Considerations When Choosing Memory Care

by Caroline Inman

If your loved one has been diagnosed with dementia, or if you’re noticing brain change with them, it’s normal to wonder how they will continue to cope at home and what the future for care and support may look like.  

There are certainly programs, services and in-home care supports (both publicly funded and privately paid for) that can help them stay within the home, but that is quite often for the immediate future and not always a longer term solution.

For that, you may want to consider a retirement home that offers varying levels of care, to include independent supported living, assisted living and separate memory care. Not everyone who has brain change needs a memory care floor, and as this article will highlight, not all memory care floors are the same. Exploring the options within retirement living for right now while keeping the future in mind, can be beneficial as very often your loved one can move into a residence and be very well supported with meals, housekeeping, laundry, social programming and access to nursing supports, with maybe some medication management and gentle cues and encouragements. Moving earlier will ensure they get familiar with their surroundings, staff and new friends and as things progress and they need more supports, there can be a seamless transition to higher care or the memory care environment itself. 

Understanding and considering the below may help you make informed decisions as you look at options. We at Solva are always here to provide guidance and be your sounding board. We are impartial and experienced and we have helped many, many seniors and families navigate the memory care landscape.

What stage of their journey are they at? – As we touched on above, not everyone who has dementia, and certainly not those with mild cognitive symptoms need to be on memory care. Oftentimes, an assisted living floor can be a choice as physical care needs can be met here, if your loved one has any. However, one thing memory care does (or should) provide is schedule, consistency and structure as these are the cornerstones of supporting someone with dementia…routine! If someone has moderate dementia then they will benefit greatly from the same people, the same order and ways of doing things each day and at each service – same for meals, same for bathing, same for dressing. It’s also a much smaller community than the whole retirement home, which is equally as important for someone with dementia. Smaller spaces equal less risk of getting lost, over stimulated, or disorientated. That’s the same for a living space. A studio space (usually 200-400 sq ft)  is wholly appropriate for someone with brain change to navigate and feel comfortable and safe within. The care provided on a memory care should be whatever the highest care level is at the home. For example, if the residence is licensed to provide a one-person PSW support to residents, then memory care will also be able to provide this. If the residence is licensed to provide a two-person assist, and a mechanical lift and a personalized feed, then memory care will also be able to provide this.

Is it more than a secure area? – A secure area is just that. You can’t leave the area unless you have a code for the door or a fob. This means that everyone who shouldn’t be leaving the floor or area can’t, and those who can, use the code or the fob. But just because an area is secure does not mean it is memory care. It just means it’s locked. There are homes that offer just this – and truthfully a memory care floor has to be secure because there are fears of wandering and exit seeking from certain residents. But just having a space/floor/area that prevents residents from leaving doesn’t constitute memory ‘care’. If you happen to be looking and you’re in a secure area, consider some of the points from below to determine exactly what is being provided and how.

A plethora of programming? – The buzz word is ‘therapeutic programming’ which ultimately means activities tailored to the cognitive needs and levels of the residents, who can benefit from engagement and stimulation specifically provided to and for them. Examples should always include music programming and sing-alongs because they’re so important for brain change. Often songs will invoke happy feelings and maybe long term memories. Dexterity activities like making things with pipe cleaners or Play Doh (that might sound childish, but this uses colour, texture, hand/eye coordination and concentration to make a shape or roll the doh). Flower arranging, making cards, painting, scrapbooking, games like Bingo or simple board or card games. Even ‘chores’ like setting the table, sweeping the floor, folding tea towels…residents are never asked to work but they can certainly feel useful and included by doing something with purpose. I know of a lady whose daughter would bring bread dough in for her to sit and knead it and make balls for bread rolls. And then she’d do it all over again. She was so happy to be doing what she loved and it kept her busy and dextrous. 

Many retirement homes generally have pets visit but certainly on memory care, having pet therapy and interaction with fluffy friends is an integral part of cognitive care. Movement too if able, with dancing, chair exercises, bag toss, balloon pass. Many ladies with advancing dementia revert back to mothering and often love to cuddle babies, so toy dolls are common, with cribs and strollers. Any visits to memory care by children’s groups, dancers, choirs, Scouts and Guides are so well received too. Check if there are any outside visits, by whom and how often.

Delve deep into staffing  – this is far more than how many PSWs, UCPs and/or nurses are on the floor at any one time. While that is very important and something to ask, I’m thinking more of the staff’s personalities, approach to care, advanced training in dementia and their communication skills with their residents. Who is in charge of the memory care community? Do they have a designated person whose role it is to guide and support both staff and residents or is it ultimately the director of care for the whole building? Is there one dedicated activities director and team just for memory care, or is that person responsible for the building? What extra training do the staff on memory care have to better understand brain change and how to approach someone? Can they share with you that it should always be ‘suggestion and not question’? Have they studied the Gentle Persuasive Approach or the Positive Approach to Care? Do they have any designations to show that training has happened, and is also ongoing? How often is there a refresher? How do staff react when a resident may have behaviours? How do they redirect them and what is their escalation policy? Can you have a look at their behaviour management policy? What happens if there is aggression from someone? When might you as a family member be called to mitigate or deescalate? What constitutes a send out to hospital? 

There are many, many things to consider and it’s why we’re also here to help you through this, and can accompany you on tours to Ottawa communities to help you ask these questions and understand the answers you’re given.

Fundamentally, someone with dementia still has an enormous amount to give and they can take part, they can engage, they can experience and they can contribute. It can be very hard to know what’s best and second guess your choices and decisions. Having conversations early with parents and loved ones can help with this tremendously; manage expectations and prepare as much as you can by talking to us, visiting options and making a plan!

We consistently go beyond a referral service and make sure to educate, inform and thoroughly support our clients. 

For a full understanding of our services, reach out to us at any time. Always FREE and without obligation.

613-421-6073    info@solvaseniorliving.ca