Memory Care - experiences /advice?

Until nursing home assisted living make their facilities safety has or will change I would not recommend seniors to go there. For the reason listed below.
COVID-19 tore through long-term care facilities across the country, accounting for a third of coronavirus deaths during the first year of the pandemic. Tragic tales of deaths due to problems with testing, personal protective equipment and infection control emerged at state veterans’ homes in Massachusetts, New Jersey, and Texas.
The inspector general’s report on the VA Illiana Health Care System in Danville is the first to publicly detail extensive breakdowns at a facility operated by the U.S. Department of Veterans Affairs. The agency runs a system of 134 nursing homes that serve roughly 9,000 veterans a day across 46 states, the District of Columbia and Puerto Rico.
An examination by the Government Accountability Office in June found there were 3,944 cases and 327 deaths among residents of VA nursing homes from March 2020 through mid-February. The cumulative case rate among residents was 17% and the death rate was 1%.
Those numbers are miniscule compared to nursing homes nationwide, where researchers estimate there were 592,629 cases and 118,335 deaths last year. The death rate among long-term care residents as of March was 8%, according to the COVID Tracking Project.

Watch how many people work taking care of patients, if it's cleaned, what activities they do with memory care patients. I would check to see if you can come in 24/7. Ask how many times they get showers a week.

Besides several posts with excellent insight I would also check the history of the facility to see if they have had any pending &/or past lawsuits against them or their staff. I would also try to find out how long their staff members have worked there, what the turnover rate is. Observe those up in wheelchairs to see if they are attended to, observe for odor. Watch staff to see if they are checking on residents or chatting amongst themselves or on their phones. An unannounced visit is best, & observe as much as possible especially the interaction from staff towards residents. Go at mealtime to see if the staff assists the residents in eating.

Courage726: Imho, perhaps you may want to ask if his physician will still be attending him.

Have a camera in the room, you are their only advocate.

Go to his Dr & your PC for exam and advice, be sure to get a CAT SCAN, other scans, brain scan, see a neurologist, a Psychologist and 2nd opinion......... contact me IF you want no money no problem I am not seeking patients just a helpful Christian! You need alot of help and much work to do! But it is all for LOVE!!!!


God is with You !! Dr Jack Grenan

Two things I have found to be particularly important:
1. Dementia training for ALL staff, including housekeeping, laundry, and kitchen staff.
2. A robust activities department with lots of dementia friendly activities, including some sort of exercise daily.

You might want to inquire if your Dad's doctors will attend him or send a nurse by to check on him in the MC. The MC's staff RN would communicate with his primary care office, but the cardiologist's nurse coming by was very helpful when it got to be more difficult to get Dad out for appointments.

Another useful tool was video coverage of the facility. We could check a video feed of Dad without him knowing to assure ourselves he was doing well. Although Dad died before mandatory covid lockdowns, I imagine the video would have been even more important during covid restrictions.

Alists Best to live at home or with family but if you have to go into a home, please check the help to patient ratio..
Most places are way understaffed.
Also, inquire about meds they may want to give because Seniors are known to be over medicated just for the convenience of the Aides and Nurses, even tho they tell you it's fir the good of your loved one calling it for their anxiety or depression but ends up making them more like a Zombie and more able to fall. It's not un normal to wait up to 20 minutes to get the patients buzzer answered by someone once they call fir help which means you'll end up in soiled pants or diapers.

Be Realistic and Know that what you see is not reality. The pretty place and all the niceness is to sell you on putting your loved one at their facility.
You need to tour the place unexpectedly and go have lunch in the Dinning Room and talk with a few of the ones living there when Staff are not around!!!

Ask if you're able to have a camera installed in your Loved Ones Room so you can check on lived one any time 24 7.

Check on any and all complaints that may or may not have been filed on the place.

Here's a question I wished I had asked: "Is there a doctor on staff? Can I switch my husband to the staff doctor as his PCP?" By the way, after I moved my husband into the MC, I found out the answers to these questions were "no" and "no". Never assume.

I would ask about Covid restrictions. Even after the Covid counts went down, and residents and (many) staff members were vaccinated, many facilities still limited visits and limited the amount of time residents could get some fresh air. I'd ask about current (and maybe future)Covid precautions and policies such as, "can the residents visit with one another," "are they eating in a communal setting or are they isolated," etc.

Great advice given so far. I only add three more points:
1. Ask (politely) the agency for permission to visit late at night only to observe how the aides look after the place. At night, there will only be a few aides, because the residents are sleeping. However, there are residents who roam at night aimlessly by themselves. What would the aides to then? Do they ignore these roaming residents and play games on their phones, chat loudly with friends or coworkers, or doze off at their work stations?

2. How often or frequent are the residents diapers changed? Some aides leave the dirty diaper duty to the inexperienced or new employee or the next shift. This means your loved one will sit in filth until someone cleans up.

3. Can you afford a private carer in the facility? This happens ALL.THE.TIME. The agency may not have enough aides to help your loved one, so you end up paying for a private caregiver to be with your LO. Unless you can afford it, the whole thing can become VERY expensive - more than keeping your LO at home with 2-3 different caregivers each day.

Watch out for the smokescreen and mirrors. What you want to observe is beyond the well-manicured lawn and beautiful lobby.

My husband’s MC failed these three tests, so I took him home. Now he has private caregivers familiar surrounding. Very challenging to me but at least I have control over his care.

Good luck.

Just a few items to add to sjplegacy's superb list:

Make at least two visits - one unannounced
Don't be overly impressed with the chantelier and the baby grand in the lobby - LO does not live in the lobby. Care and attitude is what you are concentrating on.
What payment sources are accepted (in some states, it is difficult to find MCs that will accept medicaid without 2 years of private pay)?
Get a list of the current month's scheduled activities. Stop by any activities while you are visiting and observe how the staff and residents interact. Run like get out if there are no activities!!!
Is a medicaid bed guaranteed if private funds are exhausted?
Get a list of available scheduled activities for the month
Get a copy of the weekly menu (and make sure one of your visits is close to meal time)
Can you have lunch with your LO after they become a resident?
What is the staff to patient ratio for all three shifts (guaranteed to be lower than what is stated because of constant call outs but this will get you some sense of what they should be aiming for)
Do they have an evacuation procedure in place?
What is the min. food/water supply backup for emergencies? (in NJ it is 3 days min but it may differ from state to state)

My dad was in memory care in WV then I moved him to a facility in MI. The one in WV was the classic lock down unit with about 25 residents. We moved him from the assisted living section of the same building after my mom died. Dad was a pretty easy going fellow, still very mobile but with advanced dementia. I was generally pleased with his care. They usually have a little higher ratio of staff to patients in memory care facilities.

The place in MI was sort of a hybrid- all in one care place. Not locked down which was a problem at first as dad was still looking for his car. (The car thing didn’t end until the last month of his life). Some alarm bracelets and dad -sitting by me and staff for awhile worked until he acclimated. He did well there, could roam the halls, hang out at various nurse stations and nap in the lobby by a big fireplace.

Id recommend to anyone looking at memory care to visit, hang out for an hour in a common area, watch, listen, see how residents are doing. The best places are still depressing as hell and always understaffed and under payed.

My dad died a peaceful death one year ago while on hospice.

We reached out to 'A Place for Mom'. They were very helpful and had a lot of good facilities.

Most residential facilities have a social worker that help answer your questions about the MC facilities in that area.

My dad had been in skilled nursing for 9 months and I asked to have him moved to MC because he had stabilized and he was very bored. Best move I ever made. He is in a small facility. They have a few easy activities (he loves to color - who knew). He has made friends. Enjoys 'video' church and bible study. Because he has some medical needs, I made sure those would be adequately met. That was very important in the decision on where to place him. The facility is managed by an RN. Skilled nursing had put him on insulin to control his diabetes instead of keeping him on metformin. The MC had him taken off of insulin and is controlling his sugar level with a strict diet and metformin. His blood sugar is sooo much better. And best part: they know how to deal with dementia behaviors. He is the calmest, happiest I've seen him in years.

Here is another thread, where lists of questions to ask at the MC when making a decision for placement:

https://www.agingcare.com/questions/questions-to-ask-memory-care-facilities-before-placing-a-lo-470196.htm

My mother's MC was head and shoulders above the skilled nursing facility she was in before it.

I would say my #1 concern would be to ensure that the MC was able to care for Dad until end of life. You don't want to have to move him again as he becomes more infirm.

I'd also ask if they divide the more cognizant residents from the less-cognitive ones for activities. My mom's place split them up, so things like trivia, discussion groups, and bingo could go on for the more cognitive folks while the less cognitive ones had lower-key activities. You don't want a place that caters only to the lowest common denominator.

My experience with MC was excellent. Others not so much. You might want to create a laundry list of questions to ask and things to observe. There are many things to consider. Here are just some of them:
Ask- What charges are not part of monthly fee;
What would cause discharge of person; (e.g., transfer to SNF, need for psychiatric care, can’t pay fee);
What specific dementia training have the aides received;
What are visitor restrictions (hours, eating w/ LO,etc.);
Is there 24/7 nursing in house;
Is there an outside area where residents can walk;
What is the staff/resident ratio;
Are all rooms private w facilities;
Are there adjunct facilities in the building like a salon, cafe,etc.;
What is the facilities plan to care for your LO.

Observe- Staff interactions with residents ( I eliminated one facility because a staff member was pulling a wheelchair bound resident backwards);
Is the facility odorless;
Is the decor simple, attractive, bright, not institutional looking;
Is the staff welcoming, courteous, caring;
Do the meals look appetizing;

These are just some things to consider. Choose a facility that is close enough so it's not a burden to visit, and drop in at different times of day or evening.

Be open minded about his acceptance to this new environment. It might not go as well as you would like. He may get angry, confused, or agitated by the change in environment, or think that you are abandoning him. This is not unusual. The staff should know how to address these occurrences.