Reviewed by Rachel Levy, BSW, MPHRachel Levy, BSW, MPH, and a senior national account manager at A Place for Mom, has worked in senior care for more than 20 years.
Elderly adults with dementia require specialized care, whether it’s provided in a senior living community or at home. With the right care tailored to their needs, seniors with cognitive decline can age with dignity, enjoyment, and some independence. Memory care and home care are two common options families explore for seniors with dementia. What services do they provide, and what are the most important factors to consider when making a choice of home care versus memory care for your aging loved one?
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Memory care communities can be stand-alone facilities or part of a senior living community with multiple levels of care. They provide specialized assistance for seniors experiencing memory loss, often due to Alzheimer’s disease or another type of dementia.
Dementia care facilities provide many of the same services as assisted living, including help with activities of daily living (ADLs), medication management, and nutritious dining options. They also offer unique features tailored to seniors with cognitive impairment:
Safety features, which may include alarmed doors and in-room emergency call systems
Building layouts that simplify navigation, encourage social interaction, and provide a safe space
Therapies and activities for seniors with dementia
Memory care communities offer activities and therapies designed for residents with all levels of dementia, which is a major benefit of dementia care at a community as compared to in-home care. These structured programs often require specially trained staff and aim to reduce cognitive decline, promote positive reminiscence, and comfort residents:
Reminiscence therapy. Sensory or visual cues from the past can help seniors reconnect with positive memories. Memory care communities may be well-stocked with old magazines, classic films, and music from residents’ youths.
Sensory activities. Appealing to all five senses encourages memories and exploration. Aromatherapy may bring back memories of baking Christmas cookies or mowing the lawn, while diverse textures can evoke a wedding dress, a beloved pet, or the buttons on a military uniform.
Art or music therapy. Creative expression can be soothing and feel productive. For instance, music therapy may include listening to favorite records or playing basic instruments. Some residents may retain their musical ability even after significant memory loss. Meanwhile, visual expression, like painting and drawing, are ways to express emotion safely and creatively.
Touch therapy. Memory care staff are often trained in hand and arm massage techniques to increase human contact and reduce stress. Some communities may also have contracts with licensed massage therapists who specialize in working with the elderly.
Pet therapy. Memory care communities may provide pet therapy to animal lovers who can no longer care for their own furry friends. Well-trained cats and dogs can provide companionship and comfort.
Design features for memory care facilities
Innovative design elements and relaxing spaces in dementia care communities can help ease anxiety and agitation common in people with dementia. Some of these unique features include:
Memory boxes on residents’ doors. Familiar objects can guide seniors and reduce anxiety from an inability to read or recall room numbers.
Color-coded or texture-coded walls to help those with memory loss navigate
Soft corners or circular hallways to allow continuous dementia wandering and prevent residents from feeling trapped
Secure gardens for sensory stimulation, nature exposure, and safe exploration
Simulated neighborhoods with storefronts, porches, and traditional home facades
Controlled lighting to mimic sunrise and sunset
Specialized multisensory rooms for light, sound, and touch therapy
Cost of memory care communities
The national median cost of memory care is $5,995 a month, according to A Place for Mom’s 2023 report on the cost of long-term care. Keep in mind, however, that prices vary depending on your community and state. For example, the median monthly cost of memory care in Georgia is $4,450 compared to $10,080 in Vermont.
What is home care?
For seniors who choose to age at home, professional home care offers companionship, practical help, and peace of mind for caregivers. Care aides can provide help with daily activities as well as social interaction. Levels of care vary by need and can span from a few hours of weekly meal prep and housekeeping to 24-hour supervision.
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While home care aides are trained to understand the nuances of senior care, they usually aren’t licensed to provide medical services. Senior home care services will be determined when you create a care contract, but they often include:
Companionship, which includes reading aloud, chatting, and in-home activities
Transportation to doctor’s appointments, physical therapy, or errands
Assistance with ADLs like dressing, bathing, and grooming
Meal preparation or delivery
Housekeeping, laundry, and dishes
Helping the senior organize bills, manage finances, and write checks on time for utilities
Home care is a common alternative to senior living for elderly adults who can no longer live independently. There are many reasons families may choose home care versus memory care for their elderly loved one:
Aging in place. Many seniors have lived in the same house for decades and moving to a new, often smaller, home is a difficult and emotional process.
Level of care. Home care can be adjusted to fit new needs as a senior ages. A home care agency could provide transportation and cooking assistance to an active senior as needed, or it could offer full-time care and companionship to someone who’s bedridden.
One-on-one interaction. In-home care ensures your loved one has the entire attention of a visiting aide. In senior living communities, staff members must tend to multiple residents.
Cost of home care
Budget is often a concern for families choosing between memory care and home care for elderly loved ones. While the cost of a memory care community is greater than the cost of home care, memory care offers more amenities and other significant benefits that home care can’t provide.
In-home care has a national median cost of $30 an hour, according to A Place for Mom’s 2023 report on the cost of long-term care. Hourly pay for home care ranges from $21 in Louisiana to $50 in Maine.
For seniors with early stage dementia who don’t require full-time companionship and supervision, home care may be a good choice. However, home modifications, overnight care, and tracking programs can add significant expenses for seniors with more advanced cognitive decline.
Is in-home dementia care available?
While home care can’t provide the structural or design benefits of a memory care community, dementia care at home can help seniors age in place if they have Alzheimer’s or another type of dementia. To make the right choice for your loved one, it’s important to understand the difference between memory care in a community and a memory home care service.
Aging in place with dementia
With the assistance of home care aides, elderly people with early-to-mid-stage cognitive decline may be capable of aging in their own homes or those of family members. For seniors with more advanced dementia, significant adjustments must be made to limit safety risks associated with dementia and age at home:
Full-time supervision, or alarmed doors and windows, to prevent dangers caused by wandering
Home modifications, such as locking cabinets, installing door alarms, turning off access to stove, adding grab bars and stair lifts, and replacing carpets to help promote ambulation
Clear, specially designed paths throughout the home that are free of clutter and conducive to safe, unimpeded wandering
Sensory stimulation spaces, like a room designated for touch, light, and sound therapy
Fencing for any open outdoor areas, or tracking devices in case of separation
How to choose a memory care facility or memory home care services agency
If you’ve already decided on a type of senior care or service, here are a few steps to help determine which in-home care agency or memory care community is most appropriate for your loved one.
Choosing an in-home care provider for dementia
It’s vital to work with a home care agency familiar with dementia and Alzheimer’s care, even if your loved one is only experiencing early signs of dementia. Consider these suggestions when hiring an in-home care provider:
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Does the caregiver have specialized training or experience? Caring for someone with dementia requires familiarity with symptoms of the disease and best practices for managing difficult behaviors.
Be upfront about behaviors. To help caregivers determine how they can provide the best possible care, disclose whether your loved one experiences sundown syndrome, aggression, or other symptoms.
Check references. Make sure the home care agency conducts background checks, and ask for contact information or testimonials from current clients.
Share background information. Seniors with dementia need to be comfortable with their caregivers, and providers can form stronger bonds with seniors if they know them well. Discuss your loved one’s interests, past accomplishments, and fond memories with the home care aide so they can best provide person-centered dementia care. Share photo albums, favorite music, and recipes as well. These tools are helpful for reminiscence therapy.
What are your loved one’s needs? Think about the types of assistance they’ll require and whether the facility is equipped to respond. For example, if your loved one has a chronic condition that requires regular medication or injections, will licensed staff be able to provide this care?
What amenities are available? For instance, you’ll want to know about the living spaces, dining options, and fitness or wellness programs. Do they fit your loved one’s preferences?
How are caregivers trained? Because dementia care can be complicated, learn about the community’s approach to difficult behaviors and the ways staff are trained.
What safety features does the facility provide? Visit the community to determine whether the building offers emergency alert systems, 24-hour supervised care, interior courtyards, wander management systems, and other top safety features of memory care communities.
How are dementia care plans developed? Many memory care facilities offer person-centered care by learning about a resident’s experiences, abilities, and care needs. Ask about who’s involved in care plans and how often the plans are evaluated.
What therapies are offered? Individualized therapies can help improve the quality of life for your loved one and treat symptoms of dementia. Ask about memory-enhancing therapies and how often they’re used.
Other senior living options to consider for dementia care
While this article explains the differences between memory care and in-home care, it’s important to learn about other senior living options, too. Each has benefits and features that may fit your loved one’s needs.
The following articles compare memory care to other senior care types:
Memory Care vs. Nursing Homes: What are the Key Differences? Nursing homes and skilled nursing facilities provide a higher level of medical care than memory care communities. Sometimes they offer dementia care, but you’ll want to assess your loved one’s needs before choosing between these senior care types. The decision often isn’t the family’s, though, because the potential community will tell perform an evaluation to determine what level of care a resident needs.
Additionally, A Place for Mom offers a free consultation service that has helped hundreds of thousands of families find senior living for their aging loved ones. Contact a Senior Living Advisor to discuss the needs of your family member and available options near you.
Claire Samuels is a senior copywriter at A Place for Mom, where she helps guide families through the dementia and memory care journey. Before transitioning to writing, she gained industry insight as an account executive for senior living communities across the Midwest. She holds a degree from Davidson College.
Rachel Levy, BSW, MPH
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