Currently, 6.2 million Americans age 65 and older are living with Alzheimer’s. Based on projections, this figure can double to 12.7 million by 2050.
Despite the latest technology trends, researchers still have limited knowledge about dementia. No cure has been discovered yet. But fortunately, with memory care, people living with Alzheimer’s or dementia receive specialized care and support.
Besides memory care, family caregivers also have an essential role in facilitating their senior loved one’s care needs. They can be the primary source of physical and emotional support as loved ones remain at home.
From a first-time caregiver’s standpoint, the world of caregiving may be broad. So, we’ve created this comprehensive guide highlighting everything there is to know about dementia — plus some tips on how to communicate effectively with a person with dementia.
The 7 Stages of Dementia
A person with dementia can remain in three care settings: home, assisted living, and memory care. If a loved one is diagnosed, it doesn’t mean they need to move into memory care immediately.
Depending on what stage of dementia or how severe the symptoms are, your loved one may only require minor care assistance; and, therefore, may do fine at home or assisted living.
In general, dementia or Alzheimer’s symptoms are classified into three stages: mild, moderate, and severe. But the progression of dementia is precisely detailed into seven stages of the Global Deterioration Scale (GDS) developed by Dr. Riesberg and his team.
Stage 1: Normal Outward Behavior
This stage is also known as the stage with "no cognitive decline." The person doesn't manifest any dementia symptoms. However, imaging techniques, like a computed tomography (CT) scan, might detect subtle changes in the brain.
Stage 2: Very Mild Changes
At this stage, "very mild cognitive decline" shows. The person starts to forget some words or misplace objects. Other people may consider these signs as a normal part of aging and would generally ignore them.
Stage 3: Mild Decline
When dementia progresses to Stage 3, short-term memory loss occurs frequently. The mild cognitive decline makes the person lose or misplace things more often. They forget the names of the people they just met or something they just read. Also, they find it challenging to organize things.
Stage 4: Moderate Decline
At this stage, the symptoms become evident to other people. The person starts to experience time and spatial disorientation. Doing simple math becomes difficult. In addition, the person begins to withdraw from people and social events, making them lose interest in things that they used to enjoy.
Often, clinical diagnosis of dementia occurs at this stage.
Stage 5: Moderately Severe Decline
Memory loss starts to become severe and affects significant areas of one’s life. The person forgets personal information, such as address or phone number. They may even forget how to bathe and will face challenges in getting dressed.
Stage 6: Severe Decline
At this point, cognitive decline is severe. The person can't remember the names of the people close to them. They also suffer from serious anxiety and confusion. People at this stage of dementia need a higher level of personal care, such as assistance with toileting.
Stage 7: Very Severe Decline
The end-stage of dementia is very challenging to both the families and caregivers. The patient loses their independence and can no longer carry on tasks by themselves. Assistance with eating, sitting, drinking, and moving around is necessary. Apart from incontinence, one’s communication abilities also drastically decline.
The pace at which dementia progresses is different in each person. Some people, particularly those with an unhealthy lifestyle or are suffering from complex health conditions, may experience a decline in their health at a faster rate. Generally, the need for memory care depends on this factor.
What Is Memory Care?
Memory care refers to the specialized care provided by dementia-trained staff to people living with dementia and Alzheimer’s.
Dementia is a progressive condition that can either be reversible or irreversible. Reversible dementias share dementia-like symptoms that are treatable. Examples are vitamin deficiencies and thyroid abnormalities.
In contrast, Irreversible dementias are degenerative conditions. Alzheimer’s, dementia with Lewy Bodies, and vascular dementia all fall in this category.
Since irreversible dementia changes the person’s behavior, emotional and mental state, care staff undergo rigorous training to handle these complex changes.
Memory care can help people with irreversible dementia as it offers all-inclusive services, amenities, and community features to ensure each resident receives adequate care in a safe environment.
Memory care services
Most memory care communities have a signature program focused on improving the overall quality of life of seniors with dementia. These programs are part of care services and cover essential facets of senior’s health: lifestyle, nutrition, and care.
An engaging lifestyle filled with connection, a healthy diet, and personalized care are the center of these memory care services.
Apart from this, memory care units offer services such as:
- 24-hour individualized care and supervision
- Ideal staff-to-resident ratio
- Social events calendar
- Personal care, such as hygiene, bathing, feeding, and more
- Incontinence care
- Housekeeping and maintenance
- Laundry service
- Meal preparation
- Transportation services to doctor's appointments and other activities
- Medication management
- Concierge service
- Shuttle services
Many memory care residents depend on their caregivers, so they require care in almost all areas of their daily lives. Fortunately, memory care units have a broad range of services to cater to every resident’s needs.
Memory care amenities
Amenities aim to provide convenience to residents. Many care communities usually offer the following amenities:
- Dementia trained staff
- Alzheimer's and dementia support group
- Cozy dining areas
- Outdoor spaces and courtyard
- Chefs who can cook meals based on the resident's dietary needs
- Worship spaces
- On-site salon and spa
- Game rooms
- Physical therapy room
- Fitness center
- Emergency system
- Emergency alert bracelet or pendant
- Wellness centers
- Pet-friendly environment
With these all-inclusive amenities, residents can explore different means to be physically active and find something fun to do.
Memory care community features
Memory care offers senior living options with various floor plans, rates, and apartment types, including studio, one-bedroom, and shared suites.
Families pay a monthly rate that includes apartment maintenance, utilities, chef-prepared meals, and all-time access to amenities and services.
What Makes Memory Care Different?
Many factors make memory care different from other senior living options. Some of these are the person-centered approach to care and the specialization of the care staff. It also has more amenities and enhanced safety features with 24-hour monitoring.
Memory care vs. Assisted living
Let’s look at some points that make memory care different from assisted living.
1. Staff training
Assisted living care staff often assist residents with general activities of daily living, such as bathing and grooming.
In contrast, memory care staff undergo intensive and regular dementia training to understand and respond well to dementia symptoms that cause problematic behaviors. Care staff provides not only physical but also emotional and social support to residents.
2. Staff-to-resident ratio
In assisted living, the state or the facility regulates the staff-to-resident ratio. As a result, some facilities have one staff to 20 or more residents. Since most assisted living residents require minor assistance, this ratio may work fine.
In memory care, the ideal staff-to-resident ratio is one staff in every five residents during the day. This ratio means that each resident can receive proper and adequate care at any time of the day.
3. Apartment features
Apartments in assisted living usually feature a kitchenette or kitchen. For safety reasons, memory care units do not have this.
Assisted living has a secure environment with 24-hour staff.
Memory care communities have enhanced security as a precaution to prevent wandering and other dangerous symptoms. Environmental security is a primary element of memory care facilities. Exits have alarm systems, and residents also wear tracking bracelets.
Assisted living and memory care communities offer three meals a day with full table service in cozy dining venues.
The difference is that memory care residents are often served with finger food, as using spoons and forks can be dangerous.
Memory care costs more than assisted living because residents require a higher level of care and supervision. Costs vary according to the type of living space (private or shared), care services needed by the resident, and the location.
Which is better between assisted living and memory care?
If dementia is mild, a senior loved one may thrive in assisted living as care needs are low. However, as symptoms progress and become serious, the better option would be memory care.
Many assisted living communities have a separate wing for memory care. If you look for this feature, you don’t have to waste time and energy to find another community when it’s time for memory care.
You can just request the community staff to move your loved one to the memory care wing once dementia symptoms worsen. The benefits of this setup are, it can avoid confusion, and your aging parent doesn’t have to adjust too much in a new environment since it’s the same compound.
Memory care vs. Nursing homes
Both memory care and nursing homes provide specialized care and other similar services. Let’s dive into what differentiates memory care from nursing homes.
Memory care offers individualized care exclusive to people with dementia or Alzheimer's. Staff provides care to help reduce confusion and memory-enhancing therapies to enhance the overall quality of life of the residents.
Meanwhile, nursing homes offer skilled care for debilitated seniors or those with medical issues who can’t live independently. Residents are usually bedridden, are using a wheelchair due to severe injuries, or undergoing rehabilitation therapy, such as speech and physical therapy.
2. Community setting
Nursing homes have a clinical, hospital-like setting. Memory care communities emphasize a home-like environment to help residents reduce confusion.
The cost for memory care ranges from $3,000 to $7,000 or more a month. The median average is $5,250.
Nursing homes' costs vary depending on the individual’s care needs and whether the facility is private or state-owned. A private room in a nursing home has a median cost of $8,517 per month, while a semi-private room has a median cost of $7,513.
4. Social activities
Both nursing homes and memory care have structured activities. However, in memory care, the goal of socialization programs is to delay memory loss by stimulating the brain. In comparison, nursing homes organize events and programs to increase engagement and social connection.
Activities in nursing homes, such as therapeutic cooking, may be enjoyable, but memory care residents may find this frustrating.
5. Medicare and Medicaid benefits
In some states, Medicaid covers a portion of the monthly cost of memory care. Medicare doesn't cover non-medical care services, rent, or meals in a memory care community. It may cover other medical expenses, like some types of home health services and dementia testing.
Medicare covers 80% of the cost of nursing home care for up to 100 days. In addition, Medicaid pays 100% of the cost for those eligible for its benefits.
Both nursing homes and memory care offer extensive care. The key difference between the two is specialization.
Memory care specializes in giving care to people living with dementia and Alzheimer’s. In contrast, nursing homes provide care to people with medical issues who find it too difficult to remain at home.
A nursing home may be a better option if a loved one has a debilitating medical issue on top of dementia.
Difference between memory care and other senior care types?
A person with dementia receives more thorough care in memory care than any other type of senior care community.
One reason is that dementia care staff goes through thorough training more than any senior living care staff. Therefore, caregivers fully understand the behavior patterns and care demands of those with progressive memory loss and can configure the level of care to deliver.
What Are the Benefits of Memory Care?
Memory care offers many benefits such as:
1. Especially trained staff
Memory care trained staff is available 24 hours on-site. This easy access to care ensures that residents receive care or attention even in emergency cases.
The care staff handles important caregiving tasks, such as assistance with mobility, dressing, and medication management.
2. Customized programs
Activities in memory care are tailored to the overall needs of each resident. These programs can delay the progression of memory loss.
3. Thoughtfully designed buildings for safety
Memory care has specially designed rooms, hallways, and outdoor spaces to ensure residents' safety at all times. Communities use color-coding on doors, large windows, secure locks, bright paint on walls, and tracking devices.
4. Home-like atmosphere
Medium-sized memory care facilities have only between 11 and 25 residents. Because of this, memory care communities feel more home-like, which is beneficial to people with dementia. It reduces confusion and retains the familiar sense of home.
5. Housekeeping and home maintenance
Memory care residents don't have to perform housekeeping tasks like cooking, cleaning, or laundry. The 24-hour staff takes care of these responsibilities.
6. All-inclusive amenities, such as wellness and fitness centers, on-site salon and spa, and support groups
Residents who want to pamper themselves through a haircut, manicure, or pedicure can get treatments at the on-site salon and spa. Memory care offers full amenities that make the life of those with dementia more comfortable.
7. Transportation service
Residents who want to dine out or visit their doctor may schedule a car service.
How Much Does Memory Care Cost?
In Texas, the statewide average cost of memory care is $4,699 per month. The city of Victoria has the most expensive memory care rate at about $6,529 per month. Meanwhile, Texarkana has the most affordable memory care cost at about $3,049 per month.
The nationwide average of memory care is $4,615 per month or $55,381 per year.
What Are the Options to Pay For Memory Care?
Did you know that veterans can take advantage of the VA Aid and Attendance program benefits to pay for memory care?
In most cases, residents and their families pay for memory care through their personal savings. But there are other means to pay for long-term care. You may use these methods to stretch your memory care funds and make long-term care sustainable.
1. Veterans benefits
Veterans 65 years old and older with dementia may qualify for VA Aid and Attendance or Housebound benefits. These programs provide financial assistance to veterans and their spouses. You can use the funds to pay for memory care services.
To know if you are eligible, check for more information about VA benefits.
To get the benefits, you can fill in a VA form and mail it to the pension management center (PMC) for your state or apply to a VA regional office nearest you.
2. Retirement savings without penalties
If a senior parent has a Roth IRA or Roth 401(k), you can withdraw funds from the account tax-free and without penalties and use them to fund memory care.
You need to meet two requirements for this:
- A. Your senior parent must be at least 59 years old and a half.
- B. The Roth account is at least five years old.
For those younger than 59 years old and a half who need long-term care, there are options to pull out funds without paying any withdrawal penalties.
3. Social Security
If your senior parent is retired and is collecting social security benefits, the funds can help cover memory care expenses.
Social Security Disability Insurance (SSDI) also allows seniors diagnosed with early-onset Alzheimer's before retirement age to receive benefits. Disabling conditions, like dementia, listed in the Compassionate Allowances program enable families and seniors to expedite the application reviews of SSDI and receive quick assistance.
4. Home equity
Eventually, a senior parent will move to assisted living or memory care to receive a higher level of care.
Your senior parent's home may be their largest investment. You can use this as a source to pay for memory care.
Here are some ways to do it:
- Sell their home Since they'll be moving to memory care, ask if they'd be willing to sell their home to pay for care expenses.
- Rental If your senior parent doesn't want to sell their home, rent it out to get funds.
- Reverse mortgages Senior homeowners who are 62 years old and older can convert home equity into tax-free income that they can use to fund long-term care.
To make a loan, you can contact an approved reverse mortgage counselor.
Funds from a reverse mortgage are received either in a single lump-sum payment, equal monthly payments, or as a line of credit.
5. Bridge loans
If your senior parent decides to sell their home, you can use bridge loans to receive immediate cash while waiting for a home buyer.
Bridge loans are short-term loans that let seniors receive cash funds quickly. But take note that this loan typically has higher interest rates.
6. Senior life insurance policies
Insurance policies that have a savings account inside, like whole life insurance, let you accumulate cash value, which you can use to pay for Alzheimer's care.
Many insurance companies today offer a hybrid policy that combines the features of a death benefit, long-term care, and savings.
Some of these options allow you to take a policy loan or cash out the death benefit. If your senior parent has an insurance policy, ask the company if it can be an option to pay for memory care.
7. Long-term care insurance
Coverage for long-term care insurance depends on the terms of the policy. But in general, it covers memory care. If your senior parent is living with Alzheimer's, you may qualify for financial assistance.
Your senior parent may have other options to pay for care that you’re not aware of. In this case, you can consult a senior living advisor or a dementia advisor who can help you uncover other fund sources.
When Is It Time for Memory Care?
As dementia reaches the end stage, the symptoms get worse. Generally, the severity of the symptoms is your telltale sign for memory care.
People with mild dementia may be able to stay at home where they receive care from family caregivers. But, if symptoms start to worsen — for instance, a senior parent experiences visual hallucinations or emotional outbursts — this marks the need for memory care.
When this happens, visit your doctor and get advice on the next course of action. Traditionally, doctors perform a mental status exam to identify the severity of memory loss.
Here are other red flag signs that signify a loved one needs specialized memory care:
1. They need extra help with activities of daily living.
A senior may need memory care if they:
- Struggle with bathing or dressing
- Keep missing their medications
- Have trouble eating or drinking
- Get lost in walking around the neighborhood or other familiar places.
Get lost in walking around the neighborhood or other familiar places.
A senior with profound memory loss can't stay at home because their safety is at risk.
Due to severe memory loss, they may:
- Leave kitchen appliances on after use
- Have bruises that they can't explain
- Wander and get lost
Severe memory loss can also threaten other family members’ safety, so moving to memory care is the best decision.
3. Violent behaviors
Confusion and agitation may lead to violence and verbal abuse. If a senior parent starts to bite, hit, or kick you or their caregivers, they need to transfer to memory care.
4. Caregiver stress and burnout
Many family caregivers belong to the "Sandwich Generation" who juggle parenting with caring for an aging parent. The enormity of performing both tasks every single day can take a toll on the caregiver’s health.
An indication of caregiver stress and burnout is when you no longer see meaning in what you do, or you feel frustrated with your senior parent. If you don't step away from your caring responsibilities, you will pay with your health.
5. Your instincts will tell you.
Inevitably, you'll hear a voice inside your head that tells you it's time for memory care. You need to trust this voice. Your guts will help you make the best care decisions on behalf of your aging loved one. More importantly, never feel guilty about trusting your intuition.
Is your loved one ready for memory care?
With most senior adults choosing to remain at home as they age, memory care is pushed below the list. But as a family caregiver, you have the responsibility to explain to a loved one why memory care is necessary at some point.
Opening up a conversation about this topic is also one of the challenges of family caregivers. Even after lengthy discussions, some seniors may insist on staying in their current residences.
But since many of those with dementia are less capable of making decisions for themselves, the family caregivers often decide about memory care. When it’s time for advanced care, whether your loved one is ready or not, you must choose memory care.
How to Prepare for Memory Care?
The transition from home to memory care is a process and consists of many steps. Being prepared makes everything more manageable and less stressful for you and your senior parent.
Here are some tips on how to prepare for memory care.
1. Begin with a conversation.
As stated, communication is crucial. After a loved one receives a diagnosis, check with the doctor if they can stay at home for the time being. If symptoms are mild, receiving care at home may not be a problem.
Following this, talk to your loved one about plans for memory care. Since it’s a given that they will need advanced care in the future, it’s better to start memory care conversations during the early stage of the disease. This way, your loved one is still mentally competent to participate and make decisions about their well-being.
Some families may find that less advanced memory care discussion is much better to avoid confusion. It means they only bring up talks of memory care when it's almost time to move.
You know your loved ones well, so it's up to you to decide if advanced or less advanced conversations of memory care are favorable.
2. Research and keep a list of memory care communities.
Dementia usually takes years to progress from mild to moderate and severe. But it’s also possible that the condition will progress much quicker.
Researching memory care communities beforehand will help you sieve out the best choices. You can also attend community tours to see how residents live inside the community.
When it's finally time to transfer, you need to talk with your loved one again. They may not fully understand everything, but still, you must let your parents know why they are moving out of the home.
3. Prepare and pack for them.
Preparing and packing are stressful. So, it’s better not to involve your senior parent in this process as it can make them agitated or violent.
Remember to pack only valuable items and a few decorative things to personalize your senior parent’s living space. If you can’t pack for them, you can hire a professional organizer to help you with downsizing and relocating.
4. Personalize their space.
Your senior parent will look for that sense of familiarity in their new home. So, make sure you bring decorations, like photographs or curtains, to embellish their apartment and make it feel more home-like. You can help arrange furniture in a way that makes them comfortable.
5. Give them time to get settled.
Once your aging parent is in the community, give them time and space to adjust to their new home. As to when you should start visiting your loved one, talk to the memory care staff. The care staff can identify whether your presence soothes or makes a loved one unsettled. Depending on the level of comfort or agitation, you may or may not be able to visit soon.
6. Communicate with the care staff.
Building a good relationship with the community care staff can encourage honest communication. When you're not visiting, you can ask the care staff about the living conditions of your loved ones. Since the average stay in a memory care unit is about two to three years, you might be talking with the same care staff for this entire time.
How Do I Find a Memory Care Facility Near Me?
Not all memory care communities are the same, so finding one that offers an above-industry quality of care may require more research.
If you’re in the process of finding a memory care community, here are some tips.
1. Start with an online search
Thanks to technology, even during the times of lockdowns, you can search for the best memory care communities without stepping out of your home.
You can try these online resources:
- Eldercare locator
- Online site of your state Department of Social Services
- Online site of your local Department of Social Services or Aging Services
With everything at your fingertips, it’s almost effortless to find licensed memory care communities.
2. Ask friends or colleagues.
Your friends or coworkers might have attended a memory care community tour before. If so, ask if they can recommend one or two communities near you to check out.
3. Connect with a memory care advisor.
Rather than doing all the legwork of finding a community, you can contact senior living advisors. They can help you look for facilities that offer memory care services near you.
Senex Memory has certified dementia care advisors to assist you with your memory care community search.
10 Tips to Communicate With Someone With Dementia
There are many potential barriers to communication when talking to an elderly living with dementia. To deal with these communication issues, you need to keep an open mind. Here are some suggestions:
1. Ensure proper vision and hearing functions.
The loss of hearing and sight is common as people age. For a senior with memory impairment, these issues cause more confusion and misunderstandings. So refer to a specialist first to assess whether your loved one has hearing and vision problems.
2. Get personal.
Look your loved one in the eyes when speaking to them. If they want to sit while talking, stay seated as well. Talk at the same level as them.
3. Limit choice.
Giving too many options can frustrate your loved one. Reduce choices by avoiding open-ended questions. Don't ask, "What do you like to do today?" Instead, ask, "Would you like to visit a park?
4. Remove distractions.
Group discussions and background noises, like a radio, can distract a loved one during a conversation. Find a quiet place to talk to them alone.
5. Use simple words
Avoid complex words when talking. Rather than using pronouns to refer to things, use names. For example, use "dog" instead of "it" to refer to a dog.
6. Avoid conflict.
Don't argue with your loved one. Never say "You're wrong," as this can only agitate them.
7. Validate their feelings.
It makes them more communicative if you validate their feelings by entering their world. For example, if they feel lonely, you might say, "I'm here now."
8. Be patient.
When waiting for a response, don’t rush them up. Be patient and let your aging parents complete their sentences.
9. Pay attention to visual cues.
Your loved one may find it difficult to convey their emotions through talking. So watch for cues in their body language. For example, if they're hanging out in the kitchen, they might be hungry.
10. Get creative with your communication.
If words don't suffice, use gestures or facial expressions. For example, nod if you agree or shake your head if you disagree.
Additionally, you can use their daily routine as cues for what they need to do. For instance, opening the curtain means it's time to get out of bed.
Different Roles of Family Caregivers in People With Dementia
1. Support with activities of daily living (ADLs)
A loved one who remains at home can receive assistance from family caregivers. They can provide a broad range of support, like personal care, medication management, housekeeping, and more.
2. Provide emotional and social support
Social withdrawal, depression, and anxiety are symptoms of dementia that can impact a loved one's behavior and response to others. Family caregivers can provide emotional and social support during upsetting times. This task may be the most time-consuming but also the most important task of a family caregiver.
3. Medical care
Although not required, some family members get caregiving training to support a loved one with their medical needs. In cases where medications need to be administered via injections or patches, the family caregiver can assist.
4. Care coordination
Family caregivers make doctor's appointments, talk to the doctor, order prescriptions, and sometimes handle their loved one's medical insurance.
Family caregivers coordinate with other care professionals to facilitate their loved one's health care.
When cognitive abilities have seriously declined, family caregivers make care, financial, and legal decisions on behalf of their senior parents.
By 2050, 22% of the American population will comprise seniors age 65 and older. This projection means that soon, the demand for senior care will increase. It might probably reach a point where seniors who require care will outnumber the caregivers. To fill the gap, more family members might likely become caregivers.
Being a family caregiver isn’t an easy job — however, those who’ve pursued this route share that the entire caregiving experience has changed their lives.
In the end, caregiving is about making a difference in someone’s life. Whether you’re caring for an aging parent or someone in a facility, caregiving is an opportunity for everyone to make an impact in another person’s life.
Syed has years of experience dealing with people, understanding their needs, and helping them find solutions to their problems.
As a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), Certified Montessori Dementia Care Professional (CMDCP), Syed is committed to working closely with Senior and their family knowing what is it like for individuals facing a challenging time, at times groping in dark trying to figure what is the appropriate next step or care level for their unique situation.
Syed and Senex Memory Advisors are fully committed to working closely with families in creating a personalized, step-by-step process memory care plan at zero cost.