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Signs It’s Time for Memory Care: 13 Questions to Ask

21 minute readLast updated December 19, 2023
fact checkedon December 19, 2023
Written by Chacour Koop
Medically reviewed by Adria Thompson, Certified Dementia PractitionerSpeech-language pathologist Adria Thompson is the owner of Be Light Care Consulting and specializes in creating easily digestible, accessible, and practical dementia content.
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While many seniors with early-stage dementia can live independently or with some help, those with greater cognitive decline may need assistance from trained professionals in memory care communities. However, dementia symptoms can vary day to day or moment to moment, so it may be difficult to know when your loved one requires that extra help. If your relative is experiencing confusion or disorientation that may affect their physical safety, or if they’ve had significant changes in behavior, those are some signs it’s time for memory care.

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When is it time for a memory care facility?

If you’ve recognized changes in your loved one’s behavior or think they may no longer be safe living alone due to mental health issues, consider memory care as an option. In the case that your elderly parent refuses help, try to respect their autonomy when possible. Schedule an appointment to discuss options with your loved one and their doctor. A doctor can evaluate signs of dementia using several tools and can help your family determine if memory care may be the best fit.

“When talking about memory care, or some form of a different living arrangement, I’ll center the talk around ability to perform activities of daily living and safety,” says Dr. Philip Branshaw, an internal medicine specialist in Batavia, Illinois.

The decision about when it’s time for memory care varies from family to family, according to Maureen Bradley, a senior new hire support specialist at A Place for Mom with two decades in the senior living industry. She explains how it’s common to see families disagree on the course of action over their loved one’s care.

“Family members often have a tough time agreeing on when it’s time for memory care because they often see different parts of dementia,” says Bradley. “One person may see Mom in the morning where she seems to be really sharp, while another may see her at night when sundown syndrome symptoms appear.” In these instances, Bradley suggests turning to a doctor or senior care specialist.

What signs do doctors note when they consider recommending memory care?

During patient visits, doctors look for red flags signaling Alzheimer’s disease or another form of dementia. Certain telltale characteristics can suggest that it’s time for memory care. If a senior often gets lost or agitated, or if they can’t carry on a conversation, those are concerning signs.

“Looking at someone, you can sometimes see they’re not as tidily dressed, their hair’s disheveled, or they’ve lost significant weight because they forgot to eat,” Branshaw says.

From there, doctors may ask questions about a senior’s day-to-day life or perform a brief mental status exam.

“Often, seniors come in for regularly scheduled physical appointments and are hesitant to bring up memory problems,” Branshaw explains. “It’s almost always the kids who bring up memory, or it’s an uncovering process to find dementia signs.”

Trouble with activities of daily living may show when someone needs memory care

A person with dementia who struggles to complete activities of daily living (ADLs) — such as dressing, bathing, and using the restroom — likely needs some assistance throughout the day.

To gauge a senior’s abilities and safety, a doctor may ask if they:

  • Have trouble remembering to eat or drink
  • Are able to dress appropriately for the weather or occasion
  • Are struggling to bathe regularly or thoroughly
  • Have incontinence concerns or trouble cleaning themselves after trips to the restroom

If any of these red flags are present, your loved one’s doctor may suggest a mental status exam.

Safety concerns may be signs it’s time for memory care

Bringing up safety concerns is an important way to make family members aware of behaviors that could necessitate memory care, Branshaw says. He may ask relatives or caregivers these questions:

  • Is your elderly loved one leaving burners or appliances on after cooking?
  • Is a pet not being cared for properly?
  • Have there been any emergency room visits?
  • Does your aging parent have any bruises they can’t explain or don’t remember getting?
  • Has wandering or getting lost put your loved one in dangerous situations?
  • Do they require help taking medications on a regular schedule?

To decide whether a person with dementia should stop living alone, try to figure out what stage of dementia they’re in. If they’re experiencing injuries, wandering outside the home, or otherwise putting themselves in dangerous situations, they may be in the middle or late stages of dementia. If you’re concerned about them living alone, you may want to consider memory care for their safety.

Additionally, you may consider the legal effects of letting a family member with dementia live by themselves. While it’s not illegal to leave dementia patients alone, it depends on the severity of their symptoms. Most states have laws requiring doctors and lawyers to report mistreatment of seniors.[01] This could include neglect of a senior’s needs, which is a form of elder abuse.

A mental status exam can help decide when it’s time for dementia care

“In the office, we can perform a very easy, reproducible test that only takes a couple of minutes,” Branshaw says.

If the patient can communicate, the mental status exam may give a reliable baseline for tracking dementia symptoms and memory loss. This exercise measures concentration, short-term recall, and spatial awareness, and it identifies a senior’s ability to:

  • Repeat words a doctor says, then remember them later in the appointment
  • Spell simple words backward
  • Add and subtract with basic equations
  • Name objects properly
  • Understand visual and spatial cues, like the location of objects in the room

Another common test is to ask someone to draw a clock, according to Branshaw.

“Many people with dementia will draw all of the numbers up in one corner, rather than around the circle,” Branshaw says.

Most of the time, aging adults will visit their primary care doctor or geriatrician, who will perform these baseline tests. After that, their doctor or geriatrician may refer the patient to a neurologist or other specialist for further analysis and a specific diagnosis.

These diagnostic tests can help a doctor and the family of a person with dementia understand how far the patient’s cognitive decline has progressed. The results can help you determine how much supervision and support your loved one needs. Your family may be able to provide this support at home. Or, it may be time to consider memory care as an option to keep your relative safe, stimulated, and comfortable.

When should you tell a doctor about memory loss?

“Family caregivers should reach out to a doctor right away when they start to notice signs of dementia,” Branshaw urges. “That way, we can get a baseline exam done, and we can track test results over time to see if memory loss is getting worse.”

At first, a senior may score well on memory tests and only have minor impairment, like forgetting difficult words or where they left their glasses. But it’s never too early to bring up these concerns. By discussing dementia early, you give your elderly parent or relative the opportunity to be a part of senior living conversations.

“It’s better to have the conversation with the patient now, when they can feel some autonomy and take part in the decision of what happens next,” Branshaw explains. “It’s helpful, physically and medically, for the senior to be a part of the decision and the transition.”

Talking with a doctor during early-stage dementia can also help with tough conversations. Professionals may be better equipped to broach topics like driving safety, home modifications, or the transition to senior living.

Is memory care the right fit?

Let our free assessment guide you to the best senior living options, tailored to your needs.

Questions to help decide when memory care is appropriate

Worrying behavior changes, safety concerns, and caregiver burnout are top signs it’s time for a memory care facility. Ask yourself these 13 questions to help assess your family’s situation.

1. Have friends or family members commented on changes in behavior?

“Adult kids or family caregivers often don’t notice something and think their parent is OK,” Branshaw says.

“It’s challenging for family members to identify whether something is a sign of dementia or normal aging,” adds Bradley.

This is because when you’re caring for someone with dementia full time, it can be hard to notice progressive changes, like steady weight loss over several months. This change could be shocking and obvious to a family member or friend who only sees the person a few times a year.

2. Is your loved one showing signs of agitation or aggression?

Seniors with dementia may experience confusion, forgetfulness, disorientation, or the inability to express themselves. Because of these cognitive changes, a person with dementia may feel unsafe or afraid. This can result in what caregivers may perceive as agitation, aggression, or violence, even when it’s unintentional.

Individuals with dementia may kick, hit, or bite their caregivers if these situations can’t be prevented or deescalated. In other cases, the aggression may not be physical. Verbal abuse, insults, and unfounded accusations can also be difficult for caregivers to manage.

“Often, patients will get agitated or defensive in the office when we start to have the conversation about dementia — that’s a sign in itself,” Branshaw says.

Aggression can be particularly dangerous when a senior with dementia is cared for by an elderly spouse. Agitation and violence are most common later in the day, due to sundown syndrome.

3. Is your aging relative withdrawn or nervous?

Someone struggling with dementia may begin to decline social invitations and withdraw socially. Lower energy levels are a normal part of aging. However, avoiding favorite activities is a red flag. Similarly, someone who was once confident could become nervous to drive, opting to stay at home and watch TV.

4. Are their hygiene needs met?

A senior who took pride in their appearance may forget daily hygiene practices, like bathing or changing clothes. They may also struggle to style their hair or apply makeup and become too embarrassed to ask for help. As dementia progresses through the later stages, people will develop incontinence or neglect to clean themselves after using the bathroom.

5. Does your loved one wander?

Wandering is a common sign it’s time for a memory care facility. Seniors could become confused or disoriented and wander far from home without realizing it. This can lead to dangerous situations like walking on busy roads or getting caught in severe weather.

At home, well-placed locks and alarms may be necessary to prevent wandering. Memory care communities often have unique layouts and outdoor spaces to permit safe, secure wandering.

6. Are their living conditions safe?

Someone aging in place with dementia may begin to hoard household items or neglect laundry and cleaning. They could eat spoiled food or forget to clean up pet waste. Alzheimer’s safety risks at home may also include trip hazards, fall risks, kitchen appliances, guns, or household chemicals. Dementia care at home often requires significant safety modifications and supervision.

7. Are their medications properly managed?

Forgetting to take prescription medication — or taking too much of it — can lead to serious side effects. Reminders, alerts, and pill organizers may be effective for seniors with early-stage dementia, but people with significant cognitive decline need more intervention. Medication management is an important feature of memory care.

8. Is your loved one well-nourished?

Seniors with dementia may require special diet plans to combat existing health conditions. Adults aging in place may forget to eat, or they may overeat after forgetting they’ve recently had a meal, leading to significant weight changes.

9. Have you started to feel caregiver burnout?

It’s vital to balance your loved one’s needs with your own, but it’s also normal for dementia caregivers to feel frustrated or overwhelmed sometimes. If left unaddressed, however, those feelings can lead to caregiver burnout and negative consequences for both the caregiver and their loved one.

10. Is caring for your loved one going well?

If your immediate answer is that nothing is going well, or you have to really think about it, it’s time to seek help when caring for someone with dementia.

11. Are you feeling resentful towards them?

If you can’t think of anything positive about your loved one or if guilt is a constant emotion, you may be burned out. Too much time together can lead family caregivers to focus on the negatives. Take the space and time to consider your relationship with your loved one and recharge.

12. Is caregiving affecting your health?

Caregiver burnout can have serious consequences, physically and emotionally. If your own mental or physical health is declining, consider the effect caregiving has taken on your life: Are you feeling depressed or anxious, or are the physical elements of caring for a loved one becoming painful? Remember, declining health can put both you and your loved one at risk.

13. Are you and your family safe?

Anger or aggression from an individual with dementia may place others in physical, sexual, or emotional danger. It can be hard to accept that your loved one might threaten your safety. Remember that these behavioral changes are common, though their severity varies. Some people with dementia may not exhibit violent behaviors at all.

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Planning for a crisis: Emergency placement for dementia patients

Aggression and agitation are among the most common reasons for a dementia crisis.[02] It’s important to develop a plan if your loved one’s dementia behaviors are suddenly no longer manageable at home.

An inpatient geriatric psychiatry unit is one type of emergency placement for dementia patients.{citation:3}} Some hospitals and long-term care facilities may also provide emergency placement in a designated dementia care unit. These types of facilities commonly treat seniors with dementia by offering medication management, therapies, and other treatment options. Additionally, they can help you develop a plan for returning your loved one home or finding them a care facility.

Dementia hotlines are another helpful source of information. Typically, organizations have hotlines staffed with professionals or trained workers who can offer guidance.

Next steps: Finding memory care options

Generally, a senior with dementia should go into a memory care home if their safety is at risk and their needs are no longer being met. For instance, if you’re struggling to keep up with their needs and your mental and physical health begin to suffer as their caregiver, memory care is a potential solution. Memory care facilities not only have safety measures built in, but they’re often staffed with caregivers with professional dementia care training.

If you’ve determined your loved one needs additional care, ask their doctor about next steps following a dementia diagnosis. You can also ask them about signs that it’s time for memory care. Memory care communities can enable your loved one to age in a safe, stimulating environment where their medical and emotional needs are met by specialized caregivers.

If your family decides in-home care or memory care is the best option, A Place for Mom’s Senior Living Advisors can provide a tailored list of options in your area. Our advisors will also outline memory care costs that fit your budget. They can even help plan the logistics of a move — all at no cost to your family.

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  1. National Institute on Aging at National Institute of Health. (2020, July 29). Elder abuse.

  2. Backhouse, T., Camino, J., & Mioshi, E. (2018, February 6). What do we know about behavioral crises in dementia? A systematic reviewJournal of Alzheimer’s Disease.

Meet the Author
Chacour Koop

Chacour Koop is a former copywriter at A Place for Mom, where he published articles focused on Medicare, Medicaid, dementia, and wellness with a hope that other families can use the information to improve their lives. As a former family caregiver, Chacour Koop strives to bring practical knowledge about senior care to readers who are navigating this complex topic. Before writing about senior living, he was a journalist with bylines in The Associated Press, Miami Herald, Sacramento Bee, and dozens of other publications. He earned a degree in journalism from Eastern Illinois University and a master’s degree in public affairs reporting from the University of Illinois Springfield.

Edited by

Marlena Gates

Reviewed by

Adria Thompson, Certified Dementia Practitioner

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