People with Alzheimer’s need more and more help with daily life as their disease progresses. Nursing homes and memory care facilities are two residential options for caregivers who are managing serious Alzheimer’s symptoms like wandering, emotional outbursts, and personality changes.
Both types of facilities provide long-term care for people with memory loss, but there are differences. Knowing what each offers will help you make an informed decision about what’s best for your loved one.
What Are Nursing Homes?
Nursing homes provide various levels of health care for their residents around the clock. In a nursing home, residents have 24-hour supervision and help with everyday activities such as meals, using the restroom, bathing, and getting dressed.
Nursing home care is for people with many types of disabilities and health issues that require more care than can be easily provided in a home setting. They also house and care for seniors who are unable to live on their own or care for themselves but don’t need to be in a hospital.
Some nursing homes are intended for short stays after a surgery or hospitalization. People with Alzheimer’s may live in a nursing home for the long term, and they will require higher levels of care as time goes on.
Along with basic care, nursing homes also provide skilled care from health professionals such as physical, occupational, and speech therapy. Nurses also provide direct medical care, such as managing medication, wound care, and giving IVs and tube feedings.
Nursing homes vary greatly in their size, staff-to-resident ratio, and types of trained care workers. Every nursing home must be licensed by their state and regulated by the federal government.
Nursing homes generally provide a higher level of care than assisted living facilities, which offer meals, housekeeping, help with personal care and medications, and social activities. The U.S. government doesn’t regulate these facilities.
What Are Memory Care Facilities?
Like nursing homes and assisted living facilities, memory care units offer round-the-clock care and supervision as well as help with day-to-day activities like bathing and dressing.
The main difference is that they provide specialized care for people with memory loss. They focus on creating a secure environment for people with dementia or Alzheimer’s while giving them the best quality of life possible. Their employees are trained to deal with people who have cognitive impairments (problems with memory and thinking) like dementia and Alzheimer’s.
Memory care is often offered in a separate area within an assisted living or nursing facility. Often (but not always), these units are secured to reduce the risk that people with memory loss could wander off the property and get lost. Memory care can also be provided in a standalone building.
Memory care units tailor health care to the needs of those with Alzheimer’s and dementia. They may use signs and pictures to help residents do things independently as much as possible. Many offer enclosed outdoor courtyards for recreation and common areas designed to make it easier for residents to find their way around.
These facilities often stick to preplanned schedules to provide structure to residents’ days. And they may offer special activities designed to benefit those with memory loss, such as music or art therapy.
Around 15% of nursing homes and 14% of assisted living and other residential care communities have a special dementia care unit.
How Do You Pay for Nursing Home and Memory Care?
How you pay for care depends on where you live, what kind of facility you use, and your financial situation. Many families pay much of the costs out of pocket.
The average cost for a private room in a nursing home is about $299 a day, which adds up to about $109,000 a year. A semi-private room (one you share with another person) is about $263 per day, or $96,000 a year. Memory care averages $6,935 a month, or $83,220 a year, according to the National Investment Center for Seniors Housing & Care.
Medicare doesn’t cover custodial care, which means help with everyday activities such as dressing and bathing. Most nursing home and memory home care is at this level.
In some cases, Medicare does cover some skilled nursing care after you’re released from a hospital, but only for the first 100 days. It also may cover certain medical services you may get through a nursing home or memory care unit, like hospice care. But it doesn’t pay for long-term residential stays.
Private long-term care insurance usually covers the cost of care provided in nursing homes as well as memory care facilities.
Medicaid covers many nursing home and long-term care services in Medicaid-approved facilities. To qualify for this coverage, you must meet certain requirements for your level of care, income, and assets. These requirements vary from state to state. Veterans’ benefits may also cover these services.
What to Look for on a Tour of a Long-Term Care Facility
When you’re considering a nursing home or memory care facility, you can use Medicare’s nursing home search-and-compare tool to see how they rate on health inspections, staffing, and quality measures. Once you’ve selected some options, arrange a meeting with staff to take a look in person and ask questions.
Basics to look for include:
- Medicare and Medicaid certification
- Handicapped access
- Residents who look well cared for
- Good interaction between staff and residents
- The smells and sounds at the facility
Try to visit on different days of the week and at different times, including mealtimes. Talk with staff members. If possible, speak with other families with loved ones at the facility so you can get a firsthand account of what it’s like. You can also ask to see the facility’s latest inspection or survey report.
Questions to consider asking during your tour include:
- What kind of activities do residents participate in?
- Are there extra costs for certain types of care?
- What are your facility policies?
- What’s your staff-to-resident ratio?
- How often does staff turn over?
- What’s the daily schedule for residents?
- How are families informed about changes in residents’ health?
When visiting a memory care unit, you can also ask:
- Is this a locked facility?
- Are there separate costs involved with this unit?
- What other special directives are in place for those with memory loss?
- What kind of training does your staff have in dealing with dementia patients?
- How does the staff handle challenging behavior?
- What happens if the resident runs out of money?
Medicare offers a Nursing Home Checklist worksheet you can print and take along with you on tours to be sure you cover all the bases.
