Undergoing a life change can be stressful and scary—possibly exciting too. For example, if you’re moving to an assisted living community, you may miss your home but look forward to forging new friendships and making your life easier in general. However, what if you’ve begun to notice that your memory is not what it used to be? You’ve heard about something called “memory care” and wonder if it might be appropriate for your situation and if you can get it in assisted living. Here’s the scoop on your options, starting with overviews on what assisted living and memory care are.
What Exactly Is Assisted Living?
An assisted living community is one in which the residents largely lead independent lives. They do get some assistance for needs that vary from person to person, perhaps mobility, meal preparation, transportation, medication or bathing, for example. You may be ready for assisted living if it’s become hard/dangerous for you to navigate the stairs at your home or if driving poses a risk.
Assisted living can be in a large building or in a residential-style neighborhood. Some places allow pets and include laundry as part of the charge or for an extra fee.
What Exactly Is Memory Care?
Memory care communities differ greatly from assisted living communities. The residents in memory care have specific and serious memory-related needs. They may not remember who they are from day to day and may get frustrated walking around spaces that they’ve lived in for a while but now feel unfamiliar. They may be prone to wandering off the premises and can pose a danger to themselves and to others, especially if they get aggressive when frustrated.
The approach in memory care is different, and so are many design considerations. For instance, people with memory problems may get frustrated when confronted with a door they cannot get through, so many memory care communities have circular walkways where residents will not encounter doors or other obstacles to wandering. Likewise, touching something that doesn’t match how it looks can be scary (for example, seeing a table that looks like it’s made of wood but isn’t wood to the touch). Reputable memory care facilities try to devote a good deal of attention to factors such as:
- Consistent lighting that avoids shadows
- Circular walkways
- Locked exits that prevent off-site wandering
- Activities reminiscent of eras that unlock residents’ memories
To expand on the last one, an assisted living facility might have a social room that is filled with spaces for arts and crafts, jigsaw puzzles and board games. A memory care facility might instead have spaces devoted to child care (dressing and feeding lifelike dolls) and office work (“working” at a desk with a few office supplies). It may also have music therapy sessions in which residents listen to songs from their younger days.
Can You Get Memory Care in Assisted Living?
So, back to the worries about your forgetfulness. You think you’re okay in assisted living for the time being, but what if you might need memory care soon?
You cannot get memory care in assisted living, but there are many communities that incorporate spectrums of care. For instance, there are places that offer assisted living, nursing home care and memory care. Each type of care takes place in its own wing or building, but because you’re in the same general place, transitioning from one stage to the next can be easier. The decor shares many commonalities, and there can be the same familiar staffers’ faces no matter where you are. It’s also generally easier on residents’ friends and relatives. Not only can they consistently visit the same place, they don’t have to make new decisions and tours every few years as to where you might live. This can be helpful for you as well if you are trying to plan out your options in advance.
Of course, some degree of forgetfulness is normal with aging and does not necessarily indicate serious problems down the road. In any case, it’s always a good idea to visit the doctor if you are concerned about your memory.
Some Potential Disadvantages of Communities that Incorporate Different Types of Care
As touched on above, there can be huge advantages to choosing communities that offer different types of care. That said, there can be disadvantages as well. Perhaps most important is that some standalone memory care facilities may do a better job than memory care units or wings in larger communities.
Standalone memory care communities may have personnel who focus specifically on the needs of memory care residents rather than personnel who rotate in and out of different types of care situations and who may not be particularly knowledgeable about the specific needs of memory care residents. The design of standalone communities, too, tends to be geared more with the needs of memory care residents in mind.
Some memory care units that are housed as part of a larger community might focus more on simply keeping residents physically safe and from wandering off. A standalone community, on the other hand, might have the additional ability to help residents with their emotional and mental needs (examples: music therapy and stations for child care and office work).
As always, ask questions of each place you are considering. It could be that one place you’re eyeing offers assisted living, nursing home care and memory care and has top-notch services and personnel in all three areas. Meanwhile, the standalone memory care community you’re looking at could fall short in some important areas.
Another thing to keep in mind is that many residents enjoy having visitors as often as possible. So, say you find a great memory care facility to move into if the need arises. However, it is three hours away, so you might prefer to receive any memory care services locally even though they may not be robust as you would like. Your friends and family can help make up for some of a facility’s shortcomings if they read up on memory care and use recommended practices.
Paying for Assisted Living and Memory Care
One thing that assisted living and memory care have in common: Paying for them isn’t as straightforward as many folks would like.
First, assisted living: Your state’s Medicaid program may not contribute much, if anything, toward assisted living (nursing home care is a different story). If you are a veteran, the Veterans Administration's Aid and Attendance benefit can offset part of your assisted living costs.
In a nutshell, though, you should plan to finance assisted living via private means such as long-term-care insurance, savings accounts, sales of assets, life settlements, reverse mortgages and other means. The earlier you can purchase long-term-care insurance, the lower your monthly costs may be, especially if you opt for inflation protection. Don’t get overly discouraged if one company denies you for coverage. You may succeed with other companies.
Now for memory care: Any of the private means you use to pay for assisted living can also be used to finance memory care. There is also extra help for veterans and more government support available for non-veterans who need memory care. Programs such as Medicaid help, although the extent to which they help varies by state. You may also be placed on a waiting list until you can get into memory care, which is something that would probably not happen if you had the private means to pay.
At a Glance: Assisted Living vs. Memory Care
Here’s a chart that breaks down some key similarities and differences in assisted living and memory care.
|Assisted Living||Memory Care|
Availability of Government Assistance
|Nonexistent to limited||Largely available but with potential downsides such as limited selection of facilities and wait times|
Focus on Helping Stave Off Cognitive Declines
|No. You are largely in charge of how you live your life, but assisted living does typically provide socialization and recreational opportunities that can help slow cognitive decline.||Yes and no. Some communities, particularly standalone memory care centers, have a specialized approach to keeping residents engaged and happy and that potentially slows memory declines.
In other places, “memory care” might simply mean a space that is little more than a standalone wing or unit with security measures to prevent residents from wandering off.
Degree of Independence
Skilled Nursing Available
|Nonexistent, although assistance should be available for receiving medications and transport to doctors’ appointments||Yes|
|Yes in many places||No, but some memory care facilities may use animal-based therapy such as dog visits|
Which Living Option Suits You?
It should be pretty clear which is more appropriate for you right now, assisted living or memory care. The larger question is whether you’d prefer to receive any memory care you need later at a standalone place or if you’d rather stay in the same general place for assisted living and possibly nursing home care and memory care. Factors to keep in mind for this include how close your friends and family are, whether they’d visit, how involved they would be in your care and how close/far from your loved ones these potential communities are. What’s right for one of your friends may not be right for you.
Another factor is whether you have the private means to pay for support. If you don’t, assisted living may not be possible. Private pay and some community resources tend to be cheaper than going into assisted living and can help pay for someone in your home part-time so you can stay there longer. If a time comes when you need memory care, you should at least be eligible for admission into the memory care unit of a nursing home
Yet another consideration: Enhanced private pay options such as long-term-care insurance can mean you are able to afford higher-tier assisted living and memory care communities.