When to Move from Assisted Living to Memory Care
If your loved one is living with dementia, they can successfully stay in their assisted living home for a time. However, it is a wise decision to eventually move them to a more specialized memory care community. As their disease progresses, they will need different care from caregivers who know how to implement strategies that promote dignity and independence.
Let us walk you through the signs that it could be time to make the move, as well as tips for making the transition successful, and what to expect during and after the move.
Assisted Living vs. Memory care – What’s the Difference?
Assisted living and memory care are both types of senior living communities. While both feature 24-hour caregiver support and nursing oversight, convenient amenities, transportation and housekeeping services, and friendly neighbors, the main difference is their approach to supporting those living with Alzheimer’s disease or other types of dementia.
Memory care communities provide:
- A residence designed to combat the challenges that come with cognitive decline
- Safety features like alarmed doors so that residents can be monitored without compromising dignity and freedom of choice
- Specially trained staff members who attend regular educational sessions about dementia care best practices and strategies
- Lower staff-to-resident ratios to encourage more meaningful relationships
- Structured daily programs that are created to mimic familiar routines and habits
Who Benefits Most From Memory Care (and When)?
Seniors living with Alzheimer’s disease or another type of dementia will benefit from memory care, finding support in the residence and in the staff who work there. While someone living with dementia can succeed in an assisted living environment during the earlier stages of the disease, a move to memory care prior to the middle stages can be most beneficial.
Clear Signs It’s Time to Transition to Memory Care
The line from early stages of dementia to middle stages is not always clear. However, there are some signs that could mean it is time to begin planning a successful transition to more specialized care.
Safety Concerns and Wandering
If your loved one has started to wander, or walk without purpose or destination, it is time for a move to memory care. Wandering is dangerous, and in an assisted living environment, a resident who is wandering might be able to leave the community undetected, making it an unsafe home for their current needs.
Other safety concerns that could indicate a move could include:
- Actively seeking the exit
- Getting lost in the community
- Wandering into unused shared spaces, such as the dining room when it is not meal time
- Unexplained injuries
- Not being easily redirected when wandering
Medication and Health Management Gaps
It is especially challenging to keep up with a complicated medication schedule when living with cognitive decline. If your loved one has a history of making medication errors, such as taking the wrong medication at the wrong dose or wrong time, moving to memory care will give them medication management support through caregivers.
Other signs that memory care could be helpful include:
- Inability to manage incontinence
- Weight loss
- Dehydration or a history of urinary tract infections
Personal Care and Daily Routine Breakdowns
Managing personal hygiene and other activities of daily living becomes difficult when dementia enters the picture. While assisted living communities do provide support with personal care tasks, you might need to move to memory care if you notice:
- Senior declines support with hygiene tasks
- Refusal to shower or bathe
- Wearing the same clothes over and over
Cognitive and Social Needs Aren’t Being Met
Typical assisted living programming is not designed to be dementia-friendly. This can make residents living with cognitive decline feel overwhelmed by daily events, choosing to isolate themselves from large or small group activities. Other warning signs include:
- Inability to keep up with conversations with peers at meals or other gathering times
- Refusing to attend activities or events, especially if they were usually in attendance a few months ago
Professional Input and Family Stress
Your loved one’s physician will be a guide for you, letting you know when you might expect to see significant declines in your loved one’s abilities. However, you can also rely on the input of the staff at the assisted living community where your loved one currently resides. They will keep you updated on any challenges they are having as well as when they believe your loved one should begin to transition to a memory care community.
Quick Self- Check: Is Memory Care the Next Step?
If you answer “yes” to any of these questions, it is likely time to begin researching memory care as the next step for your loved one.
- Has your loved one left their residence without supervision (eloped) in the past month?
- Does your loved one wander and/or pace at least a few times per week?
- Has your loved one had a medication error in the past month?
- Has your loved one refused help with personal care tasks in the past month?
- Does your loved one exhibit behaviors that are increasing in intensity?
- Is your loved one not easily redirected when in the midst of a dangerous behavior?
- Has your loved one stopped attending group activities?
- Does the assisted living community recommend memory care support?
How to Decide: Coordinating with Clinicians and Your AL Team
It is never too early to begin planning for memory care when your loved one is living with dementia. Here are a few ways you can start the transition by coordinating with the care team.
Request a Formal Reassessment
Your assisted living team already has a care plan in place for your loved one. However, they can reassess your loved one’s abilities and challenges at any time. Ask if they can evaluate your loved one’s cognitive status, including how they participate in their own personal care and daily routines.
Ask the Right Questions
When meeting with the assisted living team, ask questions that help you determine as a group what is the next best step:
- What support and interventions have been tried already?
- Is my loved one safe?
- What would change day-to-day in memory care?
- How soon do we need to initiate a move?
- Are there additional supports and assistance you can provide in the meantime? What is the cost of that?
- What can we do to begin the transition process with our loved one?
Preparing for the Move – Legal, Financial, and Documentation
Preparing for your loved one’s move to memory care can be the first step in having a successful transition.
Know State Requirements
In general, memory care requirements are similar to those in assisted living however, you might need to get additional documentation prior to move-in. For example, you might need to work with the assisted living team and your loved one’s physician to get items like a cognitive evaluation, a formal dementia diagnosis, and other required forms.
Organize Paperwork
Your loved one is already living in assisted living, so you can work with that team to ensure a copy of the POA/guardianship designation, Do Not Resuscitate order, and other advance directives are passed to the memory care community. Your assisted living team will also pass along medication lists, medical history, insurance information, and care plans. You can ask to have a copy of these as well if you are the healthcare POA.
Budgeting and Benefits
Memory care communities typically cost more each month than an assisted living community, as the type of care offered is more specialized. Make sure you know how much the monthly fee for memory care is at the new community, as well as what is covered in this fee. If you are worried about costs, speak with your loved one’s financial planner prior to committing to the new community.
Choosing the Right Memory Care Community
Sometimes, the assisted living community your loved one lives in will offer memory care as well. This can make the choice of where to go even easier, especially if you’ve had good experiences with the current assisted living community. However, you still want to evaluate memory care communities in order to make a confident decision.
Safety, Staffing, and Training
Ensure the memory care community you are considering has a robust training plan for all team members that includes dementia specific education. In addition, look for a community that features an environment that prevents elopement without sacrificing dignity.
Daily Life and Engagement
Search for a memory care community that has a calendar full of events and activities, including on weekends and in the evenings. Look for a good mix of large and small group activities, as well as personalized activities for residents who prefer to be alone. Make sure there are opportunities to exercise, explore the greater community, relax, and pursue individual interests.
Family Involvement and Communication
It takes a team to provide customized care for individuals living with dementia, and family members are certainly a vital part of that team. Find a community that offers family events, support groups, and educational sessions, as well as invites family members to care plan meetings.
Transition Timeline and Tips (Before, During, and After Move-In)
Now that you’ve decided on a memory care community, you can take steps to ensure the transition is as smooth as possible.
2-4 Weeks Before Move-In
In the weeks leading up to the move, your main focus will be ensuring the new memory care community has the information they need to begin caring for your loved one. Be ready for the memory care staff to call you to get more information about your loved one’s history and preferences so they can begin to build their initial care plan.
Depending on your loved one’s cognitive status, you might choose to talk to them about the upcoming move or you might not. Work with their current staff to determine the approach you will all take in order to prevent upsetting your loved one or causing extra stress.
Move-In Day
The new memory care community will help you to plan move-in day, including helping distract your loved one while you make their room feel comfortable and just like home. Keep the number of family members and friends helping out to a minimum, as too many visitors on a busy moving day can seem overstimulating and stressful.
Don’t forget to set up their room as familiar as possible. Key items, like family photos and a cozy quilt for the bed can make this new environment seem homelike.
First 30 Days
During the first month of living in their new memory care community, your loved one might feel a little extra confused. This is common. The team at the residence will be working with them to decrease the transition trauma, and they will keep you updated on what they are trying as interventions.
You can support your loved one by attending activities and meals with them while you are visiting. Be as consistent with your visiting schedule as possible, and try to visit with them in common areas. This will help them begin to see the entire community as their home.
Maintaining Dignity, Routine, and Relationships
Memory care residences specialize in offering comfort through routine and meaningful relationships. Here’s how you can support that effort.
Preserve What’s Familiar
When adding decorations to your loved one’s room, keep additions as familiar as possible. In addition to family photos and a favorite quilt, add a few favorite knick-knacks and even favorite music on playlists you create for them. You can also ensure your visits are comforting and familiar, perhaps doing the same things when you visit for the first few months: walk around the garden, look through photos, have dinner.
Keep Connections Alive
If your loved one remembers their life in assisted living, consider incorporating these relationships in their life. Have your loved one write cards to mail to their friends in the assisted living community or coordinate phone calls. But be sure to encourage new friendships as well. Accompany your loved one to activities and meals, introducing them to peers along the way.
FAQs: Assisted Living to Memory Care
Will memory care “feel like lockdown”?
Memory care communities do offer more safety features than assisted living, including monitored and secured exits. However, these are incorporated into the design of the residence, meaning your loved one won’t likely notice.
Can memory care slow decline?
Dementia is a progressive disease, so your loved one’s abilities will decline no matter what. However, a memory care community, along with its interventions and care support, can help to make your loved one feel more comfortable, enhance safety, and preserve dignity.
What if we move too soon or too late?
It’s never too soon to begin looking for memory care residences. However, moving too late can lead to frustration, stress, and increased behaviors in their assisted living home.
What Success Looks Like After the Transition
Ideally, a well-timed and supported transition to memory care can yield positive results for the senior and their family members. Potential signs of success can include:
- Fewer safety incidents and ER visits
- Better nutrition
- Better personal hygiene and sleep patterns
- Move engagement with peers
- Less isolation
- Reduced family caregiver stress
Next Steps
If you’re wondering if a move to memory care might be your next step, begin researching your options now.
Schedule a Reassessment and Family Huddle
Involve your family members and assisted living care team in your thought process. Talk about your observations and concerns. Listen to the professional assessment from the assisted living team as well as the opinions of your family members to ensure everyone is on the same page.
Tour Memory Care Options with a Checklist
When you visit potential memory care communities, make sure you are asking the same questions and gathering the same information at each one. This way, you’ll be able to more accurately compare them to one another and make your best decision. Include questions and observations about dining, staffing ratios, staff training, activities, and family communication.
Create a Simple Transition Plan
Once you’ve made your memory care residence choice, you can begin to prepare for a successful transition. Rally your family members and create a checklist to ensure everything is taken care of. Be sure to include a packing list, room setup design, medication list, and other medical documentation.
At Legend Senior Living, we provide both assisted living and memory care senior living options. We are dedicated to working with families and their aging loved ones in order to find the best care for them now, and in the future. Find a Legend residence near you and schedule a visit. We’d love to meet you, answer your questions, and give you a tour.
