Memory Care vs Assisted Living: What's the Difference?

If you're a caregiver for an aging parent or loved one, chances are you've contemplated a structured senior living solution. After all, even on the good days, caregiving can be tough. And when you're managing chronic health conditions, memory issues or mobility challenges, it can get even tougher.

As our loved ones age, it's totally natural for their needs and abilities to change, as does our ability to effectively and safely care for them. One of the most challenging aspects of caring for an elderly family member is determining the right level of care and assistance, and recognizing when more help is needed.

Indeed, the landscape of senior living options is vast and sometimes confusing. Which type of care is best for your family - assisted living vs memory care? Should you look for in-home support instead? And what is an ADL, anyway?

If you're feeling overwhelmed by the number of senior living options and trying to evaluate the difference between assisted living and memory care, you've come to the right place. In this article, we'll walk you through the key similarities and differences between memory care and assisted living and even provide guidance on how to choose the right option for your loved one. Let's start with the basics:

Defining their care needs

Perhaps the most undervalued step in exploring any senior living community is being clear about the care needs that are required - both today and in the future. Most older adults will eventually need help with what is often called ADL's, or activities of daily living. These include things like bathing, getting dressed, or managing personal hygiene. 

In addition to understanding current needs, it's also beneficial to consider potential future trends. Has your loved one recently received a diagnosis which may influence future health or their ability to manage activities of daily living in the future?  Is their  memory loss getting worse? Are they wandering more? Or has their incontinence become more regular? Are they sleeping more hours during the day? It may be worthwhile to consult with a doctor to consider how a medical professional views the progression of health in your loved one.

Types of senior living

Once you have a good idea of what kind of care you're looking for, let's review the types of senior living categories you'll find in your search. There are several types of senior assisted living residence options available to cater to the varying needs and preferences of seniors. These include:

• Independent Living: Ideal for seniors who can manage their daily tasks independently but would like the convenience and social opportunities offered by a retirement community.
• Assisted Living: Suitable for seniors who need help with daily tasks, such as bathing or dressing, but do not require intensive medical care. There is usually support staff onsite 24/7.
• Memory Care: Designed for seniors with Alzheimer's disease or other forms of dementia who require special care and a secure environment.
• Skilled Nursing: Provides 24-hour medical care and rehabilitation services for seniors recovering from an illness, injury, or surgery. These facilities are commonly referred to as nursing homes.
• Nursing Home: Nursing home is a legacy term used to describe a skilled nursing facility.
• In-Home Care: Caregivers provide assistance with daily tasks and personal care in the senior's own home, allowing them to age in place.

Who needs assisted living?

An assisted living facility is an excellent option for seniors who need help with daily tasks but do not require intensive medical care. This type of care typically includes assistance with activities of daily living (ADLs), such as bathing, dressing, grooming, and medication management. Assisted living communities also offer various amenities and social opportunities for active seniors, such as dining services, housekeeping, transportation, and recreational activities. Seniors who need some support and but still want to maintain a level of independence may find assisted living facilities to be the perfect fit. Plus, assisted living communities generally provide increased opportunities for socialization, which is so important to aging outcomes.

Who needs memory care?

Memory care facilities are designed for seniors with Alzheimer's disease or other forms of dementia who require specialized care and a secure environment. These communities offer around-the-clock supervision, personalized care plans, structured routines, and activities that promote cognitive and physical well-being. Memory care facilities also have additional security measures to ensure the safety of residents who may be prone to wandering or confusion. Like other senior living options, hospice care can also be provided onsite when the resident meets the qualifications, and can be offered by a third party organization.

What is provided in a memory care community?

Memory care facilities offer a range of services and amenities specifically for senior care, tailored to meet the unique needs of seniors with dementia. These may include:

• Personalized Care Plans: Staff members work closely with residents and their families to create a care plan that addresses the individual's cognitive, emotional, and physical needs.
• Trained Staff: Memory care facilities should ideally staff members who are specifically trained in dementia care and communication, mental health issues that are often associated with dementia, and ensuring that residents receive the appropriate support and supervision. However, it’s important to verify what special certifications they hold, if any. Depending on the state, having staff with these certifications is usually not required to operate a memory care facility.
• Structured Routines: Daily schedules and routines help provide a sense of familiarity and stability for residents, reducing anxiety and confusion.
• Therapeutic Activities: Memory care communities offer activities designed to promote cognitive and physical well-being, such as music therapy, art therapy, and exercise programs.
• Secure Environment: Memory care facilities feature enhanced safety features, such as keypad entry systems and enclosed outdoor spaces, to protect residents who may be prone to wandering.
• Purpose-built design: Many memory care communities offer special design elements to improve outcomes for dementia patients. These might include:
  • Circadian lighting: to regulate sleep cycles
  • Memory boxes: to help dementia patients recognize their room
  • Circular hallways: to reduce wandering and encourage activity
  • High contrast colors: to help those with visual impairments easily see the difference between walls, floors and doors
  • Line of sight to bathroom: may help dementia patients reduce issues related to incontinence by providing a visual reminder of toileting
  • Outdoor spaces: while most memory care communities are secure, they should also have secure outdoor spaces for residents to get fresh air and sunshine - we all need a little vitamin D, right?
• Support Services: In addition to help with ADLs, memory care facilities often provide additional support services, such as medication management, housekeeping, and laundry.

Memory care and assisted living: together at last

The good news is that you may not need to choose between assisted living and memory care, as many assisted living communities also provide memory care. Often called a "neighborhood" or a "memory care unit" within assisted living, these are special environments for those with memory care issues. 

This kind of expansive "memory care assisted living" community is also great for couples where one person may have a dementia diagnosis but the other does not. Such environments allow couples to stay physically close and still receive the specialized care each one needs. Assisted living communities with memory care units are also good for those who may be in early stages of dementia and need to move to memory care as the disease progresses.

Some facilities are exclusively dedicated to memory care. It’s important to determine if your loved one will be sharing a room with another resident at a similar stage of their condition, or whether decisions for cohabitation are made independent of that. This may or may not matter to you. You should also ask whether residents are grouped into areas of the facility according to their level of care needs or in some other way.

Assisted living communities with memory care units are also good for those who may be in early stages of dementia and need to move to memory care as the disease progresses. 

How to pay for memory care facilities

Paying for memory care can be a significant financial concern for many families. The cost of memory care varies depending on factors such as location, facility size, and the level of care required. There are several options to help cover the costs of memory care, including:

• Long-term care insurance: Some policies specifically cover memory care services. It is essential to review the policy carefully to understand what is covered and any limitations.
• Veterans benefits: Veterans and their surviving spouses may be eligible for financial assistance through the VA Aid and Attendance Program, which can help cover the costs of memory care.
• Medicaid: In certain cases, Medicaid may cover memory care expenses for those with limited income and assets through a state's waiver program. Eligibility and coverage vary by state, so it is crucial to research your state's specific requirements.
• Private pay: Some families choose to pay for memory care out-of-pocket using personal savings, investments and the like.
• Other assets: Many families have other assets that may help them pay for memory care, such as the sale of a house, long term care insurance, or even a pension plan.

Depending on your age and your remaining assets, it's highly advisable to meet with a financial planner who specializes in working with older adults. These individuals understand the complex world of senior living and senior health and can be invaluable in the planning and budgeting process.

How to know when it's time to move to a memory care facility

Determining when a loved one needs to transition to memory care can be challenging for most families. Some key indicators that it may be time for family members to consider memory care include:

• Increased care needs: If a senior's care needs exceed what can be provided at home or in an assisted living community, such as increasing incontinent care needs, or greater unsteadiness on their feet, a memory care facility may be necessary.
• Safety concerns: If a senior with dementia is at risk of wandering, becoming lost, or experiencing accidents at home, a secure memory care environment can provide peace of mind. Look for door alarms and locked gates that permit only staff to enter and exit.
• Cognitive decline: As dementia progresses, memory care facilities offer specialized care and activities designed to support cognitive function and slow decline. Check their calendar of events. There should be plentiful opportunities for residents to stay engaged.
• Caregiver stress: Providing care for a loved one with dementia can be physically and emotionally demanding. A memory care facility can offer professional support to relieve caregiver burnout and ensure the senior receives the appropriate level of care.

In-home care vs memory care

While caregiver stress and capacity is a primary concern for trying to manage care for an older adult with dementia in home, there are also safety concerns. Caring for a loved one with dementia at home or can present various safety risks, including:

• Wandering: Individuals with dementia may become disoriented and wander from home, putting them at risk for injury or becoming lost. In-home care is rarely affordable 24/7, which is what someone that wanders may need. Or family may not have the proper security at home to protect the senior from wandering.
• Falls: Dementia can affect balance and coordination, increasing the risk of falls and related injuries. A memory care facility may provide staff to assist residents with walking about, and accompany them to activities or to meal time. Hallways are often outfitted with proper railing, ample spacing, while bathrooms will have grab bars, and other design features to reduce falls.
• Medication errors: Confusion and forgetfulness may lead to medication errors, such as taking incorrect doses or skipping medications altogether. If caregivers have limited time to properly monitor medications, memory care can assist with these tasks.
• Household hazards: Seniors with dementia may be unable to recognize hazards in their home environment, such as leaving the stove on or using appliances incorrectly.

Conclusion

Choosing between assisted living and memory care for a loved one can be a difficult decision. Understanding the differences between these options and assessing your loved one's needs and abilities will help you make the most appropriate choice for their care. If your loved one requires assistance with daily tasks but maintains a level of independence, assisted living may be the right facility and the best fit. However, if they have been diagnosed with dementia and require specialized care and a secure environment, memory care is likely the better option.

Remember to visit and research multiple facilities to find the best fit for your loved one's needs and preferences. Involving your loved one in the decision-making process, when possible, can help ensure residents enjoy a smooth transition to their new living arrangement.  This transition may still be difficult for patients with dementia, but memory care staff are trained in approaches that can help make the transition as smooth as possible.  

With the right support and care, seniors can maintain their quality of life, and families can have peace of mind knowing their loved one is safe and well-cared for.