[Checklist] – Questions to Ask When Visiting Memory Care Communities

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Evaluating Memory Care FacilitiesSometimes you have to turn the tables, shift your perspective and look at things from a different angle in order to find the right answer. This is certainly the case when it’s time to search for the right type of memory care for yourself – or a loved one.

Life takes on a rather drastic shift indeed when it’s time to plan for memory care, and the key is to remember that while this move may feel like a sacrifice of autonomy, freedom and “life as you know it,” choosing the right memory care community means reclaiming all of those things in a slightly different way.

Asking the Right Questions Leads to the Right Memory Care Community

Taking a gently assertive role as you interview (yes, interview!) prospective memory care communities via their director(s) and staff, you will know when you find “the one” for you.

You are the one who controls the final decision regarding where – and by whom – loved ones will be cared for as their Alzheimer’s or dementia progresses, and that requires consistent “interviewing skills” as you learn which memory care communities or centers meet the attentive criteria you require of them.

The following questions are in alignment with The Joint Commission’s Memory Care Requirements, and are organized by:

  • Staffing
  • Policies & Fees
  • Amenities

They serve as a comprehensive guideline for the types of information you should have on-hand as you move forward in the decision-making process – and you are encouraged to add your own questions to the mix.

With the director’s/staff permission, it is a good idea to record these “interview/introductory” meetings so you can be present in the moment, knowing you can play the recording back to jot down the answers later on.

Ultimately, after visiting the centers on your list, you’ll be able to compare “apples-to-apples” via their answers – eliminating some and bumping others to the top of the list – as you narrow in on your final choice.

Questions Regarding Memory Care Staffing

Do you have a Medical Director on staff?

Memory Care StaffWho’s at the helm, so to speak, when it comes to steering the physical and emotional well-being of the residents in the right direction?

Having a Medical Director on staff indicates the community is dedicated to serving both the physical, as well as the mental/emotional, health of their residents – and has the leadership in place to do so.

Are there RNs or LPNs on staff? If so, how many? Are they on-site 24/7?

Most high-quality memory care centers have RNs and/or LPNs on staff to oversee any physical and/or medical needs that may arise in the course of a day. Nursing staff report directly to the community’s lead physicians as needed.

Consistent staff assignments (the same caregivers caring for the same patients) builds meaningful connections that foster personalized care. Ideally, trained medical staff are available 24/7.

What is the staffing ratio for each shift?

Those with dementia and dementia-related conditions are not as inherently regulated by the circadian rhythm. Thus, unlike other assisted living communities, memory care centers should maintain a consistent staff:patient ratio, around the clock.

What medical services are available?

The bulk of the residents’ medical needs can be diagnosed/treated with some basic, on-site medical services, including:

  • Labs
  • X-Rays
  • PT/OT/SP Therapy
  • Home Health
  • Hospice
  • Podiatry
  • Pharmacy

Not only does this expedite care, it eliminates confusion associated with resident location changes and non-routine appointments.

What types of training does the staff have? What are staffing ratios for each shift?

All members of of the caregiving staff should maintain ongoing, annual training in alignment with current best-practices for memory care. Participation in professional education/training should be documented.

The higher the ratio of staff:resident, the better a memory care facility typically comes to promoting resident safety and well-being. Optimally, you’re looking for a 1:6 resident/staff ratio or better.

However, according to payingforseniorcare.com, “…time and time again, relevant research has shown that assisted living communities with full-time RNs and direct care with in-house nursing staff have a direct impact on resident outcomes.”

Questions Regarding Memory Care Policies & Fees

For this section, we’ll simply list the set of questions because your interest in the answers may vary depending on your situation, and the questions’ intent is relatively straight-forward:

  • Can my loved one stay here through the end of life or do they have to move if their care becomes too extensive?
  • What types of care can your community NOT provide?
  • What is the policy for a medical emergency/ER visit?
  • Does a staff member go with the resident on ER visits?
  • What is the policy for notifying family members?
  • What is the discharge policy?
  • Is the community all-inclusive or are there additional costs?
  • What are the additional costs i.e., cable TV, phone, medication fees, care level fees, activities/outings, transportation?
  • Can my loved one come back if they have to go to rehab?
  • What happens if my loved one is no longer ambulatory?

Questions Regarding Amenities and Outings

One of the defining features of great memory care communities is they are not out-of-the way places where residents go to deflate or wither on the vine. Rather, they are vibrant communities where those with dementia and related forms of cognitive decline go to receive top-notch care while being able to create a new, colorful and creative version of their life.

Outings for Memory Care Patients This requires beautiful grounds, community gardens, recreational and creative opportunities as well as safely organized outside trips into the community.

Questions worth asking include:

  • What are the daily activities like? How many days per week?
  • Do you charge for outside activities? i.e. Lunch Outings, Museums, etc.
  • Do you have Semi-Private and Private rooms? If cost is of concern, semi-private rooms can save residents thousands of dollars per year.

Ultimately, memory care communities should provide a rich spectrum of daily activities – offered in the morning, afternoon and evening. This ensures your loved one has access to fun, interesting and stimulating activities regardless of when his/her “best hours of the day” may be.

Potential activities should cross the spectrum of the residents’ potential interests, hobbies and preferred modalities, including art, poetry, music (both played and performed), dancing, games, hobby activities, supervised cooking, sports and physical activities as well as social engagements.

All of these types of activities have been proven to slow the progression of dementia and Alzheimer’s and enhance the mood of those who suffer from cognitive decline.

But don’t forget the most important question of all…

Which memory care community makes you feel the most safe, comfortable and secure?

Your gut instincts matter. While answers to these questions are important, the feelings and intuition you receive as you tour prospective communities are every bit as valuable as the black-and-white answers you review.

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Guide for Talking to a Loved One about Memory Care

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Talking to Mom about Dementia CareTalking to a loved one about the need to transition into memory care is the definition of a “courageous conversation.” It brings up a myriad of emotions, including fear, sadness, grief, shifts in power dynamics, feelings of powerlessness, and the frustration that comes along with the everyday ins-and-outs of living with Alzheimer’s and other forms of dementia.

Speaking Compassionately & Effectively About the Need for Memory Care

After decades of providing compassionate, stimulating, and research-based memory care, we’ve learned a thing or two about how to talk to individuals about this very necessary and life-enhancing transition. 

The following are some of our suggestions for how to broach the topic and how to remain an open and engaged listener – as well as informer – throughout the conversation(s).

Have the First Conversation as Soon as Possible after a Diagnosis

By the time most individuals are diagnosed with Alzheimer’s or dementia, they’re already experiencing a grave shift in life as they knew it. That being said, in the throes of what we know is a progressive disease, this point in time is also their most cognizant when compared to what comes next.

For that reason, we highly recommend having the conversation about memory care options sooner, rather than later, so the individual has a say in their own future. The more he or she feels a sense of autonomy and empowerment – even visiting various memory care communities with you – the better it will be as decisions have to be made.

Think of this as the first in a series of ongoing conversations.

Unless your loved one jumps right on board (it does happen, but this is less common), you should think of this as a series of conversations as opposed to a single conversation in which all the decisions need to be made. In this way, more space is created for everyone to process and come to terms with the reality of the situation.

That is another reason why your first conversation should be brought up as soon as possible, rather than choosing the ostrich in the sand approach – wherein everyone is more emotionally charged because of a compressed timeline and more acute need for now-based solutions.

Start with the “what-ifs” and the “what are.”

Rather than jumping right into the, “you need to move into a memory care center…” conversation, the first conversation might be more about the “what ifs” and the “what are…?”

Examples include:

  • What is our plan if something happens to me?
  • Do we both have advanced directives and a will/trust on file with an attorney or trusted family member?
  • What would you want if I’m  no longer able to care for you – physically or even emotionally?
  • What if we need to finance long-term care options? What are the options?
  • What plan makes you feel the safest and cared for?

These questions are natural lead-ins to the “elephant in the room” you’re planning to discuss anyway and may bring about a more open engagement if the conversation leads naturally in that direction – as opposed to more abruptly.

Be clear about the options before having the conversation.

As the facilitator of the conversation, it’s important that you are clear on the available options so you can remain as centered and calm as possible. If you are unclear or confused – or have a myriad of flyers on hand but no real sense of which option is best – the more confusing it will be for you and your loved one.

Learn as much as you can about the individual’s financial status and options, whether or not they have a long-term care insurance plan, whether or not s/he is available for veterans benefits, the projected proceeds from liquidating a home or part of an estate, etc. Of course, many seniors are tight-lipped about this information in which case you’ll have to make your best guestimates and choose your prospective care options from there.

Once you’ve narrowed things down, you’ll have more concrete examples to share, discuss and/or tour over the course of the next weeks, months, or even years (if your loved one is healthy enough to do so).

Listen to all of your loved ones’ concerns and do not respond until they have finished.

This sounds so easy, and yet listening to “expected” resistance or arguments often means listening with a rapid-fire or emotionally charged response at the ready. This is very normal because you, too, are upset and saddened to even have this conversation in the first place.

Thus, the more you can provide space for truly listening, quietly and really connecting with the fears, feelings, and concerns raised by your loved one, the more supportive (and less threatening) your responses will be.

Consider the idea of a home care to memory care transitional timeline.

Speaking to a Loved One about DementiaOne thing is clear, the fewer transitions there are the better. Thus, it’s typically not recommended that you move a loved into an independent-assisted living community if you know a second transition to a memory care community is a given. If the individual is absolutely against the idea of making a transition into a memory care center sooner-rather-than-later, consider a more phased approach to the process.

Adding a caregiver or two into the weekly routine – preferably using a home care service that specializes in memory care may be the better place to start. Then, when the time is right and the individual has progressed to mid-stages of the disease, caregivers can assist with making the transition into the memory care center that you and your loved one have chosen.

Bring people your loved one respects into the conversation.

We often listen best when speaking with those who aren’t as close to us. Within these more “polite” relationships, we’re less emotionally triggered and more open to admitting the reality of what’s happening for us. 

For this reason, it can help to get others on board. If you are a spouse or child of someone with dementia, consider whether another family member might be a convincing advocate. Trusted physicians, clergy members, a therapist, long-time friends, former colleagues – all may help to ease the conversation with their more objective, yet caring, opinions and viewpoints.

Discuss the benefits of memory care.

The good news is that research is on your side. We now know that diet, stress reduction, social engagement, healthy sleep habits, avoiding head injuries, etc., can potentially slow down the progression of dementia.

Memory care centers provide places where those diagnosed with dementia-related conditions live more actively and independently for longer as a result of the memory-specific care they receive.

Speak positively about the options.

This isn’t to say you should sugar-coat things – but language and vocabulary matter when framing the possibilities and potential changes. For example, the word “facility” is cold and not very appealing – whereas “community” or “center” can strike a completely different chord. Your tone should always be respectful and come from a place of love and support, rather than a lecture or a talking-to.

If you find yourself or your loved one are triggered, and things are heated, pause the conversation and continue when everyone is in a better frame-of-mind.

Contact Us before You Start the Conversation 

Our staff has helped families with these tough discussions many times in the past. Our experts can provide you with talking points, informational resources, and other things that can help get the conversation started at home. And when you’re ready, feel free to bring your family and loved one out to tour one of our Memory Care Facilities.

Contact The Memory Center



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