About Memory Care
More than 5 million Americans currently live with Alzheimer’s disease, and 1 in 10 seniors are affected by the condition, according to the Alzheimer’s Association. Those in the later stages of Alzheimer’s or dementia are typically unable to care for themselves on their own, and many families seek outside care to help their loved one manage their condition. Memory care, also called Alzheimer's care or dementia care, is a type of senior living that specifically serves adults with memory impairment. Memory care communities are staffed by professionals with training in memory disorders and can provide individuals with the specialized care that they need to live comfortably. These communities also benefit from additional security to help ensure the safety of residents and to prevent them from wandering or otherwise harming themselves.
Memory care is oftentimes the most comfortable and safest option for seniors who have been diagnosed with disorders such as dementia or Alzheimer's disease. Still, if looking into care for a memory-impaired loved one, selecting a community can be confusing and overwhelming. This guide will help you determine if your loved one is a good candidate for memory care and, if so, how to choose the best memory care community for them. We also break down the cost of memory care and financial assistance options, and answer some of the most frequently asked questions about memory care.
What is Memory Care?
Memory care communities, sometimes called dementia care or Alzheimer's care homes, are a type of residential senior facility designed for those living with memory impairment. Memory care communities are often outfitted with enhanced security and safety measures to meet the needs of the residents, and available care and programming are catered to those with cognitive decline. Some of the most common services and amenities you can expect to find in a memory care community include:
- Auto-locking doors to prevent wandering
- Secured courtyards or outdoor areas
- Emergency call systems throughout the facility
- Cognitive therapies and cognitive-focused activities and programming
- Fully prepared and served meals
- Assistance with personal hygiene
A goal of memory care is to keep residents minds’ active and engaged while ensuring their safety and security. In addition to the specialized services and amenities described above, it’s typical for memory care communities to offer standard personal care services seen in other long-term care communities, like assisted living. These services include:
- Assistance with activities of daily living
- Social, leisure, exercise, and religious activities
- 24-hour staff on-site
- Laundry and housekeeping
- Medication reminders
- Transportation to doctor's visits or social outings
What Are The Types of Memory Care Facilities?
Dedicated Memory Care Communities
Dedicated memory care communities are residential care facilities exclusively for people living with Alzheimer’s or other forms of dementia. These communities require staff to undergo special training in caring for those with memory impairment and often provide a more personalized approach to care with a higher caregiver-to-resident ratio. They may also feature secure outdoor areas for residents to enjoy safely and activities that are catered to those with cognitive impairment.
Memory Care Units Inside Larger Facility
If you anticipate your loved one may need memory care services in the future, but he or she does not yet require that level of care, you might consider looking for a facility that offers assisted living, skilled nursing, and memory care options all in one location. These Continuing Care Retirement Communities (CCRCs) allow residents to move from one section of the facility to another as their needs change. This makes for an easier transition to memory care at a time that is already quite stressful for most seniors and their families.
Though these memory care units may share a facility with other types of senior living, memory care sections are specially staffed and will have enhanced safety compared to other areas of the community. Memory care units within larger facilities should have all of the same specialized services and amenities as standalone memory care communities.
Adult Care Homes
If you're seeking a homier environment for your loved one, an adult care home may be a good option. These homes typically house just a handful of residents, which enables excellent one-on-one care. It can also be a more comfortable choice for seniors who get overwhelmed in large groups or spaces. While the services and care provided in adult care homes must still meet state guidelines, keep in mind that these smaller care homes may not have all the amenities and security personnel of a larger facility.
How Does Memory Care Compare to Other Types of Senior Living?
Memory Care vs. Assisted Living
Assisted living facilities are long-term care residences that offer assistance with the activities of daily living (ADLs) as well as other personal assistance and hospitality services. Residents of assisted living communities may need help with some of their daily tasks such as meal preparation or bathing, but are able to retain as much independence as they please. These communities typically have amenities such as fitness centers and exercise classes, an indoor or outdoor pool, and recreational rooms for residents to enjoy.
While assisted living communities may be able to offer care for people with early to moderate dementia, they are usually not equipped to care for people in the advanced stages. However, a dedicated memory care unit within an assisted living facility will have more advanced services available in the unit specifically to best serve residents with memory impairment.
Memory Care vs. Skilled Nursing Care
Nursing homes provide extended, around-the-clock skilled care to those who are unable to live independently and perform ADLs on their own. Residents of nursing homes may have chronic medical conditions or be recovering from an injury, surgery, or illness that requires continuous supervision.
Though the focus of nursing homes is medical care, not memory care, some nursing homes have a dedicated wing for residents who have late-stage dementia or Alzheimer's. Nursing homes can be a good choice for seniors living with memory impairment as well as other medical conditions that require them to have regular access to both skilled medical care and memory care. However, for seniors who have dementia but do not have other conditions requiring medical care, a dedicated memory care community is still likely the best option.
Memory Care vs. Adult Day Care
Adult day care provides seniors with a chance to be social and participate in staffed activities such as art, leisure, and exercise programs. Some centers even offer therapy and basic health services. While adult day care is not a good option for seniors in need of around-the-clock care or supervision, it can provide a nice daily break from 24-7 family caregiving. Some family caregivers may choose adult day care as a form of respite while they care for their loved one with dementia during the other hours of the day.
Not all adult day care centers cater to those with dementia, so it is important to research the specific program before choosing it for your loved one with memory impairment. Additionally, any adult day care center that you choose should have special security and safety measures in place for those with dementia just like a residential memory care community.
How Much Does Memory Care or Alzheimer's Care Cost?
Because memory care communities must have more advanced safety measures in place and specially-trained staff, it tends to be more expensive than other types of senior care. On average, memory care costs approximately 20-30% more than assisted living. Based on the average cost of assisted living in the United States, which is $4,051 per month, expect to pay approximately $5,437 per month for residential memory care. Remember that this is an estimate assuming a 25% price increase compared to assisted living, so it’s always important to understand a specific community’s costs and fee structure.
Keep in mind that the costs mentioned above are the national U.S. average, and costs in your state may be much higher or lower. Costs can also vary widely depending on what extra amenities and services may be available in a given community. Additionally, if your loved one requires both memory care and medical care in a skilled nursing environment, care will likely be more expensive.
How Can I Pay for Memory Care?
Memory care can be quite expensive, and it is a condition that requires progressively more care, and thus more expenses, over time. According to the Alzheimer’s Association, seniors and their families need to prepare themselves for a range of expenses including ongoing medical treatment/full-time care services, safety devices, home modifications, and more.
While the cost of memory care can be very high, there are financial assistance options available to help seniors and their families cover the cost of care. Most individuals pay for memory care via a combination of state and federal programs, out-of-pocket payments, and other assistance options. You’ll find an explanation of some of the most common ways individuals pay for memory care services below.
Medicaid is a joint federal and state program to provide health insurance for low-income individuals. In order to qualify for Medicaid, seniors must have limited income or assets. While partially funded by the federal government, Medicaid eligibility and benefits are determined by each state. Thus, the exact benefits available to you or your loved one will depend on the state in which you reside. You can find out more about eligibility and how to apply for coverage on the official Medicaid website.
Medicaid in some states does include coverage of assisted living services, which can extend to memory care. In most cases, these services are covered under a waiver program. These Home and Community Based Services (HCBS) Medicaid waivers, also called 1915(c) Medicaid Waivers, are intended to prevent unnecessary moves to skilled nursing care by making other senior care options, like assisted living or memory care, more affordable and accessible. Your state’s Medicaid or Medicaid Waiver program may cover the personal care services provided in an assisted living or memory care community. However, these programs do not cover room and board, so the individual and their families will still be responsible for a portion of the cost of care.
Medicare, a federal insurance program for adults over the age of 65, does not offer any coverage specifically for memory care. However, it does provide coverage for some care and services that those with dementia may need, including up to 100 days of skilled nursing home care and 35 hours of in-home care per week. Still, there are limitations to these benefits and not all seniors with dementia will qualify for coverage of nursing and in-home care.
A better option for those who can afford it may be a Medicare Supplement Insurance plan, also referred to as Medigap. Medigap plans are private insurance policies that work in tandem with standard Medicare to cover additional services and portions of costs. Some, but not all, Medicare Supplements may offer coverage of services associated with memory care.
Aid and Attendance Benefit for Veterans
The VA Aid and Attendance Benefit (A&A) is a special benefit for war-era veterans and their surviving spouses. It is a tax-free benefit designed to provide financial assistance to help cover the cost of long-term care in the home, in an assisted living facility, or in a nursing home with memory care. In order to be eligible for the A&A benefit, veterans must be receiving a standard VA pension and meet one of several health-related criteria. These criteria include needing assistance with ADLs, being primarily home-bound, or living in a nursing home “due to the loss of mental or physical abilities,” making the benefit accessible to most veterans with memory impairment. More details about the Aid and Attendance Benefit and how to apply can be found on the VA website, or seniors can apply in person at their nearest VA regional office.
Long-Term Care Insurance
Long-term care insurance is a type of private insurance intended to cover some of the costs of long-term care in the home or a residential care facility. Unlike Medicare and Medicaid which are at least partially funded and regulated by the government, long-term care insurance is purchased through private companies. Thus, there is no standardized minimum of coverage, and both coverage and rates can vary drastically. In general, expect the cost of an insurance policy to be higher and the benefits more scarce the older the beneficiary is when they sign up.
Some companies may deny coverage for people with pre-existing conditions such as Alzheimer's disease or Parkinson's disease, or for simply being above a certain age. Not all insurance will deny based on these conditions, so it is important to explore different options. If you or your loved one does not yet need long-term care but you predict you will in the future, it’s a good idea to consider signing up for long-term care sooner rather than later.
Though life insurance is intended to benefit one’s heirs after the policyholder passes, it may be wise to look at how your loved one’s life insurance could be a source of funds for memory care. The options you’ll have greatly depend on the type of life insurance policy, so it's best to discuss with an insurance broker or financial advisor. Your options for prematurely accessing your life insurance funds include:
- Life Settlement: You can sell your life insurance policy to a third party for market value and use the proceeds to fund memory care services.
- Surrender Policy: You give up ownership and the death benefit. If the policy has accumulated cash, the insurance company writes you a check for the full amount of cash value, which is often taxed.
- Policy Loan: You can take a loan from your life insurance policy, which means you won't pay taxes. However, you can't take a loan out for the full benefit value or the policy will lapse.
- 1035 Transaction: This allows you to exchange cash value from an existing life insurance policy into a new life insurance policy with memory care insurance benefits tax-free.
While using life insurance may be necessary to cover the cost of memory care, there can be some downsides to accessing one’s benefit early. Learn more about the benefits and downsides of using life insurance to pay for long-term care on the Department of Health and Human Services website.
Reverse Mortgage Loans
The Home Equity Conversion Mortgage (HECM) is a reverse mortgage that seniors can take against their home's equity. Insured by the federal government, it is only accessible via lenders approved by the Federal Housing Administration (FHA). Once finalized, the lender makes payments in a single lump sum, monthly installments, or as a line of credit.
The loan does not have to be paid back until the last borrower passes away or moves from the home for one full year. The home is usually sold, and the lender is paid back the full loan amount plus interest. If you want to use a reverse mortgage to pay for memory care, know that one of the co-borrowers must remain living in the home to qualify for a reverse mortgage loan. Once the surviving homeowner permanently moves out or passes away, the loan is due.
In situations when memory care costs aren't covered through other means, paying via private funds is an option. Sources of private funds for memory care include retirement accounts and 401ks, savings accounts, annuities and insurance plans (including life settlements), trusts and stock market investments. Though the cost of memory care is too high for many individuals to cover completely via private funding, combining private pay with one or more of the assistance programs mentioned above can make paying for memory care more feasible.
How Do I Choose a Memory Care Community?
How to Determine When It’s Time for Memory Care
It can be easy to notice the symptoms of memory loss and dementia, but the choice to seek help from a memory care facility can be a sensitive topic between families and their older loved ones. Still, it is a choice that is oftentimes essential for the well-being of the loved one and for the safety of others. If several of these situations apply to your loved one, then it may be time to consider a memory care facility:
- Forgotten, misplaced or incorrect dose of medications or supplements
- Forgotten alarm or gate codes, or forgetting to lock doors at home, thus becoming susceptible to crime
- Getting lost on a familiar route such as a nearby walk or while running usual errands
- Declining in daily care activities such as bathing, meals, grooming, or household chores
- Important information is forgotten such as phone numbers, addresses, bank passwords or other account security information
- Appliances like a stove or oven have been left on, or running water is left on
- Personality changes like distrusting others, confusion, anger, withdrawal or depression
- Care for the loved one is becoming too involved and interfering with other important responsibilities that the family members have
Just a few of the situations described above can be enough to spark the process of looking at memory care communities and deciding whether a nursing home, adult day care center, or assisted living facility may have the right services for your loved one. Not all facilities offer memory care, so it is important to keep in mind when exploring these options.
Evaluating Memory Care Facilities
Choosing a new home for a loved one is oftentimes overwhelming, especially if the individual is unable to clearly express their wants and needs. To help you focus on the most important aspects of memory care communities as you begin to research and tour different options, we recommend you pay special attention to these five key areas.
- Are emergency and nurse call systems functioning and accessible from multiple points in residents’ rooms? Ideally, help buttons will be accessible from bedsides, bathrooms (toilet and shower), and living room areas, as well as all common areas in the community.
- Does the facility provide a wearable safety monitoring system for your loved one, along with an identification bracelet?
- Is the community secure? Check to see if there are security cameras throughout the hallways and common areas.
- Are outside doors properly locked and attended? Do the windows have safety locks? There should be ample emergency exits with alarms. Check for locks and peepholes on resident doors.
- Is the building itself equipped with the necessary safety devices? Check for smoke, fire and carbon monoxide alarms as well as sprinklers. Find out how often they're tested.
- What are the community’s emergency drills and procedures? Are there emergency plans in writing? Are there emergency supply kits? Power generators? Where do residents evacuate to and how will families be notified? How will medication and care be handled in the event of an evacuation?
- Ask how staff members are trained and their qualifications. Find out about staff turnover, as this could indicate a problem.
- Confirm what medical care staff can provide. Be sure to understand whether they'll be able to continue caring for your loved one if he or she becomes bedridden or needs to use a wheelchair. What is their procedure in case of a medical emergency? Can they provide end-of-life/hospice care?
- If the community does not have an in-house physician, ask if there is a regular visiting physician or nurse practitioner. This can make life easier by eliminating the patient's need for transportation to a clinic.
- Memory care costs more than standard nursing home care partly because a higher ratio of staff to residents is needed for safety and comfort. Ask about the staff-to-resident ratio and whether it is different at night.
Available Services and Amenities
- Find out the details about room size, whether they're private and have their own bathrooms, and the room options that are currently available.
- Learn about the community’s meal plan, see if it looks appetizing and nutritious, and if they can accommodate dietary restrictions.
- Inquire about programming and opportunities for residents to get physical exercise. Memory care homes need to be secure to prevent wandering, but ideally the residents have a secure outdoor area for getting fresh air and recreation.
- Note which amenities and activities make a community stand out from others, if any. In the best facilities, each week has a full programming calendar of activities designed to help keep residents' minds active and lessen symptoms of decline.
- Study the fees and the contract. Make sure you understand what services are included in the monthly fee, and what will cost extra.
- Find out what extra services are available as “extras.” If visiting a community in-person, take the contract home to look at it thoroughly or to have an elder law attorney look at it.
- Ask if there are move-in fees and if you'll need to hire a mover.
- Ask if there is a price-lock, and if not, how much you should expect the rates to go up each year.
- Ask about the community’s process for evaluating residents’ needs and creating customized care plans. Do they continually assess residents?
- Will you have regular meetings with community staff to discuss the effectiveness of the care plan and any changes?
- Your loved one may have an easier transition if they have familiar belongings in their new residence. Ask if they can bring their own furniture and hang things on the wall.
- Make sure you can stay engaged with your family member. Ask if family members are welcome at mealtimes and during scheduled activities. If in-person visits are not an option, ask if the community assists residents with FaceTime, Zoom, and other video calls.
- Pets are family too. If your loved one has a four-legged companion, find out if pets are permitted either to live at the facility or for periodic visits.
Memory Care Regulations
Memory care facilities are not regulated federally like nursing homes. Each state has its own laws, regulations, and licensing standards for memory care. While all states require senior care facilities to be licensed, not all states have specific laws regulating memory care. States that do not have specific licensing requirements or regulations for memory care typically group memory care with other senior living options, like assisted living.
For memory care units within nursing homes, there is oversight by the Joint Commission, a nonprofit organization that manages the accreditation of healthcare organizations and programs in the United States. The Joint Commission has established a set of memory care requirements for accredited nursing care centers and has a certification program.
For all other types of long-term senior living communities, it's important to understand your state's laws for oversight and see if there are any specific laws related to memory care. The National Center for Assisted Living (NCAL) maintains a summary of all state regulations, updated each year. Be sure to review this when it comes time to select a long-term care community for your loved one.
Frequently Asked Questions
What is the Average Cost for Memory Care?
Memory care costs an average of $5,437 per month in the United States. This average is based on data from the Genworth Cost of Care Survey 2019, which reports the average cost of assisted living in the United States as $4,051 per month. Memory care requires staff to undergo specialized training and the communities must have enhanced security, requiring a cost increase of 20-30% compared to assisted living. The figure of $5,437 is based on a 25% increase in price compared to assisted living.
Is Memory Care Covered by Medicare?
Medicare covers some, but not all, costs associated with memory care for beneficiaries. Medicare covers a portion of the cost of outpatient services and doctor visits as well as inpatient hospital care. It offers coverage for up to 100 days in a skilled nursing facility, but only under certain circumstances, and custodial care in a long-term care facility is not covered. Most individuals in memory care communities rely on a combination of financial resources.
How Do You Know When It’s Time for Memory Care?
There are some key behavioral changes that can indicate that it’s time for memory care, such as aggression, increased confusion or disorientation, and a decline in personal hygiene. Some other key signs include increased forgetfulness that results in your loved one’s danger, such as leaving the stove on, and the inability to maintain the cleanliness of their home.
What is the Difference Between a Nursing Home and a Memory Care Facility?
The difference between nursing homes and memory care facilities is that nursing homes focus on skilled medical care and therapy services while memory care communities focus on the care and safety of those with Alzheimer’s and other dementias. Both are long-term care facilities that offer around-the-clock supervision from trained staff. Both types of communities also offer meal services, assistance with personal care, and security.
What Services and Amenities Are Provided in Memory Care Facilities?
Services and amenities provided in memory care facilities include personal care assistance, around-the-clock supervision and security, meal preparation, and laundry and housekeeping. Other services and amenities may include activity programming designed for cognitive stimulation and secured outdoor areas.
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Additional Memory Care Resources
- Checklist for Finding the Right Memory Care Community
- Treatments for Alzheimer's
- Understanding Alzheimer's Symptoms
- Starting With Assisted Living or Memory Care- Making the Right Care Choice
- Selecting the Right Memory Care Community
- Signs it May be Time for Memory Care
- What is Alzheimer's and Memory Care
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