Memory Care: For When It’s No Longer ‘Just Forgetfulness’

We all forget things from time to time. In fact, most of us forget a lot. Do you remember what you had for dinner Tuesday two weeks ago, or what you were wearing? Unless it was a special occasion, probably not — because it’s not something you were trying to remember.

As we age, though, there’s a tendency to forget information we’ve purposely stored in our memories. And, given the increasing prevalence of Alzheimer’s disease and the fact that memory loss is one of the most common manifestations of the disease, it’s not unusual to become concerned when an older family member, perhaps a parent, starts to frequently forget people’s names or important dates.

Having trouble remembering information isn’t necessarily a sign of Alzheimer’s disease or some other form of dementia (e.g., Lewy body or vascular dementia). There can be many other potential causes of memory loss, such as prescription medication (including possible drug interactions if more than one medication is being taken), stress, depression or anxiety, hypothyroidism, a minor head injury, chronic alcoholism, brain disease or even a deficiency of vitamin B12.¹

If you’ve noticed that someone you care about is having greater difficulty remembering information that’s usually easy to recall, is frequently confused or is having trouble carrying on conversations (i.e., he or she can’t think of a relatively simple word midsentence, or repeatedly loses track of the conversation and abruptly changes the subject), it’s important to see a doctor so that other possible causes can be ruled out before jumping to the conclusion that it’s mild cognitive impairment or an early stage of dementia.

When it is dementia

If your loved one has received a diagnosis of Alzheimer’s disease or some other type of dementia, the diagnosing physician may have already worked with you to formulate a treatment plan and pointed you in the direction of helpful resources. Know that there’s a wealth of reliable information available online from sources such as the National Institute on Aging, the Alzheimer’s Association and WebMD.

You may also already know that although research has yet to yield a cure for these conditions, prescription drugs are available to treat the symptoms and researchers have discovered other ways of helping people with dementia feel more secure, more comfortable and even happier.

Early care at home

As long as there is no serious risk of harm to the individual or others, a person with dementia may be able to remain at home in the earliest stages of the disease, provided there is adequate assistance when needed — whether from family members or a professional caregiver. The treating physician and other members of the care team can determine whether it’s safe and offer guidance for making sure that safety and wellbeing are a priority.

Nonetheless, this is the best time to start planning. In many cases, the time will come when a person with dementia will need to make the transition from home to a setting in which a higher level of care can be given, whether that’s in assisted living or a community with memory support. Families who start the planning process early give their loved ones a voice in how the future unfolds, which can be extremely important. And, once a decision has been made about where the person will live, he or she has the opportunity to begin forming relationships with the staff and other residents. That extra familiarity can be vital to making the eventual move as comfortable as possible.

By making some of the more important decisions early on, you can be there more fully when your family member needs you the most. If you wait until the condition advances, you might feel pressured to make choices more quickly, with less information at hand — and by that point you and others involved in the decision-making process could feel overwhelmed.

What is memory care?

Memory care, also known as memory support or special care units (SCUs) in some communities, is a distinct form of long-term care. The overarching goals are to help slow the progression and manage the effects of Alzheimer’s disease and other forms of dementia (or other types of memory impairment) so that residents have better quality of life, including a sense of purpose, satisfaction and enjoyment.

While they vary considerably, most memory care locations have at least the following in common:

• Staff members have undergone specialized training that allows them to address the specific needs of people with Alzheimer’s disease and other dementia.
• The physical environment is safe and structured to reduce stress and help residents feel secure, comfortable and calm. To help prevent confusion, these spaces are typically designed for easy navigation.
• Specially developed programs and activities are offered to help slow progression of dementia so that residents can maintain — and in many cases improve — their cognitive skills.
• Care is provided day and night, and medical assistance is available 24/7.
• Since lack of appetite often accompanies the later stages of dementia, emphasis is placed on healthy, appealing meals to ensure proper nutrition.
• Security is a priority, as people with advanced dementia often exhibit a tendency to wander.
• Efforts are made to assist the resident’s family members in taking care of their own physical, emotional and mental health.

Through specialized focus and opportunities for more engagement, memory care can lead to greater independence, better physical health (oftentimes with reductions in medication and fewer hospitalizations), positive emotional changes and improved mental functioning.

Memory care is not the same as assisted living

In some senior living communities, memory care is situated within the assisted living quarters, but there are differences between the two:

• Staff members who provide memory support have additional training in communicating and interacting with people who have dementia.
• To prevent fires, burns and other injuries, there are no kitchens in memory care living spaces.
• Memory support activities and programs are designed to cheer and stimulate without causing anxiety.
• The schedules are sometimes more structured in memory care, since people with dementia often do better when they adhere to a routine — which is not to say they’re regimented. Sun Health Community locations provide person-centered care, in which staff members connect with each resident as a unique individual rather than taking a one-size-fits-all approach.
• An even greater emphasis is placed on security in memory care. For instance, residents might wear bracelets that will alert caregivers if they try to leave the premises. Usually, there are also more frequent safety checks.
• In addition to the basic activities of daily living (ADLs) that residents of assisted living receive help with (e.g., bathing, grooming, eating, using the toilet and getting in and out of bed), some places include assistance with instrumental activities of daily living (ADLs) — such as maintaining a budget, using the telephone or appliances and shopping — among their memory support services.

When is it time for memory care?

As noted previously, the best time to begin looking for a location that can provide memory care is soon after a diagnosis of Alzheimer’s disease or other dementia has been received. That gives your loved one and the rest of your family time to plan and make the best decision for everyone concerned.

Below are other signs that it may be time to seriously consider helping your parent or other family member transition to an environment where specialized support and medical assistance are readily available around the clock.

You or others who are providing care at home are having difficulty managing the extra responsibilities.

Adult children with full-time jobs and families of their own can quickly become exhausted when they attempt to care for a parent with dementia, particularly during the later stages when the need for medical assistance increases. Spouses of those with dementia often have their own health concerns, and it’s not unusual for them to neglect those needs while caring for their partner. Even with outside help from a professional caregiver, it can be too much for family members to sustain long-term.

You’re noticing a decline in the overall health of your loved one.

Maybe he or she is gradually losing the ability to drive, shop for groceries or prepare meals, or is forgetting to take medications or eat. Or perhaps your family member is losing track of when it’s time to go to bed, causing circadian rhythm disruptions that can lead to Sundowner’s syndrome or sleep disorders, which in turn can result in further deteriorations in physical health. Some red flags to look for are:

Sudden weight loss
Lack of food in the refrigerator and cabinets
Taking too much medicine or not enough
Poor personal hygiene
Unexplained injuries or bruises
Unpaid bills
Missed appointments
Trouble remembering how to get places (or back home again)

Your family member is becoming more isolated.

People with dementia often withdraw from friends and social activities out of fear of embarrassment or for other reasons. Unfortunately, having fewer interactions with others can accelerate their condition. Memory care offers the opportunity for a vibrant social life among people who understand what they’re experiencing. They can feel secure as they engage in creative activities and even go on supervised outings.

Your instincts are kicking in.

If you suspect it might be time, arrange a consultation with your loved one’s care team and/or the staff at your chosen memory care location.

Questions to ask when researching memory care providers

While many of the same questions you would ask when scouting for assisted living also pertain to memory care, there are questions specific to memory care that you should ask as well. You can find various checklists online. The following list of questions, adapted from alzheimers.net, will help you get started.

1. What levels of care and personal assistance are provided?
2. Does the staff include RNs, LPNs, a physician or other medical professionals? (Being able to receive at least basic medical care in familiar surroundings prevents the stress of having to go elsewhere for care.)
3. What type of training has the staff received?
4. What’s the monthly rate for housing and care? What services are included in that rate?
5. Are the rooms private or semiprivate? If both are available, how do the prices vary?
6. What is the policy for handling medical emergencies?
7. How is the community secured, and are there extra safety measures in place for residents who wander?
8. What meals are provided, and can special dietary requests be accommodated?
9. How often are housekeeping and laundry services provided?
10. What kind of programs and activities are offered, and at what times during the day? (Your family member’s best time of the day might be different from that of other residents.)
11. Can special care needs, such as diabetic care and mobility issues, be accommodated?
12. Are residents grouped by cognitive level?
13. What is the ratio of staff to residents during the day? At night? (Look for a ratio of 1:6 or lower.)
14. How does the facility communicate with families about a resident’s wellbeing?
15. What’s the discharge policy?

How much does memory care cost?

How much you can expect to pay depends on variables such as whether your loved one is in a private or shared room, the amount of care he or she requires and the geographic location.

According to retirementliving.com, the average cost nationally is about $5,745 per month for a private room. If your family member needs additional care beyond what the staff can provide, you might be asked to pay for outside care assistance at some locations.

Medicare will cover inpatient hospital care, some doctors’ fees and certain other medical items if your family member is 65 or older. It will also pay for up to 100 days of skilled nursing care in some situations. But, it doesn’t cover custodial, long-term nursing home care.²

Medicaid may cover some long-term costs, but not all memory care providers accept Medicaid, and there are income and asset requirements that must be met in order for your family member to be eligible.

Easing the transition to memory care

If your loved one lives in a Life Plan Community that offers memory support services within the community, then the transition should be relatively simple.

If he or she will be moving from the family home, the steps below can help make the change as smooth as possible.

When touring prospective communities

Take your loved one along with you, if possible. Let him or her interact with the staff and other residents, and see the living spaces. It’ll help you see whether your family member feels comfortable there.

After selecting a community

If permitted, take your loved one for regular visits before the move-in date to gain familiarity with the new surroundings. Tell the staff about your family member’s likes and dislikes, hobbies, habits and idiosyncrasies to assist them in forming a relationship.

Before and after the move

Plan to move some of your loved one’s favorite and familiar items into the new space and, to the extent possible, arrange the new place like the previous one. It’ll help provide comfort.

The need for specialized care

Dementia, including Alzheimer’s disease, is not just about memory loss. It changes the structure of the brain, damaging areas that affect the ability to think, plan, organize and make judgments, and can result in changes in behavior and personality.

On top of that, people with dementia almost always have another chronic health condition, and one condition can make it more difficult to treat the other.

Places that offer memory support services have invested in training their staff, developing programs and designing their spaces to meet the specific needs of those with dementia and other types of memory or cognitive impairments.

If you are contemplating memory care for a member of your family or someone else you care about, spend some time in a few of these places and watch how the residents interact with the staff and their surroundings. You’ll see the difference those investments can make.

Memory support at Sun Health Communities provides an intimate community feel, along with a stimulating, enriching experience. Contact us to see how you and your family can have the peace of mind that comes with knowing your loved one is receiving the best possible care.