The Savvy Senior: How to Choose a Memory Care Unit

By Jim Miller

Dear Savvy Senior,

My mom has Alzheimer’s disease and has gotten to the point that she can’t live at home any longer. I need to find a good memory care residential unit for her but could use some help. Any suggestions?

Exhausted Daughter

Dear Exhausted,

Choosing a good memory care residential unit for a loved one with Alzheimer’s disease is a very important decision that requires careful evaluation and some homework.

Most memory care units, sometimes called special care units, are housed within assisted living or nursing home facilities. At their best, they offer staff extensively trained in caring for people with dementia, individualized care that minimizes the use of dangerous psychotropic drugs, a home-like environment and activities that improve residents quality of life. But at their worst, they can offer little more than a locked door. Here are some steps that can help you find a good facility and avoid a bad one.

Make a list: To identify some good memory care residential units in your area ask your mom’s doctor for a referral, and use the Alzheimer’s Association online tool at CommunityResourceFinder.org. Make sure the facilities on your list are close to family members and friends who can visit often, because residents with frequent visitors usually get better care.

Research your options: Once you’ve made a list, contact your local long-term care ombudsman (see LTCombudsman.org). This is a government official who investigates assisted living and nursing home complaints and can tell you which facilities have had problems in the past.

If you’re looking at a memory care unit within a nursing home facility, use Medicare’s nursing home compare tool (Medicare.gov/nursinghomecompare), which provides a 5-star rating system.

Call the facilities: Once you’ve identified a few facilities, call them to find out if they have any vacancies, if they provide the types of services your mother needs, what they charge and if they accept Medicaid.

Tour your top choices: During your tour, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the current resident’s family members, if available.

Also, find out about staff screening and training procedures, their turnover rate, and the staff-to-resident ratio. They should have at least one staff member for every five residents.

Make sure the facility offers quality activities that can keep your mom engaged, even at night when she may be awake. Ask how they respond to residents who may wander or become aggressive. If the answer is locked doors and antipsychotic drugs, that’s a red flag.

Because transitions can be unsettling for dementia suffers, make sure that your mom will be able to remain at the facility for the foreseeable future. And find out what, if any, health conditions might require your mom to leave the facility or move to a higher and more expansive level of care.

It’s also a good idea to make multiple visits to the facility including an unscheduled visit at night or on weekends when the staff is more likely to be stretched thin.

To help you evaluate your visit, the Alzheimer’s Association offers a checklist that you can access at ALZ.org/residentialfacilities.

Paying for care: The national average costs for memory care within an assisted living facility is over $5,000 per month, and over $7,500/month for nursing home care, but costs can vary widely depending on your location. Since Medicare does not cover long-term care, most residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid (if available) once their savings are depleted.

To help you research your financial options, visit the National Clearinghouse for Long-Term Care Information website at LongTermCare.gov.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.