“There’s no perfect option out there, and there’s no community that’s going to check every single box.” — Kelly Graffius
Are you facing the moment you hoped would never come, trying to choose the right memory care community for your loved one? If you aren’t sure where to start, you are not alone.
We are Sue Ryan and Nancy Treaster. As caregivers for our loved ones with Alzheimer’s and other types of dementia, we appreciate how emotional and complicated this decision can feel. We’re sharing six practical tips from Kelly Graffius, Certified Senior Advisor and President of OASIS Senior Advisors in Roswell, Georgia, who has guided countless families through this exact process.
If you are early in your dementia journey, you may start out evaluating independent or assisted living. No matter where you begin, this often leads to evaluating memory care as well, so this is our focus here. Our episode 28: Time for a Change? Tips When Considering Home and Community Living Options: Five Essential Tips / Alzheimer’s and Other Dementias, has both a podcast version and a blog version. It includes tips to help you when you’re first beginning to consider a change in where your loved lives.
Tip 1: Establish Your Goals for Memory Care
Choosing a memory care community is one of the most difficult decisions a caregiver will face. This decision starts with a clear understanding of what you’re trying to accomplish.
Think Through Timing
Consider a memory care community even if home is your first choice, so you aren’t forced to make decisions during a crisis.
Understand the Eligibility Window
Senior living options, including assisted living and memory care, come with eligibility requirements that change as your loved one’s disease progresses. Common requirements include the ability to stand, bear weight, and are not bedbound.
Having these conversations well before a community is needed helps you understand whether you are still within the window of opportunity. Once your loved one moves in, most communities allow them to age in place, so the eligibility bar that applies at move-in typically does not apply later.
Tip 2: Choose Your Preferred Geographic Location
Once your goals are clear, location is your next filter. Think about what actually makes sense for your daily life.
- Consider where you live, where you work, where your children go to school, and define a manageable radius, or “bubble,” for the care community.
- Think through traffic patterns for the times you are most likely to visit, whether that is a weekday evening or a Saturday morning.
Sue evaluated drive times at peak traffic when choosing communities for her father and her husband, Jack, and used that information to narrow her options before looking.
Tip 3: Plan Your All-In Budget
While location narrows the list, budget requires a longer view than most families expect. This is not just about today’s cost.
Look Beyond Today’s Price
- Expect a cost of living increase of three to five percent — year over year — and check whether this increase is capped in the community’s agreement. Important note: most are not.
- Ask upfront what the pricing model looks like for both ambulatory and non-ambulatory care, since the financial model can shift as your loved one’s needs change.
- Recognize that no two communities price the same way. Some offer all-inclusive rates, while others charge a room rate plus a separate level-of-care fee, so this is rarely an apples-to-apples comparison.
Weigh Shared Rooms and Price Against Fit
A shared room can cost less than a private one, and it can also offer more social stimulation as your loved one’s needs progress. Cost is only part of this decision.
Sue explains:
When we first moved my husband, Jack, into memory care, he was very active and very social. It was better for him to have his own room. As his diagnosis progressed, he became bedbound. Having a roommate increased the stimulation and activity in the room.
A higher price does not guarantee a better fit. A five thousand dollar community may serve your loved one better than a ten thousand dollar community, so temper your expectations around what a given price point will look and feel like, and evaluate care quality separately from decor.
Tip 4: Evaluate Care Competencies, Not Just Curb Appeal
Budget and location get you in the door to evaluate the community, but neither one tells you anything about the quality of care your loved one will actually receive.
Ask About Staff, Training, and Medication Management
- Marble countertops will not help your loved one to the bathroom at two in the morning, so focus on the staff and leadership team instead of the finishes.
- Ask how long the executive leadership team has been in place. Longer tenure often signals a stronger culture of care.
- Ask what ongoing training staff receive beyond onboarding, including how they are taught to manage behaviors and keep every resident safe.
- Ask whether the community follows a resident-centered approach to medication management, since there is a meaningful difference between a resident who is appropriately supported and one who is overly medicated.
Match Community Size to Your Loved One’s Personality
Think about your loved one’s personality, even before their diagnosis. Someone who loved activity and being social may thrive in a larger community with more group activity. Someone who preferred quieter, one-on-one time may feel overwhelmed in that same setting and do better in a smaller, more intimate community.
Sue shares:
My dad and my husband had different social preferences. My husband was very active, walked throughout the day, enjoyed being part of a variety of activities, and liked the social environment. My dad preferred a much quieter pace. He didn’t like all the social stimulation and activity, so we looked for a community that had a much slower pace for him.
Understand Staffing Ratios and On-Demand Care
Home care is typically one-to-one, with a single caregiver dedicated to your loved one. Community care works differently. In Georgia, for example, the minimum staffing requirement is one caregiver for every ten residents, which means your loved one’s care needs are met on demand rather than continuously. Be sure to check what your state requirements are.
This is a real trade-off to understand going in, and it’s worth weighing against what one-on-one care at home is likely to look like in practice: long stretches with little social stimulation. A community setting can offer far more engagement and activity, even with on-demand staffing. The strongest communities often staff above the state minimum, so ask directly what their actual ratios look like.
Tip 5: Tour the Community and Look Beyond the Sales Pitch
Once you understand the care model, it’s time to see it in person. Touring is where all of the previous tips come together.
Meet the People Who Will Actually Be Involved
Salespeople are warm and welcoming; this is their job. Once you move in, you will likely have little ongoing contact with them. Ask to meet the executive director, the wellness director, the memory care director, and try to meet staff along the way as well.
Watch for the Details That Matter
- Notice whether staff smile, say hello, and engage with you as you walk through the building.
- Notice whether residents look clean, well kept, and engaged with the people around them.
- Notice whether the building is clean and whether it has an odor, since this simple detail tells you a great deal.
Ask yourself whether you feel good about the building and the people in it. This feeling is a strong signal of what will feel like home for your loved one. We’ve created a checklist to help guide your questions during a tour, available on our Guides page at thecaregiversjourney.org.
Tip 6: Consider Working With a Senior Care Advisor
This process involves a great deal to evaluate at once, and this is exactly where an expert can make a meaningful difference.
What a Senior Care Advisor Brings to the Process
- Most senior care advisors, including OASIS Senior Advisors, work with families at no direct cost.
- An advisor has already reviewed state regulations, filings, and inspection reports, so they know the good, the challenging, and the difficult realities of a community before you tour it.
- An advisor will often ask questions on a tour of the community that you would not think to ask in the moment, prompted by conversations they have already had with you about what matters most.
- Many advisors stay connected with families after move-in to check in on the experience and to help hold the community accountable if something needs to improve.
- An advisor can often connect you with families already living in a community you are considering, so you can hear directly about their experience.
From Primary Caregiver to Care Partner
Once your loved one moves into a memory care community, your role shifts. For some responsibilities, you are still the primary caregiver. For others, you shift from primary caregiver to care partner. You are no longer responsible for every day-to-day task, but you remain an important partner to the professional caregivers providing care. Our episode 35. Build a Partnership With Your Care Community: Six Essential Tips / Alzheimer’s and Other Dementias has both a podcast and a blog version. It picks up exactly where this decision leaves off.
Taking Action: Choosing With Confidence
Choosing a memory care community is one of the hardest decisions you will make as a caregiver. A clear decision process makes this much more manageable. Here is how to move forward.
- Clarify your goals. Identify where your loved one is on their dementia journey, including the eligibility window for memory care.
- Define your geographic bubble based on your daily life. Factor in traffic at the times you are most likely to visit.
- Build an all-in budget. Account for future levels of care and uncapped annual increases.
- Ask detailed questions. Learn about staff tenure, ongoing training, medication management, and staffing ratios.
- Tour communities and meet the people beyond the sales team. Pay attention to how staff and residents engage.
- Consider partnering with a senior care advisor. This is what they do every day. Have them help guide the process from the first tour through the transition to care partner.
If you’ve found the right memory care community for your loved one, please share what helped you decide on our Facebook or Instagram pages.
If you go to thecaregiversjourney.org , you’ll find additional resources and information, including our memory care checklist. If you find this blog helpful, please share it with other people who you think it might help. Please follow us or subscribe to our updates. We appreciate it.
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