By Sandy Morris
Most assisted living communities will accommodate residents with mild memory impairment. According to the Alzheimer's Association, approximately half of all elderly assisted living residents have Alzheimer’s disease or other dementias. Many assisted living residents with these conditions do not have a formal diagnosis, and family members or assisted living staff members need to be attentive to the residents' changing needs.
If your loved one is already in assisted living and you’re concerned about their safety because of cognitive impairment, it’s almost certain that staff are also aware, and possibly considering more enhanced care options. When assisted living is no longer the best option for your loved one’s care, it may be time to consider memory care that’s better tailored to your loved one’s needs.
If your loved one lives at home with you, you may have noticed signs that they have significant memory loss that may cause them to be a danger to themselves or others. In some instances, home health care is an option. Sometimes, however, it becomes necessary to find a secure care environment that specializes in providing for the physical, social, emotional and spiritual needs of memory-impaired residents.
Memory care is a specialized type of elder care specifically for the needs of seniors with Alzheimer's or other forms of dementia. A memory care unit offers an individualized approach to dementia care that caters to the needs of each resident within a safe, structured environment staffed by those who are specially trained to care for individuals with cognitive impairment. These units offer residents help with bathing, grooming, and other daily tasks, as well as secured areas that allow safe movement without the risk of wandering off. They also offer targeted therapies and activities to keep residents engaged and active.
Below you will find a list of common questions and concerns that will help you decide which memory care community may be the best fit for your loved one.
Consider your loved one’s unique needs
It’s important to find a care community that can provide the level of care your loved one needs now and also anticipate and provide for their future needs. Some assisted living communities provide a care bridge program for early stage patients, which can make the transition to their memory care unit easier and less stressful.
- What is the trajectory and progression of your loved one’s dementia?
- Have they begun to wander and are they in danger of becoming lost or hurt?
- What degree of supervision do they need?
- Does your loved one have behavior problems such as being aggressive or disruptive?
- How much assistance does your loved one require with activities of daily living?
- Do they have ongoing medical issues that require regular attention and treatment such as diabetes, a colostomy bag or dialysis?
- Are they confined to a wheel chair or bedridden?
- Would your loved one be happiest in a community that groups residents by cognitive level?
- Would they prefer living in a memory care cottage, a neighborhood-style community within a larger community or a neighborhood board and care home?
- If you’re able to provide additional outside care or companionship, will the community allow it and, if so, who coordinates the care?
Research the quality of the memory care community
Extensive research on the quality of care each community offers can be extremely helpful when weighing your options. This can include online reviews, CMS ratings, and your own personal observations during tours.
Incident reporting and community audits vary by state, but check with your state or county to be sure there haven’t been neglect or abuse issues at the communities you’re considering.
- Does the staff appear to be knowledgeable and caring?
- What kind and how many hours of training has the staff had?
- How long have the caretakers been at the community? (Not only are high turnover rates a red flag about the community, it can be distressing to have constantly changing caregivers who may not be familiar with your loved one's needs.)
- What is the staffing ratio during the day and at night?
- Is there an individual care plan for each individual?
- Do the community's philosophy of care and treatment programs resonate with you?
Available medical services
- Is there a visiting physician?
- Is a nurse on duty 24 hours per day?
- If not, how many and what hours is a nurse on duty?
- Is there an internal clinic that can provide physical, occupational and speech therapy as needed?
- What levels of care can the facility provide?
Be sure to review a current calendar of activities and social events to see if any might be of interest to your loved one. It is also wise to investigate the community’s amenities and treatments options.
- How rich and individualized is the activity program? (It should have a variety of options to meet the physical, social, emotional and spiritual needs of residents. Music, art and exercise should be offered at least once daily.)
- Are any special events or holiday celebrations held throughout the year?
- Does the community offer pet or reminiscence therapy?
It is vital for family members to have regular communication with the facility in order to stay up-to-date on their loved one's care needs and the status of their health.
- How does the community communicate with families?
- How often are family members updated about their resident's well-being?
- How frequently do family members meet with staff to discuss a loved one's care plan?
- What is the policy for handling a medical emergency?
Community design and maintenance
Be sure the indoor and outdoor environments are clean and well-maintained, but not too neat and regimented. Some wear is normal, but the community shouldn't look neglected.
A clean, organized but lived-in look is best. Furniture should be clean, comfortable and easy for residents to use. Floors and carpets should be clean. Bathroom and dining areas should be tidy and free of odor.
- Is the community easy to navigate?
- Are there environmental cues to help orient the residents to various parts of the community?
- Are there personal markers by each room like pictures, memory boxes, etc.?
- How many residents are in each community? (Too many residents can add to their confusion.)
- Do they have a specialized memory care dining room?
- Do residents have free access to secure and attractive outdoor areas?
Use these questions to help evaluate each memory care community you consider or tour. If staff members are unable to answer your questions, or you do not feel that the facility exhibits the level of quality, care or comfort that your loved one deserves, go with your gut instinct.