Considering a Memory Care Facility for Your Loved One

If you’re the caregiver or loved one of someone showing signs of memory loss, you may be wondering if it’s time to consider a memory care facility. It’s important to understand memory loss, its symptoms, and what memory care entails, so you can make the right choice for your loved one’s needs. In this guide, Dr. Abby Altman, a geropsychologist and senior mental health expert, will walk you through all of the important considerations. We’ll also provide you with additional resources so you can make an informed decision.

Expert Insights

From Geropsychologist Dr. Abby Altman, Ph.D

Memory care might not be for everyone and every family. However, I like to share with families considering this choice that moving a loved one with dementia to a memory care facility can be really positive. I have experienced this first hand with many families I have worked with, and as someone who has worked in memory care facilities, it’s often just what families and the person with dementia need.

Picture this. When visiting your mother, a senior who lives alone, you find out that she forgets to pay some of her bills. She left the oven on overnight, forgetting that she turned it on to cook dinner. Your mom misses appointments, sometimes neglects to take her medications, and has provided personal information to financial scams. You’re worried and spend more time checking in on her and her safety than ever before.

These are examples of probable memory and insight impairment, and your mom is showing difficulties managing daily life tasks independently. So what can be done if a loved one is experiencing these challenges? Finding a facility with memory care might be an option.

As we age, a few things happen to our brains that may be related to decreased blood flow. We know that some parts of our brain shrink, particularly the parts that are helpful for learning and multitasking. Communication between nerve cells (neurons) may not be as effective in certain areas as well. As a result, older adults may frequently complete tasks a bit more slowly or have forgetful moments, like not remembering a name or where they left their car keys. These experiences can be normal aspects of aging, but significant and ongoing struggles with memory may indicate something else.

Here are some experiences that are not part of normal, age-related memory loss:

• Increased frequency of forgetfulness
• Forgetting how to do things you’ve done many times before
• Difficulty communicating or finding words
• Repeating phrases or stories within the same conversation
• Difficulty planning, organizing, or handling complex tasks
• Not being able to keep track of what happens within a day
• Forgetting dates (specifically, the day of the week)
• Confusion, fatigue, and disorientation
• Difficulty reasoning or problem-solving
• Confusion that consistently occurs in the late afternoon and lasts into the night (also called sundowning)

The above experiences and the term “memory loss” are usually associated with Alzheimer’s disease. Alzheimer’s disease is the most common and well-known dementia that impacts memory, currently affecting more than 6.5 million Americans.2 The broader medical or clinical term for “memory loss” is dementia. Dementia is an umbrella term for loss of memory, language, problem-solving, and other cognitive abilities, severe enough to interfere with day-to-day life and living independently. Personality and behavior changes are also common symptoms. Abnormal brain changes cause diseases and disorders grouped under the general term “dementia,” and Alzheimer's disease is the most common form, accounting for 60 to 80 percent of all cases.4

Other diseases that fall under the category of dementia include:

• Vascular dementia
• Frontotemporal dementia
• Mixed dementia
• Lewy body dementia
• Parkinson's disease dementia
• Huntington’s disease
• Korsakoff syndrome
• Normal pressure hydrocephalus
• Creutzfeldt-Jakob disease (CJD)
• Posterior cortical atrophy

Unfortunately, there is no cure for Alzheimer’s disease and most other dementias, but there are care options. If you or your loved one suspects a memory problem, contact a medical professional for an evaluation.

Dementia's impact can be measured by the ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs). For any dementia diagnosis, including Alzheimer’s, memory struggles and other symptoms need to be profound enough to impair someone’s ability to accomplish IADLs.

Instrumental activities of daily living are tasks that allow an individual to live independently in a community. IADLs include:

• Communicating by telephone
• Cooking or preparing meals
• Housekeeping (cleaning and maintenance)
• Taking and managing medications
• Managing technology
• Managing finances
• Shopping
• Transportation/navigation

When cognitive changes like short-term memory loss or language difficulties occur, a diagnosis typically remains as Mild Neurocognitive Disorder (also known as Mild Cognitive Impairment, or MCI) until there are noticeable effects on independent daily functioning (IADLS). Only then can it be officially diagnosed as dementia, even if biomarker tests suggest a higher likelihood of dementia.

In my experience, for changes in IADLs, families often describe loved ones skipping steps in recipes, using incorrect ingredients, missing bill payments they once managed effortlessly, and/or getting lost while driving or forgetting familiar routes. The added stress of these tasks, including newer challenges like managing emails and virtual visits, can be quite overwhelming. If you suspect that IADLs are impacted, consider following up with your loved one’s medical provider or obtain new or additional neuropsychological testing to clarify impairment and a possible dementia diagnosis.

IADL deficits can be addressed with family support, additional structure, or oversight from caregiving service providers. For instance, meal delivery could help someone struggling to cook or use appliances safely. House cleaners can come to the home. VNAs or other services can offer regular medication check visits. Ride services can be scheduled for appointment transportation. Family or money managers can assist with finances.

As you can see, there are plenty of options. ADL deficits, however, are different since they require more hands-on care. Activities of daily living are tasks necessary for basic functioning and even survival, often related to health, safety, and independent living at home, including:

Activities of daily living are tasks necessary for basic functioning and even survival, often related to health, safety, and independent living at home, including:

• Getting dressed
• Eating
• Toileting (continence/going to the bathroom)
• Continence
• Personal Hygiene and Grooming (managing hair, nails, brushing teeth)
• Ambulating (rising from a chair or bed and moving from room to room)

At first, individuals with dementia might be able to live at home with help from family, in-home care providers, and community support (e.g., senior centers) and/or adult day care. But as dementia progresses and the patient’s needs grow, loved ones and other unpaid caregivers may become exhausted; we can only be superhuman for so long. During this progression to the need for 24-hour care, family and caregivers may consider memory care for their loved one.

Memory care is a type of senior living with more intensive services for people with cognitive impairments. Depending on need, residents are offered structure and oversight or hands-on care with daily life tasks. Many skilled nursing homes and assisted living facilities have special memory care divisions or special care units (SCUs), with residents moving to increased supervision as needed. There are also standalone memory care facilities.

The typical memory care patient shows symptoms of dementia, including Alzheimer’s disease. Other memory care patients may have cognitive challenges resulting from traumatic brain injury (TBI), stroke, Parkinson's disease, and other causes. Generally, individuals in memory care need help with IADLs and will eventually need help with ADLs.

Memory care centers ensure that residents will not wander away; exits are carefully monitored and are often alarmed. Employees and visiting specialists facilitate daily social events and therapeutic activities to promote community and resident well-being. They provide meals, health care, and personal care. A standard rundown of memory care services includes:

• A private or semi-private room
• 24-hour personal assistance
• Three daily meals
• Medication management
• Cognitive and physical therapies
• Exercise activities
• Social activities
• Housekeeping and laundry

Friends, family, or medical professionals may have recommendations for assisted living, skilled nursing facilities, or memory care facilities. Many facilities are open for tours, and some even offer short stays as a trial visit.

Expert Insights

From Geropsychologist Dr. Abby Altman, Ph.D

[At a memory care facility] your loved one gets expert care around the clock, which takes a huge load off everyone’s shoulders. The staff knows exactly how to help and keep them engaged with activities and socialization so they stay happier and healthier (this seems to help with the ongoing burden of “how do I keep them busy and engaged with others?”). Plus, families get some peace of mind and seem to enjoy their visits more without all the worry and stress of daily caregiving.

Socialization, Exercise, Intellectual and Sensory Stimulation, and Memory Care

Assisted living, skilled nursing, and standalone memory care facilities often have activities focused on non-pharmaceutical interventions beneficial for brain health and dementia.
Some activities may include:

• Games and trivia
• Exercise
• Baking
• Music therapy
• Pet appreciation
• Local field trips
• Reminiscing
• Nature programs

Physical exercise, intellectual stimulation, and social interaction have been supported in research as key for brain health.4 They can also individually and cooperatively play an essential role in dementia evolution and management. Such activities have also been shown to slow disease progression5 and agitation in those with dementia.6 A benefit of a residential or memory care community is easy access to these types of activities.

In memory care facilities, incorporating activities rooted in routine and reminiscence, often inspired by Montessori techniques, can profoundly benefit residents and their families. These activities provide a sense of structure and familiarity, which is comforting for individuals with dementia. They also stimulate memories and encourage engagement, fostering moments of joy and connection between residents and their loved ones. When considering a move into a memory care facility, sharing unique details about your loved one’s life (often referred to as a “life review”)—such as favorite songs, talents, jobs, and love stories—can personalize their care experience.

Expert Insights

From Geropsychologist Dr. Abby Altman, Ph.D

Reflecting on my time working in nursing homes, I cherished moments like organizing mail and possibly mail delivery routes for former postal workers, creating personalized eye charts for retired optometrists, and curating libraries for former teachers. By tapping into past experiences and personal interests, these activities help maintain cognitive abilities, provide a sense of purpose and control, and enrich the quality of life for everyone involved in the caregiving journey.

Some memory care facilities have Snoezelen Rooms (a combination of the Dutch words “dose” and “sniff”). These rooms, created by Dutch psychologists in the 1970s, are controlled environments that residents might find relaxing, comforting, and safe. They are often designed with soothing colors, relaxing sounds, aromatherapy, and comfortable chairs and blankets.

If you’re wondering whether a loved one could benefit from a facility with memory care, consider these questions:

• Have they gotten lost in previously familiar territory, as when taking a walk in their neighborhood or running errands?
• Can your loved one state their phone number and address in case they need help returning home?
• Does the person forget to lock their doors, making themselves vulnerable to crime?
• Have they forgotten to turn off a stove or other potentially dangerous appliances?
• In the event of a fire, do you believe they would handle the situation safely?
• Has your loved one’s level of personal care declined? For example, are they “not themselves” in terms of bathing, dressing, or eating?
• Are they taking medications as scheduled? Are you confident they’ll take the correct dosages?
• Have they become uncharacteristically suspicious or fearful of others?
• As a caregiver, are you risking your own health? Are your caregiving duties interfering too much with your other responsibilities?
• Could your family pay for the amount of skilled in-home care or adult day care required? A limited amount of respite care could be available for free or at a low cost. If extensive help is needed, though, a residential or memory care facility could be more affordable.

If your answers to these questions have changed in recent years or you’re concerned that your loved one may be experiencing memory loss, it might be useful to speak with your loved one’s doctor about memory care. Luckily, there are many different options for memory care today, so you can find one that’s right for you and your loved one’s needs, lifestyle, and budget.