How to Choose a Memory Care Facility
Memory care communities provide 24/7 security and personal care. For seniors who are confused to such a degree that they’re disoriented and a possible danger to themselves or others, having round-the-clock supervision is essential. You don’t want your loved one wandering off, leaving an appliance on or subjecting other residents to angry outbursts. Assistance with toileting, bathing and grooming is an important part of memory care, too.
In this guide, we’re highlighting all of the key factors to look for when searching for the right memory care community for your loved one.
What to Expect From Quality Memory Care
Compared to what was available at memory care homes a few years ago, these three relatively new developments in memory care are making a positive impact.
1. Personalized Care vs. a One-Size-Fits-All Approach
“Person-centered care that’s focused on each individual’s needs and preferences is a best practice now,” says Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care. “This type of care plan takes into account a person’s typical life patterns, such as waking, sleeping and activities, as well as their likes, dislikes, and care needs.
Caregivers tuned into the individual’s needs and wants are better able to provide care. This approach also allows an individual to keep and use personal belongings, including clothing, furniture, and other items, to the greatest extent possible.”
2. Smarter Approaches to Communication, Security and Medication
Recent memory care advancements include new communication best practices including using what’s known as empathic validation, less intrusive security cameras for 24-hour surveillance, and personalized monitoring devices such as Wanderguard. There are also new medications, which can help curb potentially dangerous dementia behaviors such as wandering.
But over-medication can be as much a problem as under-medication. “There are efforts to reduce the use of antipsychotic medications, which we know can cause serious side effects and even death for people with dementia,” says Robyn Grant, The National Consumer Voice for Quality Long-Term Care’s director of public policy and advocacy. A more holistic focus on available medications and their side effects help residents get the most suitable mix of the medications and dosage.
3. A Setting That Feels Like Home
Many of us know all too well that unpleasant feeling residents and family members have when we enter memory care to visit someone and think, I’m definitely in a dementia wing. “Increasingly, long-term care facilities are moving away from the sterile, institutional feeling and creating more home-like settings,” says Smetanka. “Incorporating personal items in resident rooms and creating comfortable common areas help residents and families feel more at home.”
From a design standpoint, many memory care centers now offer both outdoor and indoor spaces aimed at being comforting as well as secure and soothing. Many facilities now build in visual memory cues to help residents get around, in addition to well-marked paths, gardens and access to nature.
A lot of facilities are also widening the range of activities that keep residents of all physical and cognitive abilities more engaged. A few years ago, you didn’t see as many music programs, exercise classes, cooking clubs, and art programs in memory care.
Memory Care Checklist: What to Look For, What to Ask
Choosing the right residential care facility is hard, and choosing the right memory care facility is even harder.
Here are some questions to ask to help make the decision easier. As with any residential facility, try to visit at least once to get a good sense of what the facility is really like, not just what the facility’s advertising says about it.This checklist supplements the more general assisted living checklist by asking memory-specific questions, so be sure to print out both to take on tours.
- Is the facility able to accommodate people at all levels of dementia, or only at specific levels?
- Why might a resident be asked to leave the facility?
- Who assesses residents’ health and cognitive functioning? How often is that assessment repeated?
- Does each resident have a formal, written plan of care?
- Does the facility help with all ADLs, including bathing, toileting, and eating?
- If the facility is part of an assisted living facility or continuing care retirement community, is the memory care section separate from other areas?
- Is the memory care area all on one level?
- Are the residents’ rooms private or shared?
- Is the facility laid out with circular hallways so that residents aren’t frustrated by cul-de-sacs?
- Is there an enclosed, secure outdoor area with walking paths?
- Does the facility feature even, good lighting in hallways and common areas?
- Does the facility feature non-slip floor surfaces in all rooms, including bathrooms?
- Is the interior and exterior of the facility secure?
- What methods are used to keep tabs on residents and make sure they don’t wander out of the building or off the grounds?
- Are doors and rooms labeled clearly, both with words and pictures, to help residents orient themselves?
- Do residents have “memory boxes” outside their rooms to help them identify the right room and to help staff members get to know them better?
- Are the colors used throughout the facility bold and unpatterned?
- Does the facility feature good natural or faux-natural lighting in residents’ rooms and common areas?
- Is the facility generally pleasant, clean, and peaceful?
- What kind of dementia-specific training do staff members have?
- Do staff members seem to know each resident’s name, personality, and background?
- Do staff members seem kind and attentive to residents’ needs?
- What is the staff-to-resident ratio? (The ratio should be at least 1 to 7, especially for later-stage dementia.)
- Is there an RN, LVN, or CNA on staff?
- How do the staff members deal with difficult behaviors, like aggression, mood swings, and sundown syndrome?
- What is the facility’s policy on the use of restraints — both physical and chemical?
- Do residents seem to enjoy the food?
- How does the facility encourage eating among residents who are uninterested in food — or how does it encourage residents who tend to overeat not to be unhealthy? (Studies have shown that contrasts, like brightly colored plates, can encourage people with dementia to eat more.)
- Will the facility cater to special nutritional needs or requests?
- Does the facility offer spiritual or religious services that your loved one would enjoy attending?
- Does the facility allow pets? Does the facility have any of its own pets?
- What activities are offered to residents? Do they seem like they would engage your loved one?
- Does the facility offer regular exercise sessions for residents who are physically able to participate?
- What resources are available to engage residents’ long-term memories? (Some facilities offer fake kitchens where former bakers can feel at home, or stations where residents can fold laundry or do other familiar tasks that might be comforting.)
Ways to Make Sure Your Loved One Gets the Best Possible Care
Residents exhibit a range of behaviors in memory care communities (e.g. everything from severe short-term memory loss but otherwise functioning to outbursts and near-complete withdrawal). But with more person-centered care these days, it’s easier to make sure your aging loved one is getting the best care and making the most of their remaining years with attentive staff and fellow residents on their level.
Make sure staff understand your loved one.
“The first thing you can do is to help staff get to know your loved one,” says Smetanka. “Focus on your loved one’s likes [and] dislikes, what they enjoy, dislike, what comforts them, and how to respond when they are distressed. If a resident shows behaviors that are concerning – withdrawal, outbursts, aggression – staff should be assessing what the resident might be trying to communicate. Are they hurt or in pain? Bored? Hungry? Tired? Adjustments can be made to the plan of care to address the resident’s needs.”
The second thing to do is to get involved. More loved ones are participating in a loved one’s care these days from regular in-person and video visits to speaking up when there’s a problem — and that can only lead to better care.
Choose a community with well-trained staff.
Finally, ask questions about staff training. How much training does the community’s staff receive? Are they trained to stay engaged with residents, rather than ensconced at a nurses’ station? Will they help foster relationships between residents of similar cognitive levels?
One thing is clear: advances in memory care don’t just happen by accident. Sure, new scientific breakthroughs in medication and technology offer a tremendous amount. But nothing spurs progress as much as family caregivers whose active concern for loved ones propels the memory care industry to raise the bar and provide the best care possible.