How to choose a memory care community

If someone you love has been diagnosed with Alzheimer's disease or another form of dementia, you may be considering a memory care community. There are thousands of memory care communities, also known as memory care facilities, across the United States, and you'll likely have several options to consider in or near your hometown.

Choosing the right community for your loved one takes research, time, and careful consideration. You understandably want to make a thoughtful choice. While your loved one's physician, friends, or other people you trust may have suggestions, don't feel pressured to rush your decision.

Online research can help you get started and narrow your list, but you'll need to visit the memory care communities you're seriously considering. Seeing a community in person can reveal details that photos and descriptions don't capture. After all, you wouldn't buy a home based only on a few photos online.

Planning your tour of memory care communities

Start with online research to narrow your options and make a short list of communities to visit. A good place to start is putting together a list of three memory care communities, and consider touring several more if you have enough options nearby.

Once you tour your first memory care community, you'll quickly see why visiting in person matters. A tour offers a glimpse of what daily life could be like for your loved one and how residents and staff interact. Change and transitions can be very hard for people living with dementia, so finding a community that feels like a good fit is important. Visiting several communities, observing their environments, and asking detailed questions may reduce the chance that you'll need to move your loved one to a different community later.

Should you bring your loved one on a tour? The answer may depend on their stage of dementia, their fear of change, and how they usually respond to transitions. If touring multiple memory care communities could be confusing or frightening for them, you may want to conduct the initial in-person research on your own.

When should you visit?

A memory care community can feel very different depending on the time of day, the staff members present, and the activities underway when you visit.

• Morning: Residents will likely be most active and engaged in a range of social activities.

• Afternoon: Visiting during lunchtime can show you what types of food are served and how residents receive care and support during meals. You may also observe more social activities at this time.

• Evening: Prioritize morning or afternoon hours for your initial tour. However, because older adults living with dementia may have disrupted sleep cycles, consider requesting a follow-up nighttime visit to see how staff respond and support residents when they are awake.

What to look for during your tour

Each memory care community is unique, and you'll begin to understand the atmosphere and personality of each one as you visit. As you walk through the community, look for these key characteristics:

• Cleanliness throughout the community and resident rooms, if room tours are available

• Overall satisfaction among residents and staff

• Staff members who can answer your questions clearly and comfortably

• Programs that support physical and cognitive engagement

Questions to ask at memory care communities

During each tour, ask as many questions as you need. This is your opportunity to understand how the community operates and how it would support your loved one. Consider printing a list or keeping one on your phone so you don't forget anything important.

Here are some useful questions to get you started and guide your conversations:

What medical staff are available?

Start by finding out whether nurses are on duty 24/7 and, if not, what medical staff are available at night and on weekends. Ask whether the community has visiting physicians, how often they visit, and which other medical professionals, such as nurse practitioners, podiatrists, or physical therapists, regularly work with the community.

It is also important to understand how medical staff are trained, including whether they receive ongoing training specific to supporting residents living with Alzheimer's disease and dementia. Be sure to ask about the policy for handling medical emergencies, the on-site medical services available, and any types of care or services the community cannot provide.

What is the nursing staff composition and rotation?

At some point in our lives, many of us experience the important role nurses and nursing staff play in a person's health and day-to-day well-being. For people living with dementia or Alzheimer's disease, that role can be even more crucial.

Skilled nursing staff play a critical role in providing palliative care and noticing changes in a resident's health status. During your tour, spend time talking with the nursing staff, learning about their credentials, and understanding how the nursing team works.

What happens if a resident becomes physically aggressive?

Sometimes, residents living with Alzheimer's disease or dementia who have always been gentle and calm may unexpectedly become aggressive, hostile, or disruptive. Consider this question from both sides. If your loved one becomes aggressive, what steps will staff take to help calm them? Will psychotropic medications be used? Will their freedom to move around the community be restricted? Also ask what specific steps staff take to protect your loved one if another resident becomes physically aggressive.

How is the community secured?

Residents may sometimes wander or lose track of where they are. Ask whether doors are secured to prevent your loved one from leaving unnoticed. Is the building a standalone memory care community, or is it connected to another assisted living community? Are there secure outdoor grounds or other areas your loved one can safely visit?

What specialized care is offered?

Some memory care communities offer therapy and treatment for specific types of memory loss, such as vascular dementia. They may also offer treatment or accommodations for people living with other disabling diseases or conditions, such as Parkinson's disease or blindness. If your loved one needs any type of specialized care, ask detailed questions about it. You can also ask how much personal assistance your loved one can expect each day. Can the community accommodate needs related to diabetes, mobility, physical aggression, or wandering?

How are mealtimes handled?

Food can be a meaningful source of comfort and enjoyment, including for someone living in a memory care community. Review the menus to see whether your loved one may enjoy the food being served. Can residents eat when and where they want, or must they gather in a dining room at set times? How often does the menu change? Are there choices at each meal, or does everyone receive the same food? What accommodations are available for kosher, gluten-free, vegetarian, or other special diets? How does the community respond if a resident refuses to eat or wants food outside standard mealtimes?

Can residents personalize their accommodations?

Familiar surroundings can make a meaningful difference in the comfort and happiness of residents living with dementia, so ask how you can help your loved one feel at home. Can they bring their own furniture, hang pictures on the walls, or use their own linens? Can they bring a pet? If so, are there size restrictions or extra charges?

What amenities are provided?

Do residents have private bathrooms, or do they share bathrooms with other residents? Is there a TV in every room, and is cable or satellite service included? Does each resident room have an emergency response system?

What exercise programs are available?

Exercise programs may look different in a memory care community, with options such as dancing, chair-based programs, or activities involving a ball. As you review the activity schedule, look for daily programs that support and encourage movement.

How are residents kept engaged?

Daily engagement is one of the most important types of programming a memory care community can provide. This 2021 study shows that while building cognitive reserve, or CR, is important in preventing Alzheimer's disease and dementia, continuing to support CR is also important for slowing the progression of the disease.¹

During your tour, look for activities such as painting, coloring, working on puzzles, or listening to music. Pay attention to both the depth and variety of the programming, as these activities can help you evaluate the quality of care and daily engagement.

Can residents leave the community?

Can you take your loved one out for the afternoon if you choose? What do you need to do to arrange that type of visit? Is transportation available for medical appointments? Does someone from the community accompany residents or family members to these appointments? Do residents leave the community for other activities, such as a slow walk around the neighborhood?

Does each resident receive an individualized care plan?

The Alzheimer's Association has created a comprehensive guide to help families understand the stages of Alzheimer's, and each resident's care plan should closely reflect their individual stage, needs, and experience.

If staff can't give you a clear and unequivocal answer, it may be time to consider other communities. Once you hear “yes,” don't drop the subject. Keep asking questions about the process. Who creates the plan? Are physicians, nutritionists, or therapists involved?

Can my loved one stay through the end of life?

You need to understand what the community can provide if something happens or your loved one's care needs change. Ask about the discharge policy and whether your loved one can return after receiving rehabilitation elsewhere. What happens if your loved one can no longer walk or otherwise move independently? Can a resident receive hospice care in the community?

How does the community communicate with families?

Will you receive regular oral or written reports about your loved one's care and well-being? Will you have one contact person who keeps you informed? Will the community contact you during an emergency, and what types of situations does it consider emergencies?

What is the community's philosophy of care?

This question may sound abstract, but a memory care community's philosophy shapes every decision that affects your loved one. If its philosophy emphasizes kindness and encouragement, you should see those values reflected in staff members' attitudes and actions. A philosophy centered more on schedules and checklists may lead to a different set of staff behaviors. Review the written philosophy of care, and ask questions to determine whether the community follows and lives up to its stated values.

How does the community support cultural diversity?

Does the memory care community celebrate a range of holidays, activities, traditions, and events? Can it prepare and provide foods that reflect your loved one's culture? Maintaining a sense of familiarity, including practices and beliefs connected to cultural identity, might help your loved one adjust to and feel more comfortable in their new home within a memory care community. To learn more about cultural competence in memory care communities, The Crisis Prevention Institute provides an overview of the benefits of personalized care for residents and cultural competence training for staff members.

How to evaluate what you saw

After touring memory care communities, you'll likely have a lot to consider and compare. Collect printed materials during each visit to help you remember the details and keep the different communities straight in your mind.

Floor plans, brochures, and activity calendars can help you recall what you saw and learned at each community. Taking photos during your tour, when permitted, may also help you review the environment and evaluate your overall experience afterward.

Choosing a memory care community can feel like a major responsibility. Asking detailed questions, comparing the answers you receive, and carefully considering your own observations can help you make a thoughtful, informed decision for your loved one.︎