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Parkinsons, Memory Care, Skilled Nursing, Dementia

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One difference between memory care and assisted living is that memory care is a locked unit, there are limits on what items a patient can keep in their room, and often the staff work hard to keep residents in the common area unless there is a visitor who will take resident to his or her room. The focus is on safety, not much on privacy or flexibility, as a rule. But each place has its' own quirks.
Gravity happens - the risk of falls can be reduced but not eliminated, and memory impairment guarantees poor awareness of safety needs, at some point.
The difference is that a fall in a facility (usually) is discovered within an hour or so...at home someone who falls may be on the floor for a few days or more.
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People fall in ANY place they may be.

Dh was in the hospital last Spring with some kind of weird blood pressure problems. He fell IN THE HOSPITAL with 2 nurses standing right there!

It really depends on so many factors. A MC facility will have people who 'forget' they need help getting up, a NH may have the same dynamic. A dear friend of mine fell out of her wheelchair a few years back--her DH had just left her alone in her room for a minute and she got up and fell. Literally a couple of seconds after he walked out. She went downhill rapidly and died within a week. He was there with her every single day from breakfast until bedtime. Never left her alone, really. It just was what it was.

My mom forgets she HAS to walk with her walker, yet sometimes when I visit her she 'surfs' through the apartment using furniture or grab bars--then finds herself stuck in a room with no support. She doesn't GET that we aren't impressed she can 'surf' we want her to use her walker.
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mh1983 Dec 2021
Yea my mom is very mobile, quick almost too quick. She will
be sitting on couch with me & boom she bolts up quickly sometimes not falling but sometimes throwing her balance off & down she goes. She is so limber & healthy body wise she does it think or remember to use a walker. She’s in rehab right now after a month hospital stay & they have required a 24 seven sitter with her. Once her rehab is done and she’s a little closer to her strength at baseline we hope to have a in a valuation for MC. I’m so worried they are going to require a sitter 24 seven in MC or NH if she fails the memory care evaluation. NO ONE can afford that!!!
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Get a needs assessment done. Most facilities will do this or you can contact your local area on aging.

When I was told that my dad needed MC and I started looking at facilities, the difference in what these MC facilities were was confusing. My dad did not need MC based on what I saw was available. He needed AL. He couldn't afford AL, so ended up in a board and care home. Which had residents far gone in dementia, some just physically challenged but, pretty mentally there and the house policy was you could age out.

You have to go look at each facility and see what their definition of MC or SN actually is.

Walk through the facility and see what level of capability the residents are operating at. Are they being fed or feeding themselves, are there activities geared towards abilities, do you see staff interacting with the residents, how does it look, smell and feel? Be sure and ask if they allow hospice, some don't and then you are looking for a place when your LO is dying. Ask if they have continuing care, next level of care in the same facility is best, if possible. Doing this will help you know if what they are offering is a sales pitch or a snow job.

The issue of what a facility actually is, has come up before and it really has no consistency. It depends on where you live and individual facilities. Some have MC that looks like a locked AL, some look like a locked SN. Doing actual visits is the only way to determine if a facility is the level of care required, regardless of what it calls itself.

Best of luck.
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There are good and bad facilities of both types, so I think the most important consideration is the facility itself.
That said the original concept of memory care was to care for those who are functioning well enough to benefit from programs and activities designed to enhance their lives, people mostly able to look after themselves but who were no longer cognitively safe to live on their own in the community. A good memory care would probably not accept someone who needs a high level of physical care because they would be up front that they aren't designed to accommodate that and it wouldn't be in the person's best interest, a bad memory care will make all kinds of promises that they know are unrealistic due to staffing levels and less physical infrastructure available in a higher level of care.
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cwillie Dec 2021
grammar check - less infrastructure *than is* available in a higher level of care facility!
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Memory Care is usually private pay so the person needs to be able to pay for it. When I was looking into it for Mom 7 yrs ago in my area, it was 5k a month for AL and 7k a month for MC.

I really don't see much different in MC and an AL other than it is geared more to those suffering from Dementia. Both use aides mostly for residents care and RNs that handle the medical end of things. So it comes down to, how much care does the resident need. I think there comes a point where MC is not enough and care cannot be handled by the staff. So LTC is needed. This can be determined by an evaluation and not by the MC.

As my daughter, who worked in NHs for 20yrs, says, they are going to fall. LTC tends to put fall risk people in wheelchairs. Which was fine with me. My Mom had no problem scooting around in one. Better than me going to ER every month or so.
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