I’m wondering what people think about memory care. What should I know about the process of getting him ready to move, what to look for in a good one, and what is the vibe in a good situation.
I have one in mind, it’s small, but I know someone who works there.
1. Make sure it’s actually equipped for your husband’s level of dementia.
Ask specifically whether they routinely care for residents with his current symptoms—not just whether they “accept dementia patients.” Ask about wandering, nighttime confusion, agitation, incontinence, falls, medication management, and behavioral changes. California’s dementia-care regulations were updated in 2025, with an emphasis on person-centered care and residents’ ability to remain in their homes as their needs change.
2. Pay very close attention to staffing.
Ask:
How many caregivers are actually on the floor during the day? At night?
What is the caregiver-to-resident ratio?
Is there an RN or LVN on site, and when?
What happens when someone calls in sick?
How much staff turnover have they had?
Are caregivers specifically trained in dementia care?
Who gives medications?
What happens if a resident becomes aggressive, wanders, falls, or refuses care?
I’d actually visit twice if possible—once during the day and once in the evening. A place can look wonderful at 11 a.m. and very different at 7 p.m.
3. Watch the residents, not the sales representative.
Are residents sitting around sedated and disengaged, or are staff interacting with them? Do caregivers know residents’ names? Do residents look clean, comfortable, and reasonably content? Does the place smell strongly of urine or disinfectant? Are there call buttons, secured exits, outdoor areas, and places where someone can walk safely?
And notice how the staff talk about the residents. That tells you a lot.
4. Get the complete financial picture in writing.
Don’t just ask, “What’s the monthly price?”
Ask for the base rate plus every possible additional charge: medication management, incontinence care, showers, laundry, higher levels of supervision, transportation, supplies, behavioral care, and eventual increases.
Most importantly, ask:
“What happens financially if his dementia gets substantially worse?”
You don’t want to discover six months later that the facility can no longer handle him—or that the cost suddenly increases by thousands of dollars.
I hope some of this information helps as you navigate such a big decision.
12. Be sure the location is convenient for you. If one MC seems better than another but it is an additional “x” amount of time beyond another good MC home, keep in mind that your most powerful tool to monitor his care is frequent, sometimes unscheduled, visits. Visiting your hubby could go on for a long time. Consider the burn out you might begin to experience from lengthy drives through all kinds of weather for these visits.
#10 additional- Make sure the MC is licensed to prescribe ON-SITE any necessary medications all the way through end of life- like powerful anti- psychotics. Some states may require licensing for the facility. I never dreamed my rosy-cheeked gentlemanly father would ever need these, but he did briefly at the end when he became combative and started to bite and hit staff. We tried everything to control his behavior but in the end, the powerful anti-psychotics were the only alternative to me bringing a violent, completely disoriented dad home to live with me 24/7/365. Thankfully I had a nurse friend who had been down this road with her own mom, so I had selected a MC home that was licensed. With an unlicensed home, you’d have to sign out your LO every three months (Michigan) for primary care doctor visits to get a prescription renewed for these regulated medications. This may seem like no big deal at the beginning, but as dementia progresses, signing them out can become a nightmare. Laws are in place to protect the residents so that MC homes cannot use “medications to tether” difficult residents.
The best way to find a good place for him is to go there and talk with an admissions director and tour the facility.
Pay attention to how the other residents look, and what they are doing. Do they appear to be happy, clean, do they have assistance from staff when needed?
Also pay attention to the staff members you see. Do they appear to enjoy their job? Do they have a smile on their face? Do they appear tense, stressed, tired and overworked?
You can ask about the ratio of care providers to residents, and what their policy is for responding to specific needs, as it applies to your husband. Ask if they have an activities director and what type of activities are planned for residents.
Check out a few. It's just like going apartment hunting. You want to go have a look and get a feel for the new environment before you live in it.
I run a support group and this is what they made as a checklist when visiting places
Facility Site Questions:
1. Cleanliness
2. Staff ratio
3. Wandering issues: doors opened, closed, locks
4. Staff interaction with clients
5. Current client behaviors and how staff and visitors react
6. Meals
7. Activities and resident engagement
8. Medications
9. Religion
10. Visiting medical services
11. Hair and nail care ability
I do remind my group that sometimes the resident mix has aged or can be young for a time, and to keep this in mind when looking at resident interaction.
Let me tell you something and it comes from many years as a paid caregiver to countless dementia care clients. Most of the time people don't know what they're doing and even though they have the best of intentions, they end causing a lot of unneccesary pain and suffering to their LO with dementia.
Any disruption in the daily routine of a person with dementia can be very upsetting to them. If the loved one is so far gone with dementia that they have to be in memory care, any disruption to their daily routine can be devastating. It can cause major setbacks to whatever level of independence and comprehension they still have. So, the family insists on taking grandma out of her memory care facility for a holiday. She going to most likely be confused, panicking, and anxious. Then after a long day they drop her off back at memory care. Now the staff has to deal with her and getting her reset back to her normal and this can take days when someone has dementia. The other residents also need the staff's attention. So you're not doing anyone a favor, lest of all your LO, going against the advice of the facility you put them in. Then again, a person doesn't belong in memory care level care if they can still be taken out and have some independence. AL would be the place for them. All too often people get put in memory care even if they don't need to be there yet.
I agree with you about cleanliness in MC. There's always going to be some smell because incontinence is ever present in memory care. If a place looks dingy, rundown, and unkept and the residents do too, it's not a good place.
We drove up under the portico, and our family was waiting for us. When we all went inside, there was a welcome committee, all smiles and making us comfortable. We went in the dining room, ate lunch, and husband went off to an activity with an aide while the rest of us met with the director, the cook, and the director of nursing. Then we left. After husband came back from his activity, he went to his room. He'd never been there before but liked it, they said. Then they ate dinner and he spent the night. The next day I was there to walk in the garden and watch TV with him. I was there every day after, and his transition was seamless. I don't think he remembered our home at all.
No discussion, no questions, and he wouldn't have been able to process the information anyway. Keep it simple!
Does the staff like working there? What is the vibe of the staff?
How close is it to your home? Closer is better.
If you think he will be aggressively exit-seeking, pay some attention to the security system. Most people will want to leave for a while until they settle in. But some people, especially men, will be very determined to physically break out. Just mentioning in case that will be a challenge with him.
There are lots of other factors that you can evaluate in relation to his personality. I hope somewhere will "click" with you. Sometimes it's an intuition rather than a checklist.
The things to look for is how many residents are assigned to a CNA on shift. If you can find a place that's six or less, that's a decent place. Also, take tours and look around. If the place smells bad and looks dirty don't go there because housekeeping and resident hygiene are not priorities. They should be especially in memory care. Talk to the families of other residents too and see what they think of the place and if they're satisfied with their LO's care and the facility.