Caregiving Challenges

What to look for when transitioning to memory care

For families who have a loved one with dementia, the many challenges — the emotional burden, constant unknowns and high cost of care, to name just a few — may feel endless and unrelenting.

More than 16 million family caregivers in the U.S. provide unpaid care for a loved one with Alzheimer’s disease or other dementia, according to the Alzheimer’s Association. And that constant caregiving takes a toll on the caregiver.

“It’s exhausting and taxing on the caregiver’s health,” says Sara M. Bradley, MD, a geriatrician at Northwestern Memorial Hospital.

Caregivers say the stress of caring for someone with dementia mounts, especially when dealing with their challenges such as agitation, aggression, memory loss, repetitive actions and wandering, according to a national online survey from the Center to Advance Palliative Care and the Gary and Mary West Health Institute.

“Many experience the exhaustion of caregiving and often develop health challenges,” says Stacey Wilkinson, director of sales and marketing at The Carrington at Lincolnwood, a senior living community offering independent living, assisted living and memory care.

But searching for a community can be overwhelming — especially for a family caregiver who is feeling drained — so it’s important to know what to look for in the care of a loved one.

“Most loved ones want to do the right thing but have no idea where to start,” says Benjamin Surmi, a social gerontologist and director of people and culture at Koelsch Communities, which has four memory care communities in Illinois.

Depending on how far the dementia has progressed, some families may consider moving their loved one into a residential memory care community with 24-hour support.

Even in the age of COVID-19, a memory care community can provide needed assistance. “Some keep their loved ones at home with additional support,” Wilkinson says. “But many people with dementia require a setting that’s specifically designed for them and includes a team of care staff that understands the disease and knows how to assist them and keep them as comfortable as possible.”

The transition from home to a memory care community can often cause a lot of sadness, guilt and uncertainty, as family members may feel they should care for their loved one at home, Wilkinson says.

However, after a loved one transitions into a community setting, caregivers often feel a sense of relief, she says. They can focus once again on being a spouse, friend, daughter or son, while having the security of knowing that their loved one is getting the care and attention they need and deserve.

Assessing Memory Care Needs

When considering a memory care community, ask questions based on your loved one’s needs. Be sure to consider the following areas.

Personalized care. Start with a list of your concerns for your loved one who has dementia, such as safety issues, wandering, agitation or socialization, says Sara M. Bradley, MD, a geriatrician at Northwestern Memorial Hospital. Be sure that the community you’re considering can offer personalized care to address their challenges. Look for the following:

• If your loved one tends to wander, be sure the community has a locked unit.
• If your loved one is easily agitated, ask how providers de-escalate situations, including using non-pharmacologic approaches to behavioral issues.
• If your loved one is active, find out if they can stay active based on their function levels.
• If your loved one requires personalized care, inquire whether that has an extra cost.

Socialization. Look for residential memory care communities with open-door policies that allow individuals to freely walk around (under non-COVID-19 circumstances) to make connections and develop genuine friendships, instead of a closed-door policy that keeps individuals in their own space at all times. Seek out facilities with curated social programs throughout the day, such as art, music, pet therapy and intergenerational experiences, Bradley says.

Outdoor time. Getting outside in nature is important for those with dementia. Exposure to green space and nature has benefits including improved mood and slower disease progression, according to a 2017 study in the journal Dementia.

Look for a memory care community that has outdoor time worked into the schedule. Outdoor time — even if it’s just a few minutes a day of sitting outside in a common area for sunshine and fresh air — can help with sleep, mood and improved awareness, Bradley says.

Qualified care team. Find out the level of training for each member of the care team and how they handle various situations that could arise with an individual who has dementia. Ask about the staffing ratio and if there is a nurse or doctor on-site, Bradley says. “Check on the staff turnover rate,” she adds. “This says a lot about a facility and its team. If the turnover is high, this may not be the place for you.”

A structured day. A strong activities coordinator who understands the needs of individuals with dementia can make a memory care facility into a community. From safe outings to nostalgic movie nights to group activities, it’s important to have good choices of activities throughout the day. 

Healthy fare. Be sure the menu is chock-full of brain-boosting foods, including leafy greens, whole grains, vegetables and lean meats. The plant-based MIND diet can substantially slow cognitive decline with age, according to a 2015 Rush University Medical Center study published in the journal Alzheimer’s & Dementia. Scan menus for brain-boosting fare. “You’ll also want to check to be sure the menu can meet religious and dietary needs,” Bradley says.