Savvy Senior

Jim Miller

Dear Savvy Senior,
My dad has dementia and has gotten to the point that he can’t live at home any longer. I need to find a good memory care residential facility for him but don’t know where to turn. Any suggestions?
Only Daughter

Dear Only,
Choosing a good memory care residential unit for a loved one with dementia is a very important decision that requires careful evaluation and some homework.
Most memory care units, sometimes called special care units, are housed within assisted living or nursing home facilities. At their best, they offer staff extensively trained in caring for people with dementia, individualized care that minimizes the use of dangerous psychotropic drugs, a home-like environment and activities that improve resident’s quality of life. But at their worst, they can offer little more than a locked door. Here are some steps that can help you find a good facility and avoid a bad one.
Make a list: To identify some good memory care residential units in your area ask your dad’s doctor for a referral or use an online search tool like Caring.com. Make sure the facilities on your list are close to family members and friends who can visit often, because residents with frequent visitors usually get better care.
Research your options: Once you’ve made a list, call your local long-term care ombudsman (see LTCombudsman.org for contact information). This is a government official who investigates assisted living and nursing home complaints and can tell you which facilities have had problems in the past.
If you’re looking at a memory care unit within a nursing home facility, use Medicare’s nursing home compare tool (Medicare.gov/care-compare), which provides a 5-star rating system.
Call the facilities: Once you’ve identified a few good facilities, call them to find out if they have any vacancies, if they provide the types of services your father needs, what they charge and if they accept Medicaid.
Tour your top choices: During your tour, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the current resident’s family members, if available.
Also, ask about staff screening and training procedures, their turnover rate, and their staff-to-resident ratio. Make sure they provide quality activities to keep your dad engaged and find out how they respond to residents who may wander or become aggressive.
Because transitions can be unsettling for dementia suffers, make sure that your dad will be able to remain at the facility for the foreseeable future. And find out what, if any, health conditions might require him to leave the facility or move to a higher and more expansive level of care.
It’s also a good idea to make multiple visits to the facility including an unscheduled visit in the evening or weekend when the staff is more likely to be stretched thin.
To help you choose a good facility, the Alzheimer’s Association offers a list of questions to ask at CommunityResourceFinder.org/Alz/Tips – click on “Tips for choosing a residential care facility” under Housing Options.
Paying for care: The national average costs for memory care within an assisted living facility is over $6,000 per month, and over $8,500/month for nursing home care, but costs can vary widely depending on location and services.
Since Medicare does not cover long-term care, most residents pay for care from either personal savings, a long-term care insurance policy or through Medicaid (if available) once their savings are depleted. Or, if your dad is a veteran, he may be able to get funds through the VA’s Aid and Attendance benefit. To learn more, ask the facility director or contact the regional VA benefit office at 800–827–1000.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.