People with Alzheimer’s need more and more help with daily life as their disease advances. Nursing homes and memory care facilities are two residential options for caregivers who are managing serious Alzheimer’s symptoms such as wandering, emotional outbursts, and personality changes.
What Are Nursing Homes?
Nursing homes provide various levels of health care for their residents around the clock. In a nursing home, residents have 24-hour supervision and help with everyday activities such as having meals, using the restroom, bathing, and getting dressed.
Nursing home care is for people with many types of disabilities and health issues who require more care than what can be easily provided in a home setting. Nursing homes also house and care for seniors who are unable to live on their own or care for themselves but don’t need to be in a hospital.
Some nursing homes offer short stays after surgery or a hospital stay. People with Alzheimer’s may live in a nursing home for the long term, and they'll need higher levels of care as time goes on.
Along with basic care, nursing homes also offer skilled care from health professionals, such as physical, occupational, and speech therapy. Nurses also provide direct medical care, such as managing medication, wound care, IVs, and tube feedings.
Nursing homes vary greatly in size, staff-to-resident ratio, and types of trained care workers. Every nursing home must be licensed by their state and regulated by the federal government.
Nursing homes generally provide a higher level of care than assisted living facilities, which offer meals, housekeeping, help with personal care and medications, and social activities. The U.S. government doesn’t regulate these facilities.
What Are Memory Care Facilities?
Like nursing homes and assisted living facilities, memory care units offer round-the-clock care and supervision and help with daily activities such as bathing and dressing.
The main difference is that they provide specialized care for people with memory loss. They focus on creating a secure environment for people with dementia or Alzheimer’s while giving them the best quality of life possible. Their employees are trained to deal with people who have cognitive impairments (problems with memory and thinking) such as dementia and Alzheimer’s.
Memory care is often offered separately within a nursing or assisted living facility. Usually (but not always), these units are secured to reduce the risk that people with memory loss could wander off the property and get lost. Memory care can also be provided in a standalone building.
Memory care units tailor health care to the needs of those with Alzheimer’s and dementia. They may use signs and pictures to help residents do things independently as much as possible. Many offer enclosed outdoor courtyards for recreation and common areas designed to make it easier for residents to find their way around.
These facilities often stick to preplanned schedules to give structure to residents’ days. They may also offer special activities, such as music or art therapy, designed to benefit those with memory loss.
Around 15% of nursing homes and 14% of assisted living and other residential care communities have a special dementia care unit.
Signs Your Loved One Needs Memory Care
When your loved one has dementia, they may still be able to live at home, especially if a family member or a hired caregiver helps them. But there may come a time when home care isn't enough. If you're thinking about memory care for your loved one, talk to an expert, such as a geriatrician or a trusted doctor, to help weigh your options. Also, consider the following:
Safety
You may realize that you can't leave your loved one or family member at home alone for even a short time without worrying about whether they'll hurt themselves or wander away from home.
Personal care tasks
As your loved one's dementia gets worse or more complicated, personal care tasks, such as going to the bathroom and taking showers, become challenging, and they may need extra help.
Caregiver needs
Taking care of someone with dementia can be overwhelming. Memory care experts can help you maintain your mental well-being. By doing so, you can continue to be a supportive family member or friend.
Benefits of Memory Care
Moving someone you care about to a memory care facility can be a tough decision. You may feel guilty or think you should be the one to care for your loved one with dementia. But looking after someone with this condition can be a round-the-clock job, which you may not be able to manage. Understanding the benefits of memory care can help with your decision-making. They include:
- Professional health care for your loved one, such as physical therapists and psychiatrists
- A safe environment that gives you peace of mind and security for your loved one
- Social activities and exercise, which could ease the effects of dementia
- Personalized care, such as providing medication and help with everyday activities including bathing, dressing, and diet management
- Care from staff with specialized training in dementia care
- Help for caregivers, which allows them to return to their primary role
How Do You Pay for Nursing Home and Memory Care?
How you pay for care depends on where you live, what kind of facility you use, and your financial situation. Many families pay much of the costs out of pocket. Other options include:
- Pension payments
- Social Security benefits
- Stocks
- 401(k) and IRA accounts
- Proceeds from the sale of your home
- A personal life insurance policy
- Long-term care insurance
- Veterans benefits
The average cost for a private room in a nursing home is about $299 a day, which adds up to about $109,000 a year. A semi-private room (one you share with another person) is about $263 per day, or $96,000 a year. Memory care averages $6,935 a month, or $83,220 a year, according to the National Investment Center for Seniors Housing & Care.
Medicare doesn’t cover custodial care, which means help with everyday activities such as dressing and bathing. Most nursing home and memory home care is at this level.
In some cases, Medicare does cover some skilled nursing care after you’re released from a hospital, but only for the first 100 days. It also may cover certain medical services you may get through a nursing home or memory care unit, like hospice care. But it doesn’t pay for long-term residential stays.
Private long-term care insurance usually covers the cost of care provided in nursing homes and memory care facilities.
Medicaid covers many nursing home and long-term care services in Medicaid-approved facilities. To qualify for this coverage, you must meet certain requirements for your level of care, income, and assets. These requirements vary from state to state. Veterans’ benefits may also cover these services.
Think about talking to an elder law attorney where you or your loved one lives to get some advice and structure your assets, which will help you qualify for memory care financial assistance. You can also reach out to your local area agency on aging where a social worker can help guide you through the Medicaid application process.
Memory Care Alternatives
If memory care isn't right for your loved one, here are a few other options:
- In-home care. A home health aide, companion care, or homemaker services can help with cleaning, cooking, bathing, dressing, and using technology.
- Adult day centers. These services offer therapy, social time, and some health care during the day when your loved one can’t stay home alone.
- Respite care. If you need some time off, respite care can temporarily take care of your friend or family member.
- Dementia support groups. Available online or in-person through your local agency on aging, these dementia support groups offer helpful resources to you and your loved one.
How to Choose a Memory Care Facility
When you’re considering a nursing home or memory care facility, you can use Medicare’s nursing home search-and-compare tool to see how they rate on health inspections, staffing, and quality measures. Once you’ve selected some options, arrange a meeting with staff to take a look in person and ask questions.
Basics to look for include:
- Medicare and Medicaid certification
- Handicapped access
- Residents who look well cared for
- Good interaction between staff and residents
- The smells and sounds at the facility
- The overall environment (for example, does it have a common area for those who prefer to be social or an outdoor area for residents who enjoy nature?)
- Staff training and expertise
- The highest level of care provided
Try to visit on different days of the week and at different times, including mealtimes. Talk with staff members. If possible, speak with other families with loved ones at the facility so you can get a firsthand account of what it’s like. You can also ask to see the facility’s latest inspection or survey report.
Questions that you can ask during your tour include:
- What kind of activities do residents participate in?
- Are there extra costs for certain types of care?
- What are your facility policies?
- What’s your staff-to-resident ratio?
- How often does staff turn over?
- What’s the daily schedule for residents?
- How are families informed about changes in residents’ health?
When visiting a memory care unit, you can also ask:
- Is this a locked facility?
- Are there separate costs involved with this unit?
- What other special directives are in place for those with memory loss?
- What kind of training does your staff have in dealing with dementia patients?
- How does the staff handle challenging behavior?
- What happens if the resident runs out of money?
Medicare offers a Nursing Home Checklist worksheet you can print and take along with you on tours to be sure you cover all the bases.
Takeaways
Nursing homes offer care to people who need help with daily activities and medical needs. Memory care facilities also offer these services, along with specialized care for people with memory problems. The right facility will meet your loved one's needs with trained staff who will help with everyday activities. Research the costs of different types of care before deciding for yourself and your loved one.
Memory Care FAQs
How long can a dementia patient be cared for at home?
Dementia affects everyone differently, and symptoms appear at different levels. But, with good support, many people live without help for years. As dementia advances, taking care of yourself and your home will become harder. You might need extra help with daily tasks such as housework and shopping.
What are the stages of dementia?
Stage I (No dementia). You have no visible symptoms or changes in memory or behavior. People see you as free from (without) mental health issues.
Stage II (subjective memory loss). You may notice some memory loss signs, such as forgetting names or where you placed things.
Stage III (mild cognitive impairment). You start having trouble remembering information or recalling events and may repeat questions or struggle with tasks.
Stage IV (moderate cognitive decline). You have evident trouble performing daily tasks such as paying bills or preparing meals. Your memory loss includes forgetting recent events, but you can still recall some information, such as where you live.
Stage V (moderately severe cognitive decline). You need help with daily activities, such as choosing what to wear. It may be difficult for you to recall important information.
Stage VI (severe cognitive decline). You need help with most daily activities, such as dressing and bathing. At this stage, your memory loss includes confusion about your family members and current events. Behavioral issues such as agitation or aggression can appear too.
Stage VII (very severe cognitive decline). You need continuing help with all of your everyday activities. You may only be able to speak a few words and lose the ability to move by yourself.
What is the survival time for dementia?
Life expectancy for dementia depends on which type of dementia you have and your overall health. People with Alzheimer's disease live for around 8 to 10 years on average after diagnosis.
