Memory Care - how to evaluate?

[Anonymous]

If you have a loved one in Memory Care please share your advice on what to look for when evaluating different facilities. Any specific questions to ask? Also, is Memory Care the best place for someone in early stages of cognitive impairment but still w/ outgoing & engaged?

[Anonymous]

Allow yourself to trust. They are the professionals. They will tell you the appropriate level of care. You do not know. It's not your profession. Do the work, meaning spend the time with staff. Through personal connections you will trust what they say.

[Anonymous]

Anonymous wrote:Allow yourself to trust. They are the professionals. They will tell you the appropriate level of care. You do not know. It's not your profession. Do the work, meaning spend the time with staff. Through personal connections you will trust what they say.

Lot of words but not much substance.

[Anonymous]

Anonymous wrote:Allow yourself to trust. They are the professionals. They will tell you the appropriate level of care. You do not know. It's not your profession. Do the work, meaning spend the time with staff. Through personal connections you will trust what they say.

Trust no one. “They” are the “experts” at separating people from their money, disavowing responsibility, demanding babysitters to do what the staff should, and on and on.

The whole “memory care” monicker is a cynical misdirection.

All that said, tour the place(s). Not just what they want to highlight, and especially not the visually impressive stuff like a big staircase that nobody, and least of all your loved one, will ever use.

Look (and smell) for whether the place is clean. Look for hazards. Carpets can be filthy and dangerous. What about fall risks? Some places put the mattress on the floor. That can be good or bad. What do the bath/shower facilities look like.

Be extremely direct in your questioning. How often do they change diapers? If somebody needs a new one five minutes later is that going to get noticed and taken care of or will they wait for the next scheduled round?

Look at and watch the staff, especially from a distance. Caring is everything. I’ve seen people front flipped out of their wheelchair by staff in a hurry.

Try to see the place at off hours.

What do the residents look like? Over medicated? Restrained? Protected from each other? Are people getting the eating help they need? Are they getting human contact or just screen time? Are they getting moved around, repositioned, stimulated.

Are more-able people being maintained or allowed to slide?

Your best ally will be a person with experience, ideally a caretaker or if not a person who has been through it all.

[Anonymous]

Adding: be aware that places wax and wane. A place that was great five years ago may not be anymore. Or a place that had challenges may have gotten its act together.

Trust your gut. I know somebody whose loved one insisted on “x” facility even though the experienced allies and their connections in the community weren’t fans. It turned out poorly.

[Anonymous]

No, go a visit lots of places. Memory care is a locked facility where the people are totally out of it. I have a relative with early stages of dementia and they have said he can be in independent living.

[Anonymous]

Adding: location/convenience are a big deal. The more often you can conveniently host, ideally at unpredictable times and intervals, the better. Buttering up the staff helps. Many times visitors/family treat them like furniture. A smile and a sincere thank you or recognition that they did a good job can go a long way.

[Anonymous]

Anonymous wrote:If you have a loved one in Memory Care please share your advice on what to look for when evaluating different facilities. Any specific questions to ask? Also, is Memory Care the best place for someone in early stages of cognitive impairment but still w/ outgoing & engaged?

This is what is hard, most people in Memory care are not engaged at all. My mom is getting too needy for assisted living but when I toured memory care places she was still way too high.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Allow yourself to trust. They are the professionals. They will tell you the appropriate level of care. You do not know. It's not your profession. Do the work, meaning spend the time with staff. Through personal connections you will trust what they say.

Trust no one. “They” are the “experts” at separating people from their money, disavowing responsibility, demanding babysitters to do what the staff should, and on and on.

The whole “memory care” monicker is a cynical misdirection.

All that said, tour the place(s). Not just what they want to highlight, and especially not the visually impressive stuff like a big staircase that nobody, and least of all your loved one, will ever use.

Look (and smell) for whether the place is clean. Look for hazards. Carpets can be filthy and dangerous. What about fall risks? Some places put the mattress on the floor. That can be good or bad. What do the bath/shower facilities look like.

Be extremely direct in your questioning. How often do they change diapers? If somebody needs a new one five minutes later is that going to get noticed and taken care of or will they wait for the next scheduled round?

Look at and watch the staff, especially from a distance. Caring is everything. I’ve seen people front flipped out of their wheelchair by staff in a hurry.

Try to see the place at off hours.

What do the residents look like? Over medicated? Restrained? Protected from each other? Are people getting the eating help they need? Are they getting human contact or just screen time? Are they getting moved around, repositioned, stimulated.

Are more-able people being maintained or allowed to slide?

Your best ally will be a person with experience, ideally a caretaker or if not a person who has been through it all.

So this.

[Anonymous]

I toured a lot of memory care facilities. Most residents were bedbound and pretty advanced.

We found it helpful to talk to staff in the parking lots entering and exiting work. It is amazing what you can learn by talking to staff.

If someone is outgoing and engaged consider caregivers in the home who can take your loved one out in the community.

[Anonymous]

Also, is Memory Care the best place for someone in early stages of cognitive impairment but still w/ outgoing & engaged

I might suggest starting in assisted living that has on-site memory care. My mom is stage 3/4 Alzheimer’s and is level 1 assisted living. She has medication management but otherwise can dress, toilet, get herself to meals and will not get lost, have outbursts etc. I hire additional help 2x week to help her shower, fold laundry, get her to CVs etc. she is a long way from memory care even though her short term memory is terrible and she can’t cook, drive, pay bills or work her tv. She doesn’t need to do any of that in assisted living…

As for how to choose:look up violations; visit; see ifbthey have a 1, 2 or 3 year license (3 is best); how much turnover esp if nursing staff and director level. Look at activity sheets. Ask questions about how they handle x,y,z (aggression; falls; wandering etc).

[Anonymous]

What everyone else said, plus look up their Medicare ratings and all online reviews. Choose non-profits only. Gold standard is a strong accreditation by CARF.

[Anonymous]

You don’t necessarily need a memory care now, but it’s good to find an assisted living that also has a memory care onsite that she can transition to - ideally a CCRC that has assisted living, assisted living memory care, and long-term memory care on the same campus.

The biggest reason for a locked memory care unit is risk of wandering, or behaviors like sundowning, agitation, paranoia, etc.

[Anonymous]

Anonymous wrote:

Also, is Memory Care the best place for someone in early stages of cognitive impairment but still w/ outgoing & engaged

I might suggest starting in assisted living that has on-site memory care. My mom is stage 3/4 Alzheimer’s and is level 1 assisted living. She has medication management but otherwise can dress, toilet, get herself to meals and will not get lost, have outbursts etc. I hire additional help 2x week to help her shower, fold laundry, get her to CVs etc. she is a long way from memory care even though her short term memory is terrible and she can’t cook, drive, pay bills or work her tv. She doesn’t need to do any of that in assisted living…

As for how to choose:look up violations; visit; see ifbthey have a 1, 2 or 3 year license (3 is best); how much turnover esp if nursing staff and director level. Look at activity sheets. Ask questions about how they handle x,y,z (aggression; falls; wandering etc).

Thank you, PP. Can you tell me why a 3 year license is preferred?

[Anonymous]

My mom is middle of the road stage 6 dementia but is still pretty engaged even though her memory is shot. Her memory care residents range from people who are almost okay to people who are pretty much vegetative. Her place has lots of activities every day, and field trips once a week for those who are able. They get everyone out of their rooms to engage.

I toured every memory care in a 30 minute radius. I’ve learned that closer is better. Ignore online reviews, I found some places had staff reviewing them and my mom’s assisted living was the highest rated and just awful. The memory care place with the best reviews felt like a prison to me- it was dark and smelled like urine and everyone was completely disengaged.

I moved my mom from rehab directly to memory care after a fall (it was time anyway) so I needed a place that would put eyeballs on her because she was wheelchair bound initially and would never remember she couldn’t get up and use the restroom by herself. I picked a place where the staff physically puts eyeballs on the residents every hour, even throughout the night. One place used motion detectors at night and would respond to motion but I thought that might be too late.

Once I’d almost decided I went by several times to visit during different timeframes and they all seemed to be enjoying themselves doing some sort of activity or another. My moms place has therapy dogs that come in about once a week and they have “live concerts” once or twice a week. Engagement is key.