Memory care is a type of senior housing that provides personal care and hospitality services to seniors that suffer from dementia or Alzheimer's. These services can either be provided in an assisted living or a nursing home setting, but memory care is more often provided in assisted living.
What's Included in Memory Care
Memory care is focused around the holistic wellbeing of the residents that suffer from Alzheimer's or dementia. Residents are typically cared for around the clock by staff that provide meals, activities, socialization, manage and dispense medicines, and assist with the activities of daily living.
- Personal care services for memory care
- Medication management
- Housing - apartment
- Dining - 3 meals daily
- Laundry services
- Social activities
Who Needs Memory Care?
Memory care typically has two requirements: age and need for care.
Most age restrictions typically only require that the resident be 55 or 62 years or older. Most memory care residents, however, are much older, with many in their 70's, 80's, or beyond. Sadly, a few younger individuals do develop dementia or Alzheimer's. However, if you find a memory care community with several younger residents then they're likely serving a mentally ill or challenged population, which will not appeal to many seniors.
The most pertinent admission requirement is that the prospective resident must have a medical professional's recommendation that the senior needs personal care services for memory impairment. Communities often complete a parallel test to determine if they also agree with the needs assessment and to determine the appropriate level of care. Most seniors qualify for memory care once they have progressed beyond the earliest stages of dementia or Alzheimer's.
Memory Care in Nursing Homes
Most memory care is considered "assisted living" memory care. That is, memory care is really a sub-type of assisted living since they both provide similar personal care services to meet the senior's needs, but memory care's services are focused around the needs of seniors with memory impairment. Some nursing home communities, however, also offer memory care services. This is where it gets confusing.
Memory care offered in nursing homes provides the same core services that assisted living memory care provides but has some unique quirks as well. Both provide three meals per day, housing, medication management, and the personal care services (bathing, dressing, grooming, etc.) tailored to those seniors that suffer from Alzheimer's or dementia.
The primary differences between memory care in nursing homes and "assisted living" memory care are the costs, who pays for the care, the setting, and the intensity of care.
In general, the cost for memory care in a nursing home is significantly more expensive than the equivalent assisted living memory care. This is the result of a few staffing and other requirements that raise the average cost to provide care in nursing home. For instance, most nursing homes are required to employ one or more registered nurses, which are not required in other memory care communities.
Even though memory care in a nursing home is often more expensive, it's less likely that the senior resident or his/her family is picking up the bill. Many seniors in nursing homes qualify for Medicaid. This means that the state and CMS will be covering the resident's stay.
Assisted living memory care is often paid for by the resident or family. So even though memory care in a nursing home is more expensive, for residents that qualify for Medicaid it is cheaper to receive memory care services in a nursing home.
Like most nursing home care, the setting for memory care in a nursing home tends to be more institutional than that of a newer assisted living memory care community. Nursing homes have many building and other code requirements that result in a more institutional feel: these laws included certificate of need law, building code requirements (vinyl tile flooring, handrails, line-of-sight to nurses' stations), and previous or current Medicaid or Medicare reimbursement requirements that encourage low cost facilities. Assisted living memory care communities often offer a more home-like environment with nicer finishes.
Finally, like all nursing care, memory care in a nursing home can take residents that need 24/7 nursing care, not just assistance with personal care services. This means that the most acute (in need of care) residents may only be able to have their needs met in a nursing home.
Memory Care Costs
Memory care frequently costs from $3,500 - 10,000+ per month, with an average of approximately $5,400 per month. This makes memory care the second most expensive type of senior housing after skilled nursing.Memory care costs are typically broken up into a couple of items: monthly rent, levels of care costs, medication management, and extra costs. Monthly rent is typically the largest cost and may be the only ongoing cost for all-inclusive or care-inclusive communities. Levels of care and medication management often vary from resident-to-resident depending on the actual care need of the senior. These costs are sometimes charged in addition to monthly rent.
One-time or up-front costs may also be required. For instance, one-time community fees of $1,000 - 10,000+ are commonly charged. If the community is part of a CCRC, then a larger fee called an entrance fee may be charged.
Who Pays for Memory Care
Memory care in assisted living is typically paid through a combination of funds: social security income, long-term care insurance, pension income, investment income, veteran's benefits, sale of assets, and other sources of income. Some states will pay for memory care in assisted living for qualifying residents through Medicaid. However, it's more common for states to reimburse nursing homes for memory care through the Medicaid Waiver program.
Paying for Memory Care
- Social security, pension, investment, or other income
- Long-term care insurance
- Selling a home or other asset
- Receiving assistance from friends or family
- Veterans' benefit
- Medicaid Waiver
Most memory care apartments include a living area, a sleeping area, and a bathroom. Due to obvious safety reasons, memory care apartments do not include kitchens. Also excluded are large walk-in closets. Sometimes memory care residents will get disoriented in a closet and may become trapped. This is a common enough phenomenon, that most memory care communities exclude closets and place the residents' clothes in a wardrobe or dresser.
Most memory care apartments are studios, although some one-bedroom and two-bedroom apartments exist. In a studio, the resident's sleeping area and living area are combined into a single room. One-bedroom apartments are common in more expensive communities. Two-bedroom apartments are rare, except when a community is offering a more-private companion suite option.
Companion suites or shared apartments are frequently offered in memory care to provide an affordable option. These apartments feature two residents in the same room (studio) or more privately with separate bedrooms and bathrooms with a shared living area (two-bedroom). Semi-private apartments may not be for everyone, but the rent savings per resident can often be $1,000+ per month. So, if you or your loved one is on a tight budget, then it may be a helpful option.
Memory care communities come in many different forms and types. Some are standalone communities where other types of senior living are not available. Other memory care communities are part of a larger senior housing campus that includes independent living, assisted living, memory care, and skilled nursing.
Many standalone memory care communities have been built over the last couple of years. These communities are typically single-story, house 48-64 apartments, are split into two or more main neighborhoods, and offer exclusively memory care services. Most of the providers for standalone communities focus either exclusively on memory care or have many other memory care communities. Some seniors and their families like this exclusive knowledge of the community.
Another common format is a combined assisted living and memory care community. Many providers like this community type, because assisted living and memory care residents have similar needs and the staffing and expertise needed to meet those needs is similar. Increasing the size of the community, may also result in cost savings for the provider, some of which may get passed down to the resident or the family.
Also common, are large senior housing campuses, some of which are called CCRCs, that offer independent living, assisted living, memory care, and skilled nursing. Some couples prefer these campuses, because one spouse can be in assisted living and walk over to visit the other in memory care. That way, both of their needs are being met, but they aren't far from each other.
Another benefit of these types of communities is that residents can "age-in-place". For instance, a senior may move into independent living when she is relatively healthy, move into assisted living as her need for care increases, then moving into memory care when dementia or Alzheimer's have begun to run their course. Many seniors and families like that this model prevents the need to move multiple times.Learn more about memory care