Assisted Living For Dementia Patients: What Is Memory Care?
Memory care, a specialized form of assisted living for dementia patients, appears to have experienced significant growth in recent years. According to the American Association of Retired Persons (AARP), the number of memory care units grew by approximately 84% between 2013 and 2023, making memory care the “fastest-growing sector of the senior housing market.” These facilities are often used to help those experiencing the memory-related symptoms associated with various types of dementia, including Alzheimer's disease, dementia with Lewy bodies, vascular dementia, and frontotemporal dementia. Understanding how memory care functions and what sets it apart from other types of assisted living may benefit individuals with dementia and their families. Therapy may also be helpful for individuals and family members coping with a dementia diagnosis.
What is memory care? Understanding this form of assisted living
How memory care facilities can improve quality of life
The non-residential spaces inside a memory care facility are often set up to ensure the safety and comfort of its residents. While some facilities may keep residents separate, most feature communal living spaces to reduce isolation. To further encourage socialization, memory care facilities may provide ways for residents to engage in group activities, such as aerobics classes, community gardens, bingo nights, and family events.
What is memory care housing like?
As for the houses themselves, they may include furniture, decorations, and other items from a resident's previous home to personalize their living situation. While these homes often lack anything that may harm their residents, such as difficult-to-use appliances, cooking implements, and tools, they often have specially designed bathrooms, bedrooms, and kitchens. These spaces can allow residents to maintain a sense of independence while ensuring they remain safe. This is one of several differences that may help individuals differentiate between memory care and other forms of long-term care, such as a nursing home.
What is the difference between memory care and a nursing home?
Like a memory care facility, a nursing home is generally a place for those who require care but may not need the level of medical attention that a hospice facility or hospital would provide. Both memory care facilities and nursing homes often assist with activities of daily living (ADLs). In many cases, an individual who cannot complete at least two ADLs may meet the requirements for their insurance to cover long-term care. These ADLs may include the following:
- Dressing: The ability to put clothes on and select appropriate clothing items for different settings, weather, and activities
- Feeding: The ability to use utensils and feed oneself
- Ambulating: The ability walk and move on one’s own
- Toileting: A person’s ability to get to the bathroom, use the toilet appropriately, and clean oneself after using the facilities
- Personal hygiene: The ability to groom, bathe, and maintain one’s overall hygiene
- Continence: A person’s bladder and bowel control
Memory care facilities specialize in Alzheimer's and other forms of dementia
The primary difference between nursing homes and memory care facilities tends to be the focus of their care. While nursing homes may assist individuals with a variety of illnesses, disorders, and impairments, memory care facilities typically specialize in the care of Alzheimer’s disease and other forms of dementia. This may allow them to tend to the specific challenges of dementia more effectively and facilitate a higher quality of life.
Cost of memory care vs. traditional assisted living options
Memory care facilities may also cost less than nursing homes. The AARP estimated that the average monthly cost of a nursing home was $12,240 in 2023, while the cost for a month of residency in a memory care facility was $8,399. While this may indicate that memory care could be a more affordable option, it can be important to note that the AARP estimated that the average cost of traditional assisted living was significantly less at $6,694 per month. However, these less expensive facilities may not provide the services required for an individual with dementia.
What services and benefits can a memory care facility provide?
In addition to helping with activities of daily living, memory care facilities can address the specific struggles that a person with dementia may face in their daily life.
Safety procedures in facilities
According to the National Council on Aging, one of these struggles may be the tendency to wander, which memory care facilities may address by having specially designed safety procedures, such as doors with alarms that let staff members know when individuals leave the unit. These procedures may also include ensuring that external exits are locked and that outdoor areas are secured and supervised. While residents may be allowed to leave a memory care facility, they are typically required to be accompanied by staff or an approved family member.
Other memory care services that can improve quality of life
In addition to being secure, many memory care facilities employ staff who facilitate regular group activities. These activities may keep residents mentally and socially engaged while also providing a sense of routine and structure. Most facilities also provide access to a variety of healthcare professionals with specific training in dementia care. These professionals can include psychiatrists, physical therapists, licensed practical nurses (LPNs), registered nurses (RNs), and certified nursing assistants (CNAs). Together, these and other care team members can provide residents with supervision, socialization, and treatment.
What treatments are there for dementia?
According to Stanford Medicine, several forms of treatment may help those experiencing dementia. These may include what is classified as palliative care, which can be defined as care that is designed to improve the quality of life of those with a potentially incurable and serious illness.
Medications
One type of treatment involves the use of medications. In the United States, the Food and Drug Administration (FDA) has approved several types of medication, including amyloid-targeting treatments designed to reduce plaque accumulations in the brain. While these medications may be effective, they can cause side effects, such as headaches, falls, infusion-related reactions, and amyloid-related imaging abnormalities (ARIA). ARIA may lead to swelling in the brain, bleeding, dizziness, nausea, changes in vision, and confusion.
Various types of therapy
Another potential treatment approach involves the use of various types of therapy. According to the Los Angeles County Department of Mental Health, a few therapies may improve function, cognitive skills, mood, behavior, and quality of life.
- Supportive psychotherapy: Supportive psychotherapy can improve an individual's confidence and self-esteem during difficult experiences, including dementia. A supportive psychotherapist may provide emotional support and listen to the challenges a person is facing while teaching helpful coping skills.
- Reminiscence therapy: Reminiscence therapy typically focuses on recalling pleasant memories and past events through various sensory experiences, including sights, sounds, tastes, smells, and tactile sensations. This may reduce stress, irritability, and feelings of isolation in those experiencing dementia.
- Validation therapy: Validation therapy may help those around an individual with dementia empathize with their situation, while also allowing those with dementia to communicate their emotions more effectively.
- Simulated presence therapy: Simulated presence therapy may alleviate agitation and feelings of anxiety in those experiencing dementia. This is often done using audio or video recordings of an individual the person trusts. These recordings may recount stories from the person's life or pleasant memories to provide a sense of comfort or security to the individual with dementia.
- Cognitive behavioral therapy (CBT): CBT sessions can help an individual identify, understand, and change potentially harmful thoughts or behavioral patterns. For those with dementia, CBT may address the feelings of anxiety that often occur. Although updated evidence may be needed, in two case studies, individuals with dementia underwent CBT and experienced clinically meaningful reductions in anxiety.
Support through online therapy
While therapy may be beneficial for individuals with dementia and their loved ones, in-person therapy sessions may not be available to everyone. In some cases, a person may not have health insurance, or they may live in an area with an insufficient number of mental health providers. Others may prefer the comfort and convenience offered by other communication formats, such as video conferences, online chat, and phone calls. In these situations, it may be helpful to explore alternative therapeutic approaches, such as online therapy.
Although not much research currently exists regarding the efficacy of online therapy specifically for treating dementia, studies suggest that online and in-person therapy can have similar levels of efficacy. In a 2022 systematic review and meta-analysis of randomized controlled trials, researchers found that there were no significant differences between in-person and online therapy in a number of different treatment outcomes, such as the following:
- Symptom severity
- Overall improvement
- Working alliance
- Function
- Client satisfaction
These results were recorded not only immediately after treatment, but during follow ups at three, six, and 12 months.
Takeaway
What an individual experiences in memory care can differ from what they may experience in a nursing home. While both can provide care and tend to activities of daily living, memory care facilities are often designed to address the specific struggles of those with dementia. This may be done through certain safety procedures, such as doors with alarms and supervision, or with specific treatments, such as medication and therapy. Both individuals with dementia and their loved ones may benefit from attending online or in-person therapy sessions to cope with the difficult emotions that can arise in response to a dementia diagnosis.
Frequently asked questions
Read more below for answers to questions commonly asked about memory care.
What is memory care, and how does it help patients with Alzheimer’s?
Memory care is a facility that provides a safe environment for people with Alzheimer’s and other forms of dementia, assists them in coping with their daily activities, and supports them in managing their symptoms.
The level and type of support provided in a memory care facility differ from what is provided in other residential facilities such as senior living communities and assisted living facilities. In most instances, memory care is a carefully structured environment where residents are offered the chance to engage in a variety of daily activities designed to stimulate them physically and mentally. Security features such as 24/7 monitoring and locked exterior doors ensure residents remain at all times. In most places, meals are provided and residents eat together. Many memory care facilities coordinate with outside agencies to maximize the number of services provided to residents; speech, physical, and occupational therapists may be scheduled to come work with patients.
The specialized care of a memory care facility tends to the overall health of the residents so that all of their needs can be met and they can experience the best quality of life possible.
Why is memory care so expensive?
The average monthly cost of memory care is $6,160. Memory care is often more expensive than residing in an assisted living community because it requires specialized training, specific equipment, specialized living facilities, and certain safety features to care for patients experiencing memory loss. Memory care units typically provide:
- 24/7 supervision
- skilled nursing care
- medication administration
- an exclusive room or semi-exclusive room for residents
- access to specialized therapies
- personal care such as assistance with bathing and dressing as well as laundry services
- safe outdoor spaces such as gated patios or walking paths
- a physical environment designed to keep residents safe with minimal safety hazards
Families who are unsure how to pay for memory care may benefit from consulting with an elder law attorney. This type of attorney may be able to help create a long-term care plan that protects the patient’s assets as much as possible.
Do dementia patients do better at home or in a nursing home?
The level of care available can help determine if dementia patients will do better at home or in a nursing home. People living with memory problems often feel more comfortable in the familiar environment of their home. In the early stages of the disease, many people can safely live at home, as long as they are provided the appropriate amount of support.
However, as memory loss progresses, many patients benefit from the services provided in residential care communities such as nursing homes, assisted living communities, and memory care communities. While each type of facility is different, the majority of them offer specialized support designed to protect residents and help them thrive in their current stage of life. For example, residents may be provided with a specially designed environment that minimizes safety risks, 24/7 monitoring, medication management, daily activities designed to physically and mentally engage residents, and more.
Will insurance pay for home health care for dementia patients?
Insurance may help cover out-of-pocket costs associated with caring for someone with dementia but typically don’t cover long-term custodial care, such as home health care provided by a licensed provider. Medicare will pay for up to 35 hours of home health care a week for people who are homebound, but this does not include nonmedical services such as bathing, dressing, and generally keeping the person safe.
When should you put someone in memory care?
The decision to place a loved one in memory care can be difficult to make, and many families may struggle to know when the time is right. Significant cognitive impairment and diminished physical abilities are often signs that someone can no longer live at home or with a loved one. Specific indicators that someone may require the assistance available in memory care programs include:
- ongoing health issues that necessitate skilled nursing care
- being unsafe at home without a way to provide a secure environment, such as the patient leaving the stove on or leaving the home at night while caretakers are asleep
- inability to complete personal care tasks such as bathing or getting dressed
- a noticeable decline in cognitive abilities and reasoning
- trouble arranging the necessary care coordination to keep a loved one living at home
- no access to activities that provide mental or physical stimulation
Caregivers should also consider how their loved one’s dementia is impacting their own life. Constantly providing the personalized care required by dementia patients, especially without assistance from paid caregivers, can be draining. Memory care may be the best solution if caregiving is negatively impacting a caregiver or their family.
What is the average lifespan after entering memory care?
According to research published by the Alzheimer’s Association, the average dementia patient dies 1.1 years after entering memory care.
How often should you visit a spouse in memory care?
It’s recommended to visit a spouse living in memory care at least once a week, although the frequency of visits comes down to personal preference. Some spouses may prefer to visit every day if they are used to living together at home, while others may choose to visit a few times a month to reduce confusion that may occur because of their visit.
During a visit, you might choose to join your spouse at the scheduled activities, listen to calming music, or look through memory boxes that contain familiar pictures from their past.
Do dementia patients prefer to stay at home?
85% of people say they would prefer to remain at home as long as possible if they were diagnosed with dementia. The comfort and security of home may help minimize confusion, especially if someone lived there for an extended period of time.
What are signs that dementia is getting worse?
Dementia is a progressive disease, with symptoms worsening over time. Signs that dementia is getting worse include:
- noticeable cognitive decline
- taking longer to complete daily living tasks
- experiencing hallucinations or delusions
- becoming physically or verbally aggressive
- changes in personality
- repeating questions or struggling to remember words
- worsening physical health conditions such as infections or significant weight loss
Does Medicare cover dementia care?
People with dementia and their families pay an average of $6,160 a month for the personalized care provided in a memory care facility. According to the National Council on Aging, Medicare may help cover the cost of some services provided to memory care residents.
Medicare Part A will cover:
- Up to 100 days in a skilled nursing facility after someone experiences a hospital visit
- Home health care for people who cannot leave their home due to their condition
- Hospice care for patients who have a life expectancy of 6 months or less
Medicare Part B will cover:
- Cognitive testing often used to diagnose dementia
- Services that help create care plans for people who were recently diagnosed
- Outpatient prescription medicine for dementia and Alzheimer’s, such as antipsychotic medications
Some people may also have Medicare Advantage plans, which may help cover dental, hearing, medication, and eye-related costs. For people who served in the military, veterans benefits may help cover the cost of caregiver support, long-term inpatient and outpatient care, and adult day health services.
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