residential Care Communities, by Community Bed Size: United States, 2012.
With the larger communities being those that primarily offer memory care, you may be reluctant to have your loved one join, as he/she might not receive one-on-one care or be overwhelmed by being surrounded by many people. However, many memory care communities are designed around a neighborhood-style setting, where common areas are duplicated throughout the community. This allows residents to have a homelike atmosphere within a larger setting.
Once you have identified a community, your loved one will be assessed to determine whether they are a good fit for the community, i.e. whether the community can provide the type of care they require. Depending upon the community’s assessment policy, a nurse may visit your home to assess your loved one. It is important to be honest about your loved one’s behavior, whether he/she wanders or has difficulty walking, so the nurse can develop a care plan that thoroughly addresses all his/her care needs.
Finding inspection records on memory care communities
Unless services, such as medication management and assistance with activities of daily living, are provided by a third-party home care agency, most memory care communities are licensed and inspected by a state agency charged with oversight of long-term care facilities. These inspection records are available from each state, either online or through a public records request. If the memory care community is part of a larger campus, the community might be listed in a directory search by its name rather than the campus name. For example, if the community is called The Pines, the memory care community might be called The Terraces at The Pines.
Most states also require communities to post or make available their most recent inspection results upon request. By viewing several years’ worth of records, you can see if there are patterns of failing to follow procedure, and whether the violations are life-threatening or minor.
Touring a memory care community
It is also important to visit the community to see if it is a good fit for your loved one. Touring a community at different times is recommended, as this way you can view residents and staff throughout the day, rather than just at lunch or during activities. And because touring can be overwhelming at first, bring a checklist with you to note certain features. Also, make sure to use all of your senses to study the community. If you smell urine or see the building is in need of repair, it could be a red flag.
Be sure to ask whether staff are certified or received training in memory care because this ensures that your loved one will be care for by staff who understand how Alzheimer’s or dementia affects the mind and body. Also ask if the community has a specialized memory care program. Because of the unique caring challenges that Alzheimer’s and dementia pose, some communities developed unique memory care programming, such as the Clare Bridge Program by Brookdale or Life Guidance at Atria, that guides how residents are cared for to ensure every aspect of their lives is properly handled—from physical well-being to being nurtured spiritually.
Moving your loved one to the community and life after move in
Once you have selected a community, you may dread the trauma that the transition will cause. However, there are a number of steps you can take to make the moving process less traumatic. Of these steps, establishing and sticking to a story is the most important. This could be as simple as telling your mother, “Your father is visiting a family friend.” Having your loved one’s room already decorated will also help with the transition and reduce the stress of moving. Some communities may also assist in escorting your loved one to the community.
After the move, your loved one may not readily take to community life and ask to leave. In these situations, be prepared to have a story as to why he/she cannot come home, such as the house is being repaired. Eventually, your loved one will settle into a routine and accept the community as home.
Written by SeniorHomes.com’s Andrea Watts.