Ultimate Guide to Selecting a Memory Care Facility

Caring for a loved one with Alzheimer’s disease or dementia can be an emotionally challenging journey that requires immense strength, compassion, and support. As the condition progresses, there often comes a time when the demands of caregiving become overwhelming, and professional help is essential. This is where memory care facilities play a crucial role.

Memory care facilities are specialized care communities designed to provide a safe, comfortable, and supportive environment for individuals with Alzheimer’s disease or other forms of dementia. They offer round-the-clock care, comprehensive assistance, and tailored programs to meet the unique needs of individuals living with memory impairments.

However, selecting a memory care facility for your loved one can be a daunting task. It requires careful consideration, research, and a clear understanding of the specific qualities and services that are essential for ensuring the well-being and quality of life of your family member.

In this guide, we aim to shed light on the key factors that caregivers should look for when choosing a memory care facility. Whether you’re just starting to explore options or are in the midst of making a decision, this article will provide valuable insights to help you make an informed choice.

Initial Areas to Consider

The Senior’s Needs

First, before choosing a particular memory care facility, it’s crucial to think about the senior’s needs. This includes considering their current level of independence, their safety, and whether it is indeed time for memory care.

Their Level of Independence

There are two areas to think about here:

How independent is the senior? Can they live safely on their own? Are there any immediate health or safety concerns? Have there been any falls or other recent issues?

How much support is available? Are family members able to provide assistance? What about paid caregivers or other service providers?

Generally, you’d want memory care when the senior can no longer safely live alone and external assistance isn’t realistic. This might happen because there are no adult children who live nearby or because the people who have been providing care are getting overwhelmed.   

Underlying Health Problems

It’s important to consult with the senior’s doctor as part of this process. Notably, some health challenges can aggravate dementia symptoms considerably, making the condition seem worse than it is. For example, unmanaged pain, dehydration, and infections can also sometimes make dementia symptoms worse. UTIs have particularly dramatic effects.

By working with a doctor, you can evaluate any underlying issues and decide whether the senior’s condition is severe enough for memory care. 

The Type of Facility

You can also consider the type of facility. In particular, some seniors may benefit from a specialized memory care facility. Other times, working with elderly care communities that specialize in memory care is a valuable approach to consider. Such communities focus on the full spectrum of care, allowing seniors to get support early, with a level of care that adapts to their needs.

A community offering a spectrum of care might be perfect for a senior who is still mostly independent, but has been diagnosed with Alzheimer’s disease and will need memory care support at some point.

Researching Memory Care Options

Start your search with a broad lens. Online resources offer a wealth of information, including reviews and testimonials from other families navigating similar journeys. Personal recommendations from friends, family, or healthcare professionals can also provide invaluable insights.

Don’t overlook the potential benefits of working with a professional advisor who specializes in senior care options. They can offer personalized guidance tailored to your loved one’s needs, including which facilities have the best programs for memory care.

While you analyze various options, create a comparison chart to help keep track of the different amenities, services, and programs offered by each memory care facility. Include factors such as location, room types, staff credentials, and activity schedules.

By systematically organizing the information, you can more easily identify the differences and determine which facilities truly stand out in catering to the specific needs of your loved one.

Visiting Facilities and Evaluating the Environment

Once you have a list of potential facilities, visiting in person is crucial. Pay special attention to the overall feel of the environment. Is it welcoming and safe? How do the staff interact with residents?

In the following sections, we’ll talk about specific areas you can look at and questions to ask.

Areas to Consider when Selecting a Memory Care Facility

The Facility’s State Inspection Report

Once you’ve decided on the type of facility and have some specific facilities to consider, it’s time to start digging into the specifics – starting with the facility’s inspection report.

These reports provide a range of important information, including whether there were any violations to expected standards, the grade the facility received, customer satisfaction, and details about pricing.

Such information gives you a sense of what to expect from the facility and helps you compare different memory care facilities.

These reports exist because memory care facilities are often required to undergo regular inspections by state regulatory agencies to ensure they meet specific standards of care and safety.

Will the Facility Share Their Report?

However, the exact regulations and requirements regarding the sharing of state inspection reports by memory care facilities can vary depending on the jurisdiction. Because of this, it is advisable to consult the specific laws and regulations of the state where the facility is located to confirm laws around the disclosure of inspection reports to prospective residents or their families.

Some states may mandate memory care facilities to make inspection reports readily available to the public upon request, while others may require the reports to be posted on the facility’s premises. Additionally, there might be variations in the level of detail provided in these reports.

Where to Begin

To obtain accurate and up-to-date information about a memory care facility’s inspection report, reach out to the facility directly and inquire about their policies regarding disclosure. They should be able to provide you with the necessary information or direct you to the appropriate regulatory agency that oversees their inspections.

What’s Next?

While state inspection reports provide crucial information about the facility, they’re not enough on their own.

There are other factors that you need to consider, including staff qualifications, resident-to-staff ratios, the overall environment, the quality of care provided, and the facility’s approach to memory care. In conjunction with inspection reports, these factors can help you make a well-informed decision about the best memory care facility for your loved one.

Room Assignment and Privacy

The assignment of rooms in memory care facilities and the protection of residents’ privacy are critical considerations. This is crucial to ask about, as the process of room assignment may vary among facilities.

While private rooms may be available, they are often reserved for residents who are privately funding their care. Ask about the facility’s criteria for determining who gets a private room, especially if it feels like your loved one would need a room to themselves.

The Need For Room Reassignment

Occasionally, residents may not have compatible roommate dynamics, which necessitates reassignment. What are the facility’s policies around this? What happens when one roommate isn’t happy with the current arrangement, but the other is?

Overall, the protection of residents’ privacy is paramount, and memory care facilities should strive to create a comfortable and secure environment that respects the individuality and dignity of each resident. If a room reassignment is needed, family members should be informed and consulted. Constant moving can be distressing for residents with dementia.

Will You Be Notified of Changes?

Another crucial aspect is the facility’s policy about notifying families if residents need to be moved to another room, ensuring that accurate explanations are provided. This is important, as constant moving can be distressing for residents with dementia.

What About Furnishings And Other Items?

Additionally, reviewing the facility’s policy on room furnishings is essential to determine whether residents are expected to furnish their own rooms or if the facility provides necessary furnishings.

If your loved one will receive on-site hospice care, the hospice provider may provide certain items, such as a hospital bed that allows staff to easily lower, raise, and adjust the bed to assist with daily care.

Activities and Engagement

Memory care facilities should strive to provide a wide range of recreational and engaging activities for individuals with dementia, ensuring their days are filled with meaningful experiences.

The availability of plentiful and frequent activities throughout the day is vital to provide continuous stimulation and keep residents engaged. It is essential to ensure that residents are not merely sitting idle but actively participating in various activities such as music sessions, arts and crafts, and other mentally stimulating exercises.

Think About Types of Therapies

Are there any particular types of activity that might be better suited to your loved one? Approaches like music therapy, art therapy, or pet therapy could be attractive, but vary in availability.

What about solo activities versus group ones? Is there enough variation to meet the senior’s needs?

Ask for a Schedule

When considering a facility, ask for the activity schedule and even take a picture to share with family members for a comprehensive understanding of the offerings.

Also ask about planned versus spontaneous activities. Is there space for residents to do activities spontaneously or does everything need to be carefully planned? This is an important distinction, as some people prefer their days to be planned, while others respond better to flexibility.

Consider Qualifications

You can also check for the qualifications of the on-site activity coordinator. This role may go by different titles. A well-qualified coordinator will likely be better at designing an activity schedule that stimulates residents and keeps them engaged.

Ask About Walks with Residents

Caregivers should also inquire about opportunities for staff to take residents on walks around the facility, but it’s important to note that staffing shortages can impact the feasibility of this activity for every resident.

By discussing these aspects, caregivers can gain insight into the facility’s commitment to providing a diverse range of activities that promote social interaction, cognitive stimulation, and overall well-being for their loved ones with dementia.

Staffing and Training

Assessing the quality and training of staff in memory care facilities is crucial for ensuring the well-being and safety of your loved one. Start by inquiring about the staff-to-resident ratio and the presence of registered nurses (RNs) on staff.

Keep in mind that if the memory care facility is classified as an Assisted Living Facility (ALF), having an RN on staff might not be a requirement. It’s also important to understand the separation of duties between hospice care and onsite staff, such as medication prescriptions, diaper changing, and bathing.

How Often Are Staff Available?

Clarify how often the onsite staff is available, especially in the case of hospice care. Ask if residents are assigned to the same staff members every day or if the assignments may change over time.

What Is Their Background?

When evaluating the staff’s expertise, consider factors like the presence of nurses and clinical staff, their technical knowledge, and the frequency of staff training. Take note of the facility’s shift schedules and staffing patterns, including any differences in staffing on weekends.

Additionally, inquire about the availability of staff who can communicate in languages other than English, as residents with advanced dementia may revert to their native language.

Determine if any staff members are certified dementia care managers (CDCMs) and what proportion of the staff holds such certification. Additionally, ask about the frequency of staff training to ensure they receive regular updates on dementia care practices and techniques.

Approaches to Behavior Management

Assessing the quality and training of staff in memory care facilities is crucial for ensuring the well-being and safety of your loved one. Start by inquiring about the staff-to-resident ratio and the presence of registered nurses (RNs) on staff.

Keep in mind that if the memory care facility is classified as an Assisted Living Facility (ALF), having an RN on staff might not be a requirement. It’s also important to understand the separation of duties between hospice care and on-site staff, such as medication prescriptions, diaper changing, and bathing.

How Often Are Staff Available?

Clarify how often the on-site staff is available, especially in the case of hospice care. Ask if residents are assigned to the same staff members every day or if the assignments may change over time.

What Is Their Background?

When evaluating the staff’s expertise, consider factors like the presence of nurses and clinical staff, their technical knowledge, and the frequency of staff training. Take note of the facility’s shift schedules and staffing patterns, including any differences in staffing on weekends.

Additionally, inquire about the availability of staff who can communicate in languages other than English, as residents with advanced dementia may revert to their native language.

Determine if any staff members are certified dementia care managers (CDCMs) and what proportion of the staff holds such certification. Additionally, ask about the frequency of staff training to ensure they receive regular updates on dementia care practices and techniques.

Medication Management

It is essential that you advocate for family involvement in your loved one’s care plan from the onset and ensure that your family or the primary caregiver’s approval is sought before any changes are made. This is particularly important when it comes to the administration of sedatives or psychotropic medications.

How Medications May Be Misused for Behavioral Control

Unfortunately, the overuse of medications as chemical restraints on older adults with dementia has been a concerning issue in some care settings. This is why it’s helpful to assess how staff manage difficult behaviors without medications.

Family members should be informed and involved in discussions about medication management, and staff should not administer such medications without explicit authorization.

According to a report by Human Rights Watch, approximately 179,000 nursing home residents in the United States are prescribed antipsychotic medications without a diagnosed mental illness, indicating potential overuse for behavioral control. Additionally, a study published in JAMA Internal Medicine found that around 18% of older adults in assisted living facilities were prescribed benzodiazepines, despite their association with increased fall risk and cognitive impairment.

These statistics highlight the concerning prevalence of antipsychotic and benzodiazepine overuse as a means of managing behavior in these care settings, emphasizing the need for appropriate and person-centered approaches to care.

Other Negative Medication Impacts

The American Geriatric Society’s BEERS (Beers Criteria for Potentially Inappropriate Medication Use in Older Adults) provides guidelines on medications that are contraindicated or have a high risk of adverse effects in older adults, particularly those with Alzheimer’s disease or dementia.

Some of these medications, such as benzodiazepines and antipsychotics, can increase the risk of falls due to their sedating or psychotropic effects. It is important for families and healthcare providers to be aware of these recommendations and advocate for the appropriate use of medications that minimize the risk of falls for older adults with Alzheimer’s disease or dementia.

The Importance of Communication

It is essential to be vigilant and proactive in addressing the potential overuse of medications as chemical restraints in memory care facilities. Open communication with staff about your loved one’s care plan, including medication management, can help ensure that their behaviors are not solely managed through the unnecessary use of medication.

By actively participating in care discussions and emphasizing a holistic approach to care, you can help create a supportive environment that prioritizes the well-being and dignity of residents with dementia.

The Risk of Falls

Falls pose a significant risk to older adults in nursing homes, assisted living facilities, and memory care facilities. Recent statistics highlight the importance of fall prevention measures in these settings.

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related deaths among older adults. In nursing homes, it is estimated that around 50% of residents experience at least one fall each year, with two-thirds of those individuals experiencing multiple falls.

For individuals with dementia or Alzheimer’s disease, the risk of falling is even higher. The Alzheimer’s Association reports that people with dementia are three times more likely to experience a fall compared to their peers without cognitive impairments. The progression of dementia can lead to challenges with balance, mobility, and spatial awareness, increasing the vulnerability to falls.

The Role of Medications

It is crucial to consider the role of medications in fall prevention among older adults with dementia and ensure that the memory care facility follows current guidelines, such as those from the American Geriatric Society’s BEERS (Beers Criteria for Potentially Inappropriate Medication Use in Older Adults).

Other Fall Prevention Approaches

By addressing fall prevention strategies, promoting a safe environment, and closely monitoring medication use in accordance with guidelines such as the BEERS criteria, memory care facilities can effectively reduce the risk of falls among residents and ensure their safety and well-being.

Dining Experience

Assessing the quality and variety of food served in memory care facilities is essential for ensuring that your loved one receives proper nutrition and enjoys their dining experience.

Questions to Ask

To evaluate the food service, start by asking how many meals or snacks are provided each day and inquire about the schedule. Request to see the menu for the day and even the month to get an idea of the variety of dishes offered.

Consider how and where meals are served. It’s important to know if staff escort residents to the dining area, or can bring back a plate to their room if they require additional assistance.

If your loved one needs assistance with eating, confirm that staff will be readily available to help, which is common in the later stages of dementia.

Inquire if staff members are available to help residents select their food and ensure that special dietary needs or preferences can be accommodated. Many persons with dementia may be grappling with other comorbidities, such as heart disease or diabetes, which can influence the best foods for their needs.

Additionally, find out how staff manage situations where a resident misses a meal due to illness or other reasons.

What About Food Preferences?

Additionally, if your loved one has specific cultural or ethnic food preferences, check if the facility offers a variety of options that can cater to their tastes. It’s worth noting that most memory care facilities allow family members to bring in food that their loved ones enjoy and dine together with them. You can also take them out for a meal.

Observe Mealtime Dynamics

Observing how staff members handle mealtime dynamics is crucial. Inquire about their approach to residents taking food off each other’s plates, as this can occur. Understanding their strategies for managing such situations is important for maintaining a pleasant dining environment.

By considering these factors and asking the relevant questions, you can assess the quality and variety of food served in memory care facilities and ensure that your loved one’s dietary needs and preferences are met with care and respect during mealtime.

Safety

Memory care facilities must have solid safety measures in place to ensure the well-being and security of your loved one. When evaluating a facility, inquire about specific safety features they have implemented.

24-hour supervised care is an important area to ask about. This ensures round-the-clock monitoring and assistance for residents. Additionally, ask about emergency alert systems, such as call buttons or wearable devices, which allow residents to quickly summon help when needed. These systems can provide peace of mind, knowing that immediate assistance is always available.

Access Control Measures

Take note of the facility’s access control measures. Ask about keypad entry systems that restrict unauthorized entry and help maintain a secure environment. Verify the presence of alarms on emergency exits, ensuring that these exits are properly monitored and any unauthorized attempts to use them are detected.

Interior courtyards designed for secure wandering are beneficial for residents who may exhibit wandering behavior associated with dementia. These courtyards provide a safe outdoor space where residents can freely move and explore within a controlled environment.

Why These Topics Matter

By asking about these safety features and reviewing the measures in place, you can make an informed decision about the safety and security provided by a memory care facility for your loved one. Remember to consider the unique needs and potential risks associated with their condition to ensure a safe living environment that promotes their well-being and minimizes potential hazards.

Preventing Dehydration

Preventing dehydration in residents with Alzheimer’s and dementia is of utmost importance in memory care facilities.

These individuals are particularly vulnerable to dehydration due to various factors, including difficulties in communicating their thirst, memory impairments that hinder their ability to remember to drink, and decreased cognitive function that may affect their ability to recognize signs of dehydration.

The Risks of Dehydration

Dehydration can lead to serious health complications, including urinary tract infections, constipation, confusion, and even hospitalization. There is a significant association between dehydration and fall risk among individuals with Alzheimer’s or dementia, as dehydration can lead to dizziness, weakness, and poor balance.

Furthermore, dehydration can impair cognitive function and contribute to confusion and disorientation, further elevating the risk of falls among those already affected by cognitive decline.

Therefore, maintaining proper hydration is crucial in reducing the risk of falls and promoting the overall safety and well-being of individuals with Alzheimer’s or dementia. Therefore, staff in memory care facilities must prioritize hydration and take proactive measures to ensure residents are adequately hydrated.

How Staff Members Should Assist

Staff members play a critical role in monitoring and encouraging fluid intake among residents. They should be attentive to the signs and symptoms of dehydration, such as dry mouth, dark urine, fatigue, and confusion, and take prompt action if any signs are observed.

Regularly offering fluids, including water, juice, and other hydrating beverages, and providing reminders or assistance with drinking can help prevent dehydration. Additionally, staff should ensure that water is easily accessible and readily available throughout the facility, encouraging residents to drink regularly.

By being vigilant and proactive in promoting hydration, staff in memory care facilities can significantly contribute to the overall well-being and health of residents with Alzheimer’s and dementia.

Final Thoughts

Memory care facilities can be a scary idea, especially for families who promised to keep their loved ones at home. However, such environments can be essential, especially in the late stages of dementia. For one thing, caring for someone with dementia is incredibly overwhelming, much more so than other types of caregiving.

To find the right location, it’s important to consider the senior’s needs carefully and do your research.

By taking into account factors such as state inspection reports, room assignment and privacy policies, activities and engagement programs, staff qualifications and training, medication management practices, and falls risk prevention measures, you can make a well-informed decision that prioritizes the safety, well-being, and quality of life of your loved one.

Remember to actively engage with staff, ask pertinent questions, and observe the facility’s environment and interactions to ensure that the chosen memory care facility provides the level of care and support that aligns with your loved one’s needs and preferences.

By selecting a reputable and suitable memory care facility, you can provide your loved one with a nurturing and secure environment, promoting their overall health and happiness.