If you visited these pages last week, you may have read our exploration of the signs and symptoms to look for when a parent or loved one is beginning to suffer from dementia or Alzheimer’s disease. This week, in part 2 of our review, we’ll take a deep dive into the next logistical step: What to look for in a Memory Care facility.
Memory Care units, also known as Special Care Units (SCUs), are often housed within an assisted-living or skilled-nursing facility. At best, they can offer a home-like environment, activities that improve residents’ quality of life, and a staff extensively trained in caring for people with dementia. But at worst, they may offer little more than a locked door.
Common services to look for include 24-hour supervised care, medical monitoring and assistance with daily living tasks, in addition to a pleasing environment that is easy for residents to navigate.
“There are no consistent standards for Memory Care,” says Mitzi McFatrich, executive director of Kansas Advocates for Better Care.
What’s more, according to Scott Mayeda, a Southern California resident whose father has dementia, there are no Trip Advisors in the Memory Care world, referring to the popular website and app for travelers.
“You can’t just go online and find nearby facilities rated in terms of their quality of care and costs with frequently updated testimonials,” he says. “I learned that the hard way with my dad’s first facility.”
Ultimately, Mayeda discovered someone locally who acted as a consultant and directed him to the home his father is in now.
But if you’re considering memory care for a loved one, you need to do your homework to find out exactly what services are being offered at each facility. That means:
Here is an extensive list of categorized questions to ask to help make the decision easier.
Is the facility able to accommodate people at all levels of dementia, or only at specific levels?
What is the monthly rate for housing and care? What services does that rate include?
Who assesses residents' health and cognitive functioning? How often is that assessment repeated?
Does each resident have a formal, written plan of care?
Does the facility help with all ADLs, including bathing, toileting, and eating?
What is the policy for handling medical emergencies?
How does the facility communicate with families about a resident’s well-being?
What is the discharge policy? Why might a resident be asked to leave the facility?
If the facility is part of an assisted living facility or continuing care retirement community, is the memory care section separate from other areas?
Is the memory care area all on one level?
Are the residents' rooms private or shared? How do prices vary for each?
Is the facility laid out with circular hallways so that residents aren't frustrated by cul-de-sacs?
Is there an enclosed, secure outdoor area with walking paths?
Does the facility feature even, good lighting in hallways and common areas?
Does the facility feature nonslip floor surfaces in all rooms, including bathrooms?
Is the interior and exterior of the facility secure?
What methods are used to keep tabs on residents and make sure they don't wander out of the building or off the grounds?
Orientation and comfort:
Are doors and rooms labeled clearly, both with words and pictures, to help residents orient themselves?
Do residents have "memory boxes" outside their rooms to help them identify the right room and to help staff members get to know them better?
Does the facility feature good natural or faux-natural lighting in residents' rooms and common areas?
Is the facility generally pleasant, clean, and peaceful?
Does the facility accommodate special care needs, such as physical aggressiveness and wandering?
What kind of dementia-specific training do staff members have?
Do staff members seem to know each resident's name, personality, and background?
Do staff members seem kind and attentive to residents' needs?
What is the staff-to-resident ratio during both day and night? (The ratio should be at least 1 to 5, especially for later-stage dementia. “If you don’t have that, you end up with people placed in front of the television,” McFatrich says.)
Is there an RN, LVN, or CNA on staff?
Do most of the staff members have a long history there? Or has there been a lot of turnover recently?
How do the staff members deal with difficult behaviors, like aggression, mood swings, and sundown syndrome?
What is the facility's policy on the use of restraints -- both physical and chemical?
Food, activities, etc.
What meals are provided? Are special nutritional needs and dietary requests, such as kosher meals, accommodated?
Does the food look appetizing and taste good? Do residents seem to enjoy it?
Is there adequate staff to assist those who need help eating? Are there residents calling out who are being ignored?
How does the facility encourage eating among residents who are uninterested in food -- or how does it encourage residents who tend to overeat not to be unhealthy?
Does the facility offer spiritual or religious services that your loved one would enjoy attending?
Does the facility allow pets? Does the facility have any of its own pets?
What activities are offered to residents (exercise, physical therapy, social, etc.)? Do they seem like they would engage your loved one?
Does the facility offer regular exercise sessions for residents who are physically able to participate?
What resources are available to engage residents' long-term memories?
Finally, and perhaps most importantly, consider the one factor that patient advocates say can all but guarantee more successful residencies: proximity to family and friends. Even a good facility can’t make your loved one a happy camper without you and other family members being there on a regular basis and being very involved, even though they may not remember who you are.
“It’s definitely sad that I’m no longer able to reminisce and share memories with my father,” says Mayeda. “But I find that we can still laugh and enjoy each other’s company just by being in the moment together.”
Sunshine has Memory Care facilities in Pharr, Texas, Beachwood, Ohio, and Mishawaka, Indiana, all of which offer programs and specialized care that are designed to ease the symptoms of Alzheimer’s and dementia. To find facilities in your area that offer memory care for your loved one, go to CommunityResourceFinder.org. Also, A Place for Mom can help you devise a plan and offer local expertise on the communities available in your area. Think about talking to friends and others you may know who have gone through this decision-making process. Their insights can help you in your search and give you much-needed support in what can be a very trying time for your family and your loved one.