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What is the difference between a nursing home, assisted living and memory care facilities? I understand the nursing home and assisted living, but I didn't even know about memory care facilities.

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Laceysterror, hugs to you.

Why, should you have known about memory care facilities? I only ask because there is a tone in your question as though you think it some sort of dereliction of duty on the part of a functioning member of society not to have all this information at her fingers' ends. And it really isn't, is it. Happy are they who need never know, indeed.

But seeing as you do need to know, the important thing is that these terms, although they do have meaning, are not necessarily applied as they should be; and therefore when you are looking for the right choice of facility for your loved one(s) remember the label is only a guide.

Loosely speaking:

retirement communities are developments designed with elders' typical preferences and convenience in mind, usually with some sort of on-call assistance or concierge service, often with access to additional services.

Independent living: as above, but with more formal support in place and a wider range of communal services such as dining rooms and activities.

Assisted living: as above, but with the expectation that help will be needed by residents with a wider range of personal care and activities of daily living

Nursing home: comprehensive support with personal care and activities of daily living, in addition to nursing and medical services.

Rehab: nursing home with therapies and treatments aimed at recovery, so that the person can return to their previous preferred living style (aim, not necessarily outcome)

Memory care: secure assisted living environment, where staff should be trained in working with people with dementia.

The quality of dementia care and memory care facilities varies *enormously*. Some facilities are inspiring, brilliant, transform the prospects of people living with dementia. Some... aren't that great.

Further to complicate matters: there are communities that offer "stepped" care, also called continuing care. These are necessarily quite large facilities, offering for example quasi-independent mini-apartments through to full-on dementia care. The advantage of these is that they can accommodate couples with widely different needs; and a further advantage is that residents become known to the staff teams as individuals and can remain in a familiar setting, even as their care needs change and increase.

I hope this helps just as an introduction. If you'd like to say more about your own situation, perhaps we can help to narrow it down a bit?
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Laceysterror Jun 2019
Thank you for your response! My father is in a VA home but I just didn't know that there were other facilities with different names, that is why I was asking, just curious.
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These are very murky waters to navigate because in many cases the label has more to do with marketing than reality. Picture a sliding bar with 65+ communities, independent living, assisted living, memory care, nursing care; with each category increasingly encompassing many characteristics of those next to them on the scale.
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If you’re just beginning to research facilities in your area, one question to ask at the get-go is if they only accept residents who can walk. In my area in upstate NY both the AL and MC facilities we toured would only accept residents who could walk from their room to the dining room. My Mom was borderline at the time, only able to walk about 100 feet with her walker at the most, on a really good day. Wheelchairs were only allowed if the resident was normally mobile but was recovering from something and would walk again. We knew it would be a constant struggle for her, and we might be having to move her again soon due to that, so we had to find a nursing home instead. So if mobility is a concern for your Dad, you may want to ask that question in a phone call before bothering to schedule any tours.
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NYDaughterInLaw Jun 2019
I had no idea about the policies about walking. Thanks for sharing. It's helpful to know that I have another good reason for my FIL to downsize to a smaller apartment. His current apartment is very far from the elevators.
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In my area the biggest difference is MC is a locked facility with no cooking devices (even a coffee pot) allowed in the room, more supervision, and a staff trained to work with people with memory issues and dementia. The MC my father lived in would provide a insulated carafe of hot coffee for the residents who could safely handle one, but they strongly encouraged those residents to drink their hot coffee somewhere in the common room. As my father's Parkinson's caused his hands to shake more, the staff started using a cup with a lid so he couldn't spill the entire contents on himself. The assumption in MC is that most residents will require at least some assistance with a lot of ADLs. For example, your LO may be able to dress themselves if someone lays out all their clothes and tells them it's time to get dressed.

Since people in AL often have no or limited cognitive problems, the rooms/apartments often include a small kitchenette and does not require all meals be taken in the group dining room. Help is available as needed/requested and there is less supervision. Staff will interact with everyone on their medication schedule and the residents are usually required to show up in the dining room twice a day but if the resident still does their most of their own ADLs, they can pretty much just hang out in their room/apartment. I have an older cousin with diabetes and mobility problems who moved into an AL apartment about 4 months back and she says that other than scheduled interactions (medication, shower assist, housecleaning) she has as much privacy in her apartment as she had at home (although the neighbors coming knocking more). When she took a nap and didn't show up in the dining room for lunch, staff did come knocking at her door. Residents who need help with more ADLs will see the staff more often.
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Lacey, there are differences by state ( just to make it even more confusing!)

In most states, Memory Care places are regulated as a subset of Assisted Living facilities.

If you Google your states name and the type of facility you're looking for, you'll find the rules.

Each facility is different (we didnt know this at the start!)

Some Assisted Living facilities maintain an on site Memory Care unit within the same building. Some MCs have medical staff available, others not.
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