In 2014, there were approximately five million seniors (over sixty-five years olds) who were diagnosed with dementia in the USA, with a further projection of 14 million by 2060.
Dementia covers a wide range of neurological conditions that affect the brain and worsen over time.
- Losing the ability to think, remember, and reason
- Inability to perform common daily activities.
- Losing control of emotions
- Erratic outbursts
- Personality changes
There will come a time when seniors living with dementia and their families will need to address the option of them moving to an assisted living facility. Families often become overwhelmed as their loved ones’ cognitive abilities worsen. Still, this isn’t always an easy transition, especially when emotions are running high for both the seniors and their families.
Further down the line, as dementia progressively takes hold of the senior, families will also need to decide when to move from assisted living to memory care nursing homes. Given the nature of dementia, it is advisable for families to look for facilities that have continuum of memory care options to ease the transition from assisted living to memory care with less upheaval.
While there is no definitive guideline for deciding the right time, there is an array of suitable senior living facilities that provide different amenities and services that cater to both physical and cognitive health issues. One such place is the Dove Estates Senior Living Community in Kansas, which offers assisted living, independent living, and memory support providing tailored programs with a high level of care.
The staff at Doves Estates pride themselves in ensuring their residents are both safe and comfortable, meeting medical conditions using efficient long term care software in a home-like environment. Jill Steiner, the Manager Partner of Dove Estates, recently joined the LTC Heroes podcast to discuss her first-hand experience of running a senior living community.
Unlike other long term care leaders, Steiner also cares for her father, who moved into the facility following a stroke. That experience has changed her outlook; she does not see the facility as “just a business” but rather as her parents’ home, where “every decision she makes will directly affect them too.”
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What’s the Difference Between Assisted Living vs Memory Care?
Exploring senior living options can be a confusing process, especially if one does not know the difference between assisted living vs memory care. There are many factors that come into play, such as gauging the current condition and having the foresight to plan ahead for when a loved one will need memory care services.
Families must research facilities extensively while bearing in mind that, in the case of dementia, there is no cure or way to prevent the deterioration of the brain. Therefore, it is better to find a facility that can address both the present and the future in order to give them peace of mind. It is also worth investigating the assisted living management software to ensure resident records and medication will be properly administered.
An assisted living facility caters to seniors who do not need around-the-clock care but need assistance with ADLs (Activities of Daily Living). The buildings are designed to be home-like spaces where residents can bring their furniture, making them feel more comfortable. Assisted living is perfect for seniors who want to retain their independence by living in private apartments yet have the advantage of some assistance.
While each facility differs from the next, most facilities offer a wide range of services such as:
- Catered meals (three per day)
- Assistance with personal care
- Help with medication
- 24-hour supervision
- On-site staff
- Social and recreational activities
Financially, there are varying costs for assisted living facilities. The prices depend on the size and type of the apartment (shared or private), the level of services needed, and according to the state. Steiner comments that during her tenure at Dove Estates, she has noticed a change in residents who come to stay. She categorizes them into two groups: those who have saved for this specific housing, and those who have not.
Those who did not set aside savings or plan for assisted living in advance often turn to Medicaid to help finance their assisted living costs. However, Medicaid is funded by both the federal government and the state. And while the federal government sets the guidelines on how each state spends its Medicaid funding, it is down to the individual state to develop its policies to support seniors in assisted living facilities.
The cost of assisted living is rather high. According to a Genworth Cost of Care Survey, the average national cost across America for assisted living is $4,000 per month. This adds up to around $48,000 per year and roughly $133 per day. Residents in an assisted living facility pay a monthly rental fee with additional fees on top, depending on the level of care they need. However, low-income residents can also apply for government subsidies to help finance these extra fees based on a percentage of their income.
Even though Medicaid contributes toward some assisted living costs, it does not cover the total amount. The responsibility for the remaining payments falls on the shoulders of the seniors and their families. There are also limited beds available for Medicaid residents, as many assisted living facilities do not accept Medicaid payments on account of the low reimbursement rate. This makes it more difficult for lower-income families to find assisted living facilities. Therefore, it is worthwhile to look for alternative long term care options outside of Medicaid.
Like a nursing home that caters to different medical issues, a memory care facility specifically caters to people with Alzheimer’s disease and other forms of dementia. Memory care centers tend to be secure environments because their residents tend to wander. Residents are given the freedom to roam within the grounds but not go beyond them. For this reason, the layouts of memory care facilities are designed to provide a calming ambiance with circular hallways so wanderers don’t encounter dead ends. There are also security doors with special locks to keep residents from leaving the facility.
People living with dementia become easily agitated and confused, which can lead to aggression. Therefore, they need twenty-four-hour monitoring and care from specially trained staff. National regulations require memory care staff to complete an eight-hour comprehensive course set by an approved NCCDP Certified Alzheimer’s Disease and Dementia Care Trainer CADDCT. At a minimum, staff will be trained in communication techniques, how to approach residents, how to care for residents, and reading in between the lines with dropped words, a common speech impediment for people living with dementia.
Like assisted living communities, memory care facilities also offer a range of services, such as:
- ADLs assistance
- Organized social activities
- Around-the-clock monitoring and care
- Transportation services
- Interior and exterior maintenance
- Meal preparation with eating aid (if needed)
- Care planning and coordination
The financial implications for residents and their families are also a concern. Memory care is one of the most expensive types of long term care due to the high level of care and training needed. On average, memory care costs are 20 to 30 percent higher than assisted living facilities in America. Therefore it is worthwhile to check what long term care EHR system a memory care unit is using, to ensure the level of care provided is adequate for their fees.
A recent Genworth survey estimates the nationwide cost for memory care is approximately $8,821 per month. That comes out to $105,800 per year or roughly $294 per day. However, the survey also found that the average cost varies dramatically depending on the state, with Alabama being the most affordable across the country ($655 per month).
Inevitably, families will need to decide when to move from assisted living to memory care, often seen as the follow-up treatment. Therefore, it is advisable to plan as early as possible, especially while their loved ones can still express their wishes and make autonomous decisions. In particular, financial planning is essential due to the high costs associated with memory care.
The most common financial planning documents families will need to prepare are:
- A will – This legal document specifies how a person’s assets (property and money) are distributed after they die.
- A power of attorney (for finances) – This document names a recipient who becomes responsible for financial decisions when their loved one can no longer.
- A living trust – This binding document appoints a trustee to hold and distribute any property and financial assets on behalf of someone when they lose the cognitive capacity to manage their affairs.
What is the Average Length of Stay in Memory Care Unit?
Alzheimer’s is one of the top 10 causes of death in America. As it is a degenerative disease that slowly destroys someone’s memory and cognitive skills, it is difficult to place a time frame on how long it will take for the disease to progress.
Although the symptoms may start mild, with someone losing their keys or struggling to stay organized, over time, the disease will inevitably worsen as a person’s forgetfulness and confusion become more prominent. The later stages are such that it becomes dangerous to live independently.
Memory care facilities offer safety and relief to support people living with dementia with experienced staff who can provide around-the-clock care, using efficient care plan software. Dementia does not have a one-size-fits-all solution. Therefore, the length of stay in a memory care unit can vary from a few months to ten years.
However, the average length of stay in a memory care unit ranges from two to three years. Many factors impact the length of visit, such as what transpired before moving into the memory care unit. If a senior received regular home-based services, the average time usually drops to less than a year.
Still, it is not uncommon for residents to live in memory care units for three years or more. Each resident’s dementia will progress at a different pace, with seniors typically living between four to eight years following their diagnosis. Therefore, when to move from assisted living to memory care will be assessed according to their progression rate. Ultimately, the average length of stay in memory care, whether long or short, is irrelevant because the most crucial factor is how to provide the best level of care that will improve the residents’ lives with the least amount of upheaval.
In some cases, residents will be able to remain at their facility and simply move to memory care. For instance, at Dove Estates, there is no need to choose between assisted living vs. memory care because the facility provides both services and has extensive memory care programs. Previously, Dove Estates only offered assisted living. This led to heartbreaking experiences for Steiner, who was forced to say goodbye to residents she saw as family. The strong bonds she formed with residents drove Steiner to adapt her facility’s services to include memory care. “It was the right thing to do,” she said. Soon after this realization, she set the wheels in motion by calling the architect and builder to get started.
The 3 Things to Consider in Deciding When to Move From Assisted Living to Memory Care
Having built their memory care unit on the same campus, Dove Estates has given families and residents the ability to decide the appropriate time for when to move from assisted living to memory care. But for facilities that do not have this capacity, residents and their families have a difficult decision to make.
While it is difficult to know the right time to move from assisted living to memory care, here are three key signs to look out for:
- Losing interest in the assisted living lifestyle
Assisted living is designed to give seniors as much independence as possible with the additional support of ADLs. These facilities include a wide range of social activities and restaurant-like dining rooms that provide ample opportunity for seniors to engage in the community.
However, if a resident suddenly stops participating in community events by losing interest in social activities and eating meals in the dining room, these are telltale signs their dementia is making these things more challenging.
If that is the case, transitioning to a memory care unit may be the right course of action, as doing so will ensure that they are stimulated with alternative activities and eating enough.
- Requiring more services
If a resident is needing more familiar companionship, this could also be a sign that they need to be moved to memory care. When residents live in an assisted living facility, it should give their families some respite from constantly caring and keeping them company. But when residents start calling their families more frequently, needing them to visit more often and for longer periods of time, or needing more assistance during their visits, these are clear signs that their dementia is progressing.
Memory care is designed to give more guided support so seniors can avoid being overstimulated. This will reduce their feelings of anxiety, so they feel safer and more comfortable, relying on memory care services rather than their families.
- Signs of regular confusion and losing track of life activities
As dementia gradually worsens, seniors will become more confused and forgetful. When they reach the point where they can no longer keep track of communal activities, meal times, or their personal affairs, then it may be time to consider memory care.
Observe any piles of unopened mail, regularly misplaced items, or abandoned medication, as these are all signs that a resident needs more support than they are currently receiving in assisted living and, thus, need to be moved to a memory care unit.
A little forgetfulness is normal. But when it becomes a regular occurrence, you will observe a distinct change in personality as well. Seniors suffering from dementia become increasingly confused, depressed, and agitated.
When residents can no longer manage their lives, even with the help of assisted living, then it is time to make the transition to memory care, so that a supportive team can tailor their care according to the physical and mental needs of the residents.
Before any decision is made, though, families need to take the time to explore the long term care facility they have in mind by talking to the staff and visiting the premises. A good way to gauge the facility is by observing the amenities like the room conditions, the common areas, and the social calendars. It is also worthwhile to talk to other residents to understand their first-hand experiences while taking note of important details, like whether they are neatly dressed or not.
It is important to find a memory care facility that enriches the lives of its residents. Thus, it is advisable to start memory care research as early as possible, as one never knows when the symptoms of dementia will advance rapidly.