Memory Care – Dementia Care – Alzheimer’s Care : What is the difference and where do we go for them?
Memory Care – Dementia Care – Alzheimer’s Care
What is the difference and where do we go for them?
In my last article, I talked about assisted living – what it is and what it isn’t.
In this article, I want to talk to you about Dementia Care – and other similar terms in senior care – Memory Care, Memory Support, Alzheimer’s Care. What are these terms, what are the differences, and who provides this type of care? I hope I can help give you some clarity.
First of all - terminology.
What we are talking about is providing help and care for people with dementia. Memory Care and Memory Support are just softer, easier terms for the lay public to digest. They mean “dementia care.” In the assisted living world, the terms memory care and memory support are now very commonplace and somewhat interchangeable.
Hint# 1: Sometimes, “memory support” may indicate they will care for people only with early stages of dementia, but may not care for those with moderate or later stage dementia.
Three stages of dementia.
As in many things, the industry and world has broken down dementia care into approximately three categories – early, moderate, and later stage. While these are not clinical terms, they do help us in understanding someone’s current condition, and, importantly for our sake, help us determine what type of physical setting a person should be living in.
Hint #2. People with early-stage dementia are often referred to as having MCI – Mild Cognitive Impairment.
Question: if you have early, mid-level or later stage dementia, what is the appropriate setting?
Stay at home.
If you have early stage dementia, or MCI, you very well an stay at home. People with early stage dementia or MCI can usually still stay at home, (unless they have other physical needs, where they may need assisted living care). But – and this is a big but – only if they have support from a spouse, family member or friend, at least to “watch out” for them, in case things get worse, or there is an emergency. However, if you have moderate to later stage dementia, you probably will need a 24 setting, like assisted living.
Assisted Living and Memory Care.
Most assisted living communities accept people with dementia. Some have a Memory care wing or even whole building for memory care or support. Some do not. Licensed Assisted Living Communities ARE allowed to care for people with dementia regardless if they have a separate area or not.
Hint #3. The “assisted living” neighborhood (another nice term, instead of wing or unit) is perfect for people with MCI or early dementia. In fact, most people there, besides having some level of care for physical needs, have some early dementia.
Moderate to Later State Memory Care.
Assisted Living with memory care neighborhood. Moderate or larger communities – 50-100 units – many times have a separate assisted living neighborhood for moderate and later stage dementia. Let’s start with later stage. The memory care neighborhood is perfect for people with later stage dementia. This is a more appropriate setting for them, rather than being at home, or in the regular assisted living neighborhood. Memory care neighborhoods (should) have specially trained caregivers who understand dementia. They usually have a Memory Care director who is an expert in the field. And the better places adjust meals, activity and personal care, virtually custom made for each individual and their specific cognitive needs.
For those with moderate level dementia.
This is where it gets a little tricky. It depends on the individual. If someone has a pleasant personality, has control of their toileting (even if incontinent and needing some support with that) and does not have behavioral issues, they can stay in the “assisted living” neighborhood even with moderate dementia. However, if they start having difficulty keeping their toileting to their own apartment or bathroom, and start to have disruptive behaviors to staff and other residents, then it is probably time to move to the “memory care” neighborhood. That’s what it is for.
Nursing Homes.
A word about nursing homes. These days nursing homes primarily care for two types of people – those with complex physical or cognitive needs who are on Medicaid with no funds left (for assisted living), or, they provide short-term “Rehab,” under one’s MediCARE benefits.
Hint #4 : When a doctor tells you, you need “Rehab”, while there are a few specific “Rehab” facilities, it is generally in a nursing home.
Nursing homes do take care of people with later stage dementia (and sometimes moderate dementia if one runs out of funds.) However, if you have the funds to pay for it, with any stage of or dementia, residential style assisted living communities are generally much nicer and more pleasant than institutional nursing homes, which were built from the model of a hospital, not an apartment building.
Hint #5. Watch out for the fancy buildings with dementia care. Just because a senior community is beautiful, and offers care for those with dementia, it doesn’t mean they do it well. All communities with memory care have the same issues. To do it right, you have to have a) the passion to do it right; b) a great leader; c) comprehensive and on-going training; d) a wonderful and committed staff who actually love being around seniors who have dementia. Some fancy buildings look great, but don’t have the mission, leader, training, people and passion to offer wonderful and compassionate memory care. If the building is decent, and you have wonderful people working there, I would recommend that over the fancy building. But that’s just me.
I hope that helps!
Dean Solden
Dean Solden is the CEO of Creative Senior Solutions (CSS), a management and development company specializing in senior living. CSS currently manages Orion Oaks Assisted Living and Memory Care in Lake Orion, Michigan. (www.orionoakassistedliving.com). You can reach Dean at (734) 260-3600 or dean@creativeseniorsolutions.com and Orion Oaks Assisted Living at (248) 688-7464, or email at klewis@orionoakssl.com.