When Does Your Loved One Need Memory Care?

When Does Your Loved One Need Memory Care?


By Nancy Kriseman

I often get asked, “When will my loved one need memory care instead of assisted living?” Memory care is a specialized program that is designed for individuals with dementia who require more structured activity and hands on care than what is typically offered in general assisted living. Quality memory care facilities extensively train their staff members in dementia care and have higher staff to resident ratios than in the assisted living section. They also have a program director dedicated to the resident activities and a licensed nurse dedicated solely to the resident’s medical care. Memory care typically offers a secured and locked environment, so outside access only occurs with a staff or family member escort.

There are three primary reasons that your loved one would need to be in a memory care program: safety, problem behaviors, and need for structured activities.


When a person develops dementia, particularly Alzheimer’s disease, her safety is often at risk. For example, your loved one may drink mouthwash because she is thirsty, she may wander outside of her residence and get lost, or she may not know what to do in an emergency situation, such as a fire.


In many circumstances, when your loved one develops dementia, her reasoning and judgment, along with her social filters, can be impacted. For example, she may not understand why it’s important to shower or she may take off her clothes in public. When your loved one exhibits inappropriate behaviors, it can cause great discomfort to those around her. If your loved one is placed in assisted living, other residents may not tolerate this type of behavior or may make fun of your loved one. As a result, your loved one can become socially isolated and depressed. In a memory care program, this type of behavior is expected, less offensive to other residents, and dealt with compassionately.

Structured Activities

Unfortunately, many people who develop dementia are not able to plan their own activities and social engagements, either because they forget to do so, or become overwhelmed and confused. Memory care programs are structured to help your loved one remain active and give your loved one support throughout the entire day. Activities should be meaningful and geared specifically toward those with cognitive challenges. In addition, activities should help support the spirit of the person, Activities like music, dance, drumming, arts, and aroma therapy will help accomplish this goal. General assisted living communities offer programs, but expect the residents to engage in them mostly on their own.

Does Sylvia Require Assisted Living or Memory Care?

Two years ago, Sylvia was diagnosed with dementia and has been living at home, but her dementia is progressing. She is having frequent issues with incontinence, remembering to shower and failing to change her incontinence briefs. She struggles with what to fix for meals and seems to have forgotten much of her cooking skills. She spends most of her day sleeping or watching TV and doesn’t want to do anything else. Her family doesn’t think she should live at home and believes assisted living care would be the best thing for her.

However, Sylvia would most likely benefit from memory care. Sylvia was unable to remember how to cook, so it is possible, as exhibited by other elders with dementia, that she could forget to turn a burner off, creating a fire hazard. Sylvia’s refusal to take a bath could result in health issues, such as skin breakdown or urinary tract infections. Lastly, Sylvia is interested in few activities and is at risk for depression. In quality memory programs, the activities engage the elder. This could greatly improve Sylvia’s quality of life. Sylvia would be able to participate in supervised music, exercise, craft and cooking programs and would be able to enjoy the companionship of other residents and the interaction from staff.

Bottom line: Memory care programs should provide a sense of warmth, comfort and safety for your loved one, which should help both you and your loved one feel more at ease.

Nancy Kriseman is an author and licensed clinical social worker who specializes in working with older people and their families.  This column is about helping families make the best decisions possible and be proactive when supporting and caring for elder family members. To contact Nancy, you can visit her website at www.nancykriseman.com, or her Facebook page, or twitter feed @GeriatricMSW.

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