Memory Care vs. 24-Hour Home Care: Which is Right for Your Loved One?

If you are taking care of a spouse or parent with dementia, you know how important it is to have help. You may even have in-home respite care during the day. But as dementia progresses — whether it is Alzheimer’s or Lewy Body or Parkinson’s dementia — your loved one will eventually need some kind of round-the-clock care.

For many families, full-time care becomes necessary when a loved one can no longer be left alone at any time. People living with dementia will often wander at night, or lose the ability to walk without assistance, be unable to get in or out of bed, or to the bathroom.

At that point, it is not safe for them to be unattended.

It can be very helpful to have a plan in place, even if you and your family are just beginning to grapple with the challenges of providing care for a loved one with dementia. Understanding how dementia care works will help you make the best choice for your loved one and your family.

The biggest decision you will have to make is choosing between moving your loved one to a residential memory care facility or keeping them at home with 24-hour care.

Answers to Your Questions About Memory Care

Is Memory Care the Same as a Nursing Home?

Memory care refers to the care given at a specialized senior living community for individuals with dementia and meets most of the needs that a resident may have. Care workers in a memory care facility manage medications, provide all meals, housekeeping, transportation, and activities. But, memory care is not a nursing home. It is not a 24-hour nursing service with physicians and one-on-one care support.

How Does a Memory Care Community Work?

Memory care communities specialize in taking care of people with dementia. Some are attached to assisted living communities. Memory care should have a higher staff-to-resident ratio than assisted living and they should have staff trained in dementia care. To manage wandering, most units are locked and are accessible with a code.

Is Memory Care Expensive?

The financial costs of memory care can be high. For example, in California, the average cost of memory care is $6,000 per month or higher.

What Questions Should I Ask a Memory Care Facility?

• What is the staff-to-resident ratio?
• Is the care staff trained in working with people who have dementia? If so, what does this training consist of, and how often does it occur?
• What is the makeup of the residents? Age, gender, level of impairment?
• Under what circumstances would a resident be required to leave?
• What kind of activities are offered and how often do they take place?

How Does 24-Hour Home Care Work?

Many family caregivers start by bringing in respite care, with a caregiver coming to the home for a few hours a day. As a loved one’s dementia progresses, more and more assistance is needed, eventually leading to round-the-clock care in the home.

Some benefits of 24-7 home care include:

• Your spouse or parent is in a familiar setting. A move to a memory care facility, while offering comfort and safety, can still be distressing for a person with dementia.
• Family caregivers can closely manage and monitor care. Home care companies can come up with a care plan that is tailored exactly to the needs of your loved one.
• The potential to develop a plan of care that is very specific for the present and flexible for the future. Having a hands-on approach to care can be very empowering for you and healthy for your loved one.

What Questions Should I Ask a Home Care Agency about 24-Hour Care?

1. How many caregivers will be in the home over the course of a week?
2. How will changes in caregiving staff be handled?
3. If you are dissatisfied with a particular caregiver, how should you let the agency know?
4. How are changes to the care plan made?
5. Who is the care manager that is managing your family member’s care?

How to Choose Between Memory Care and 24-Hour Care

1. Level of Impairment. If your parent or spouse is mildly or moderately impaired, in-home care may be the best option. You can tailor caregiving tasks and responsibilities to meet their specific needs.
2. Availability of Good Memory Care. Some communities will have limited options for good memory care. Or, the community you have selected is full. Consider 24-hour care until an appropriate memory care community becomes available.
3. Caregiver Management. A good agency will do a good job managing caregivers. They can interview you and your loved one and find caregivers who will match your loved one’s needs and personality.
4. Isolation: Despite caregivers coming to the home on a regular basis, people can become socially isolated. For some, being with other people their own age may be more beneficial.

Benefits of In-Home Care: Patricia and Kirk’s Story
Patricia is in her seventies and has been diagnosed with Alzheimer’s. Her memory is starting to fail her and she has become quite anxious in social situations. Her husband, Kirk, travels for his work and he has become concerned about leaving her alone. Although Patricia’s memory is getting worse, she is an avid walker and gardener. These activities help ease her anxiety.

Kirk decides to hire a home care company to be with Patricia during the day. Caregivers stay overnight with Patricia when Kirk is out of town. Kirk is very specific about the activities that Patricia enjoys. The agency is able to assign caregivers who walk with Patricia and garden with her so she is able to continue to enjoy the activities that are meaningful to her.

In Patricia’s case, a residential facility would not have the staff to engage in this level of activity. For Kirk, it was great to be able to rely on an agency to select a variety of caregivers to care for his wife.

The decision between memory care and 24-hour care is a very personal one. Accept that your family member’s situation will change. Be flexible and adapt to the challenges that are a part of full-time care. It can feel like an afterthought, but remember to consider what works best for you and other family caregivers. Taking the time to look after yourself is an incredibly important part of taking good care of someone else.

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