What Nursing Home ‘Memory Care’ Means
“Memory care” has a gentle ring to it, a sense of precious keepsakes highly valued and lovingly tended. In the realm of long-term care, memory care refers to specialized settings offering stepped-up services for people with Alzheimer’s or other types of dementia. Demand is rising for this type of care – usually found within assisted living facilities and nursing homes – despite the premium cost. If you’re thinking about memory care for a family member, here’s what to consider.
Secured units, alarm devices and enclosed outdoor areas to keep people safe from wandering are only part of the picture. Staff members should be trained to understand the needs of people with dementia, who can lose the ability to communicate in normal ways yet still respond to verbal cues and sensory stimulation. Good memory care engages residents and gives them space to be active, promotes their physical and emotional well-being and doesn’t overly rely on medication.
The type of memory care that is best suited for someone depends on how far dementia has progressed and how symptoms manifest. In early stages, people can do well in memory care communities. But eventually, they may need services within a facility.
Families and at-home caregivers usually seek memory care placement when they’re in a crisis situation, realizing one day that things have become overwhelming. Sometimes new residents can be placed right away, depending on their range of memory care needed, with early-to-moderate and moderate-to-advanced, but other times no rooms are readily available.
Safety and Room to Move
Eloping or wandering is a risk for some people with dementia. Freedom of movement is important for people with dementia, who, as younger seniors, tend to be physically active. People who are coming into early-to-moderate [memory care] are in their mid-70s. Some with early Alzheimer’s can be in their 40s or 50s, so being aware of the safety procedures set in place at a facility are important.
Look for protected outdoor accommodations for those seniors who are mobile but cannot be left unattended. Safety and freedom without the feel for restriction is important.
Memory units are also classified based on whether residents exhibit certain behaviors – aggressive or destructive behaviors that sometimes appear with dementia. Banging on objects or throwing dishes are examples. Medications may be needed in some cases, she says, but well-designed facilities, supportive staff members and tailored activities go a long way to easing disruptive behaviors without requiring drugs.
Staff: Quantity and Quality
Adequate staffing ratios are critically important for good memory care. An ideal ratio is about five residents to one care staff member, meaning nurses and aides (not dietary or housekeeping staff) who actually provide care to residents. Staff members need to understand how to communicate with people as dementia progresses.
If you’re considering a memory care facility, look for these signs of respectful care:
- Do staff members respond to individuals in a patient, positive and caring way during interactions?
- Do they communicate with residents as adults who can make choices, affording them dignity rather than treating them as infants?
- Is the staff good at redirecting individuals in ways that don’t escalate anxiety or anger? For instance, they might take the time to walk on the grounds with a resident who seems eager to leave the building whenever he sees visitors do so.
- Are basics of communication the norm? Looking into people’s eyes when speaking and using an appropriate volume and tone of voice are as important as ever in memory care.
- Are staff members gentle in assisting a person to move, rather than pushing him or her in a direction?
- Is the staff open to nonverbal communication methods? For instance, using pictures and symbols, such as pictures of food for eating, or of baths and showers, or indoor and outdoor activities, allows people to make day-to-day choices.
Premium Care/Premium Costs
Memory care costs more than standard nursing home care. For those who qualify, Medicaid may cover dementia care costs. Medicare typically does not cover long-term nursing home care because it’s considered custodial care. However, Medicare special needs plans may offer some benefits for people with dementia.
Memory Care at Night
Sleep patterns may change with dementia, and that can be difficult for family caregivers of loved ones in the home. With Alzheimer’s and dementia, there’s a lot of sleep dysrhythmia. It interferes with people’s circadian sleep and wake cycles. The caregiver may be up and down all night long trying to prevent them from leaving the house.
In memory care, activities to engage residents often reach them through their senses. Music is huge, gearing it toward the population to bring something back to them, to their memories.
Teamwork to memory care is needed, whether it’s the physical therapy/rehab department suggesting a walker to help someone get up and do more, or the therapeutic activities department bringing in arts and crafts, like beading, or even the dietary program, whose pancake and waffle days are big hits. The smell evokes memories of childhood, she says, and people are encouraged to eat more and eat better.
If you’re evaluating memory care facilities, look for those that offer cutting-edge ways to help people enjoy life and communicate with others. Always, always talk to residents that are there. Talk to their families. Find out what people think about what works there and doesn’t. Be wary of cookie-cutter
approaches, like having a stuffed animal in every room. Just because something works for one individual, that doesn’t mean it may suit the needs for your senior.