My Visit to a Memory Care Facility

Denise1847

Prompted by all of the experience of this forum, I visited a memory care facility to get a plan in order for if and when I need to make decisions. I chose this facility to visit because they have the entire spectrum of care onsite (independent living, assist living, memory care, advanced care, hospice). It is a very nice facility with great amenities for the residents. As I toured the facility and then was taken to the memory care section, the stark difference was immediate. Memory care was on a lower level (so less light). The flooring in the rooms was vinyl compared to nice carpeting in the regular rooms. There were no drapes, no furniture. It was drab and reminiscent of an older facility I visited years ago. I observed the patients (approximately 25) all in an activity room with 3 aides. The patients were engaged in the activity. The staff was nice but I walked about with a feeling of "bait and switch", meaning they spent a lot of time showing me fancy things that my DH would most likely not be able to engage in when I would need to place him. They told me that memory care patients care use the amenities when accompanied by an aide. I would wonder how much opportunity there would be due to any staffing issues. I am wondering what you all have experienced in the facilities you have visited. Am I expecting too much? The entrance fee is $5500 and the costs can range anywhere from $7000 to $11000/month. We are in Maryland. We do have long-term care insurance, but wow, this will take us broke in no time.

jfkoc

Are you expecting too much ? Take a look at

https://www.abesgarden.org/

and

The Hearthstone Institute | Dementia and Memory Care Training

Then use these for comparison

loveskitties

My parents were scheduled to move to a facility like the one you mentioned when my father was hospitalized. When he was ready for release they had no memory care beds available.

The place we selected was just assisted living and memory care. Much different in size and scope, but definitely a better choice for him. Staff was great. Care was all we could have asked for...and of course the cost was much less.

In my experience the places which have all levels available are geared more toward "younger" more mobile clients and the amenities are wasted on a patient needing assisted living or memory care...but you are paying for them.

Look for a clean, well maintained facility with a good patient staff ration. You mentioned that there were no drapes and no furniture...do you mean in the patient rooms or in the whole of memory care? If the latter, I would give it a pass as it appears they don't go out of their way to provide a pleasant area for them.

Elshack

Actually in memory care it is best that they do not have carpet in the resident's rooms as often they have trouble with incontinence and it is much easier to clean a vinyl floor. ( or fake wood ) My DH is in memory care and I am in indepependent living. Check to see if the general living spaces are pleasant and the staff ratio is the most important thing. I moved my DH's recliner and standing lamp and side table to his room and also his bed and bedside table so things looked familiar.

I am in NC in a small town and rent for his room is $ 5200.00 a month with no entrance fee since he switched from independent living. To me, cleanliness and kindness of the staff are the most important elements. I hung some familiar artwork in his room but seriously I don't think he even notices his surroundings. He has been there 9 months but will soon be 93 so I don't think he will be there for much longer. Be sure you check to see if your LT insurance will indeed cover the expenses. It is very wise on your part to make these plans now so when the time comes you can transition to memory care.

Denise1847

Thank you all for your experience and insight.

harshedbuzz

I toured a dozen places when looking for dad. They ran the gamut from religiously affiliated non-profits to state VA homes, to corporate, to community charity, from CCRCs to stand-alone MCFs.

A couple things I noticed-

The quality of CCRCs can vary a great deal between levels of care. Often, they're terrific for IL and AL, but not great at, say, rehab or MC. The one I wanted my parents to consider recently did away with their MC and folded it into their small SNF. Another I like is world class for hospice and IL/AL, but lousy at MC. The one my mom liked had a nice enough MCF, but when a resident converted to a Medicaid bed (PA/Medicaid doesn't fund MC here) they were moved to another building that was not only bleak, didn't have many of the same activities available.

Some of the corporate places were clearly designed to appeal to families making the choice rather than to meet the needs of the residents. Often these were decorated beautifully with chandeliers, plush carpeting, massive silk flower arrangements and tall case clocks. I'd rather see money spent on staff training and retention. The places near me that were like this also cherry-picked their residents for the well dressed and pleasantly befuddled.

Dad's place was somewhere in the middle. It was a purpose-build, stand-alone MCF. It wasn't posh, but it was clean, and the staff was amazing.

HB

Joe C.

I visited 5 facilities before settling on my preferred choice and in the end I choose a stand alone Memory Care facility with no Assisted Living. Four of the facilities I visited had AL & MC rooms and some a couple were similar to what you described but others had equally nice rooms & common areas as the AL side. The main thing I realized by visiting multiple facilities is there’s a major difference in how long a MC facility will allow residents to stay as the disease progresses. Some of the facilities that I visited which were very visibly pleasing would require resident to move out as the disease progressed. I learnt to ask questions like, can my love remain her if: she needs her medications crushed, needs two person assist the walk, is in a wheelchair, needs a hoyer lift. I learned to watch out for acronyms like LMA (limited medication assist) meaning if a resident needs pills crushed their staff will not give the medication or it’s time to move your LO elsewhere. One of the “nicer” facilities I visited would not accommodate any of the assistance I listed above, two others would provide some but not all these accommodations and two facilities would provide all these accommodations. The process of placing my wife was heart breaking but the idea of having to move her to another facility as she decline was unacceptable. To be clear, MCs are not skilled nursing facilities so it is possible if DW develops medical care such as needing IVs or feeding tubes then the MC is not licensed to provide this level of medical care so a future move is still possible but my chosen facility will do everything they are allow to under state law to keep her in place. My choose facility is a visibly nice as the best of the other facilities I visited, has a great staff, a lot of activities for the residents and take very good care Old DW. I visit DW 4 or 5 days a week and I am confident that the staff cares equally well to other residents who do not have regular visitors. One final note, the Move In fee can be negotiable often depending of how many open rooms the facility currently has. The move in fee for DW’s MC was $7,500 but I got it down to $3,750 and I know others who got the fee waived completely. My understanding is if you are using a referral service such as a “Place For Mom” then the agency is payed out of the entrance. My position was that since I did my own leg work and that the did not need to pay an agency they should waive the fee. They would not waive it completely but did reduce it by 50%.

toolbeltexpert

Denise1847 your description of the stark change was what I saw in one place I checked out. It was worse though. I went from really nice to warm humid, wall paper peeling, really, a perfect place for pneumonia to breed. Staff was all occupied by smoke break and residents were wandering the halls looking for their room. I believe it was under 3k that's self explanatory. My dw is in an almc. they have 3 sections al, sn,almc. She can age in place. Not the prettiest place, good staff, decent food I get 5 free meals a month, although I think they would go beyond and not charge its 5 $ a meal if I was doing it all the time which isn't bad at all. I was a volunteer activity person for 8 yrs, I sang with the residents in the almc during those yrs and knew all the residents by name. I am considering starting back doing that again. During those yrs I visited I never fully understood the emotional pain of the families that visited, they would take videos of their lo singing, they thanked me but now I understand that pain all too well and I am thankful when a volunteer singer comes,I take videos and thank the volunteer. It so different understanding it from the other side. I wish you good success in finding a place that is close,clean and compassionate.

Stewart

MN Chickadee

If you don't like the vibe of a place, trust your gut. .

However, do keep in mind the realities of memory care. The ones I toured yes the MC was not as nice as the AL. But knowing what I know now, it makes sense. Staff get tired of shampooing carpet. In the early days of MC my mother was always taking her Depends off and making an enormous bio-hazard mess. That room had carpet, and it had been so shampooed by the time she left it's color had changed. Her second facility had vinyl flooring, which while not as home-like was so much easier to keep clean. It smelled better because it didn't hold the odor like fibers do and was easier to disinfect for safety reasons. Also remember that MC residents are hard on stuff. They pee on the chairs. They pull pages out of books and tear blinds down. Things become tattered very quickly even when replaced often. So places tend to choose carefully what they have out and what style of furniture they buy etc. It is never going to be as nice as an AL where residents know how to treat stuff. And think about what amenities he actually would enjoy. Their world does get small, often by design. A PWD often does not do well in groups and settings a regular AL resident would. Most thrive on a "grouhdhogs day" scenario with the same routine every single day and small and quiet activities. My mother's two facilities also had amenities she could not or would not enjoy, and yes some were due to not enough staff. However we as family were able to use them. The outdoor paved walking paths and garden for example; while staff didn't have time to take her out we did when we visited and it gave us something special to do.

So I would advise putting some but not too much weight on decor. You want a place that spends their money on staff and activities, so focus there. The staff ratio, training, quality of activities and food etc. For example bringing in musicians and animals is money better spent than decorations that will please a touring family member and a PWD will never notice. You should be able to expect it to be clean and somewhat pleasant though. I would tour a few more. Even tour one that is out of your price range to get a sense of the full spectrum of care in your area as well as one you may not consider based on recommendations. This will give you an idea of what is normal and if this place stacks up.

Dio

I opted for a memory care only facility so that the focus is on residents with memory problems, which are more difficult to care for than assisted living residents. I also opted for private-owned rather than corporate-owned. While there are pros and cons to each, I concluded that corporations tend to focus more on the bottom line instead of the actual care for the residents and more prone to execute evictions when it suited them. Also, please be aware that some places won't accept LBD or FTD patients. I'd rather have them be upfront and reject entry rather than promise you the world then later come up with a convenient reason to evict your LO.

Just my two cents worth in my selection criteria:

• Facility is clean, smells nice and pleasant (not an onslaught of industrial cleaning solution or worse, urine stench, upon entering the facility).
• Atmosphere was pleasant and lively where residents looked engaged and active, although of course some are in stages where they're napping (unlike some facilities that felt dreary and "lifeless"). Look at how staff is interacting with the residents.
• Good staff to resident ratio of 1:7 (although up to 8 may be within the normal range), not just during day but night shift as well.
• Low staff turnover rate, which means staff are happy working there.
• Staffing gets regular training.
• If your LO is close to needing a high level care, then an all inclusive care pricing structure would be better than having the facility nickel and dime you. Important: what is the annual price increase?
• Ask what would constitute an eviction--if the facility has ever evicted a resident and under what circumstances.
• Features stay-in-place till end-of-life. (or does resident need to be transferred to SNF at such time when it's needed?)
• Has nurse or LVN on site. Visiting doctor was a bonus.
• Small to mid-size facility. (Larger facilities tend to operate more frenatically, IMHO.)
• Visiting hours, open to calls 24/7.
• What is the reason(s) owners are in this business and their staying power?

You may not find one that has everything you want, but 90% was pretty good in my world.

Denise1847

Thank you all for your wonderful feedback and experience. Your suggestions and experiences are so very helpful.