So what is life in memory care really like? How is it different from assisted living? What typically happens there day to day? What are the residents like? What are the caregivers like? Well, it’s all more varied and more active than you might think. One thing it most definitely isn’t: a hellscape.
A lot of new caregivers initially view memory care with some trepidation, and some may choose never to place their loved one into such an arrangement. I think these are reasonable concerns, and I had them myself. You worry about leaving your person with dementia (PwD) alone in a strange place. You worry that it would feel as if you’ve somehow failed in your caregiving duties. And in the case of a spouse, you worry that it would feel as if you’ve abandoned them.
My personal fears stemmed from knowing that my sister was deathly afraid of being placed in memory care because of how it was described to her by residents of assisted living. She mentioned it often. However, I knew that I was not capable enough to provide her all of the care she was going to need. I knew that, ultimately, memory care would be the best place for her.
A Smaller, Safer World
I will be honest. Moving Peggy into memory care—and making sure everything was okay with her life there—was a process, and it took time. When she first found out her move might be imminent, she felt it was a punishment for “being bad.” She promised to be good, if only we wouldn’t force her to go live there. There were a lot of tears. Not for the first time, my gut reaction was: kill me now. It was definitely a sad moment, especially when I tried to explain to her that she wasn’t being bad, that the move wasn’t a punishment, and that it would be good for her.
At the root of things, the why of it was clear: my sister could no longer easily navigate her apartment, or the dining room in assisted living, or really any other public space. She was more than ready for memory care. It was a big dose of reality for all of us on Team Peggy that her cognition was in severe decline. I wished that we didn’t have to place her because I knew it meant that her world was about to get much smaller. Even though I knew that it would be so much easier for her to navigate, I still didn’t want to do it. But I had to accept the facts.
When your loved one is ready for memory care, it means they really do need a much smaller, structured, safer environment than even assisted living can provide them.
Memory care is far less stressful for a PwD and far less confusing as well—no more getting lost in an apartment that somehow feels too large now, much less wondering, “What am I supposed to be doing?” on the daily. It’s a simpler existence, where daily life is structured and organized.
Fortunately for Peggy (and all of us who loved her), she settled in to her daily life in memory care after only a couple of post-move meltdowns. She was especially comforted by the fact that the hellscape she once feared never materialized. In fact, once she became acclimated to her surroundings and the daily routine there, she told me that she felt okay, and that she actually wished she had moved to memory care sooner! It was such a relief to hear that.
A Day in the Life
So, given all of that, what’s life in memory care like? So many things you will see:
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Everything is always on schedule. Wake-up times and bedtimes in memory care are uniform every day, as are all meals. Your PwD may not be able to express it to you, but these routines become security, a kind of “anchor” for them. Deviating from these routines is stressful and risks a meltdown, while keeping to them ensures their stability.
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Activities and interests are always explored. Staff in memory care assist residents with crafts, physical exercises (in chair), indoor activities like karaoke, and occasional outdoor excursions, such as a short local drive and park visit. Sometimes, staff will facilitate PwDs walking over to assisted living to take part in a happy hour (sans alcohol), or to see a musical guest, for those who have the ability to engage in those activities.
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Medication is managed. Med techs come in and out of residents’ rooms throughout the day to administer their medications, so everyone stays on track.
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Visitors are welcome. Loved ones also come and go throughout the day. Sometimes they spend time with their PwD in their bedroom where it’s quiet and familiar, and sometimes they leave memory care together for doctors appointments or for a fun outing.
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Engagement and guidance available. You will often see staff redirecting residents who are on the verge of a meltdown or who are lost. They are often engaged with residents, bringing them a meal, a snack, setting up the TV, or spending time outside in the garden.
Supportive Staff
My experiences with memory care staff were mostly good during my sister’s stay. Of course, you always have to watch out for the common problems that pop up, like residents “shopping” other residents’ rooms, your PwD’s clothes getting mixed up in the laundry, or your PwD getting the wrong food (i.e. it’s not finger food like it should be, or it’s got milk products when it shouldn’t, etc.)
I tried to stay aware of all of these issues, but still they would happen from time to time. For example, we had a few instances where we needed to intercept food meant for Peggy; she was lactose intolerant, so any milk products were going to cause a big problem (both for Peggy, and for those who had to take care of the clean-up). And there were a few times when I’d see Peggy wearing clothes that were clearly not hers. But we always got it all sorted out.
The only thing I really didn’t like was that the memory care director brought her dog to work, as did the activity director, and one of the aides. In my opinion, that’s way too many dogs to be roaming about in memory care, where most residents aren’t steady on their feet and their visual perception is likely quite diminished. I was always worried that someone would trip over one of the pups, although thankfully I am not aware of any incidents that happened.
Overall, I was pleased to see that memory care staff are usually on their toes, because you just never know when a resident is going to fall, need an immediate trip to the restroom, or want food. Another thing I loved was that, no matter when I visited, I would see staffers mopping floors and cleaning surfaces, meaning Peggy’s home was always spotless and free of smells and debris.
Rolling With the Residents
Resident turnover in memory care is fairly high, which makes sense since everyone there has a fatal disease that will eventually kill them. And most of these people are elderly, making them more vulnerable to other ailments besides dementia, such as Covid and flu.
Some of these residents are barely aware of their surroundings. At the other end of the spectrum, there are often some residents that are fairly highly high functioning, and you could be fooled into thinking they might not belong there at all. Here are some of the people I encountered:
Ester: She was always looking for her husband, always wanting to go home, and always worrying that people will be looking for her. She’d lapse into Spanish periodically. She was always friendly.
Gina: When Peggy first moved into memory care, Gina could still speak, a little, and in whispers. She spent her time pacing up and down the hall. She was alarmingly thin. By the time Peggy passed away, she could no longer walk, and seemed mostly unaware of her surroundings.
Virginia and her husband: They were from Sicily. One day Virginia came right up to me and cupped my face in her hands like Italian grandmothers are wont to do, and was completely enchanted with my vivid purple hair. The next time I saw her, I didn’t register with her at all.
John: He was a former nuclear physicist. He could fool you with his vast cognitive reserve. One afternoon he heard me talking about running an errand. He asked me if I’d like him to look after Peggy while I ran my errand. He tempted me to say yes until he started talking about how the paintings on the wall were moving. You almost had me there, John!
Marilyn: She seemed okay when she first moved in. She was always impeccably dressed. She was a former paralegal and also had a lot of cognitive reserve. Her husband visited often. But for whatever reason, her decline was swift. By the time Peggy passed away, Marilyn was usually disheveled-looking. She paced up and down the hall counting numbers from bridge plays.
Nancy: She looked good, but all she could say was “excuse me!” loudly, as she tried to get attention. But when she got someone’s attention, she didn’t know what to do after that. I’m not sure she understood much of what staff told her. She moved out of memory care not long after she moved in. My guess is that she was deemed too disruptive.
Then there were the quiet ones, who never said a word and sat vacantly in front of the TV. There were other more active residents, but I didn’t encounter them often. (I expect—or at least, I hope—they were off on fun little excursions with staff or loved ones.) But as you can see, there was such a wide spectrum of abilities and levels of dementia represented in memory care. So my default mode when I was there was to smile at anyone I encountered, say hi, and then move on.
Labels and Lifting
Here’s another hot tip for you: Memory care is always filled with magpies, who like to gather shiny objects. As I mentioned, all of the residents, it seems, are “shoppers” at some point. Residents spot pretty or interesting things in other bedrooms and pick them up and take them back to their own rooms. I’m not sure why this happens, but it does and it is so, so common.
This is not really stealing per se, but it is absolutely why you must label everything for your loved one. Everything—photos on walls, scrapbooks, underwear, shoes—must be labeled. If it can be picked up and taken out of the room by another resident, it just might be! So be prepared.
Even my sister did this. One day I found a humongous necklace in Peggy’s room. No way would she ever wear this, I thought. Why did she have it? She couldn’t tell me. It must have caught her eye. It wasn’t labeled, so we gave it to staff so that they could deliver it to its proper owner.
And you never know where you might find something that belongs to your person. Peggy’s iPhone disappeared. I tracked it via “find my iPhone”—it was in the building, but I couldn’t pinpoint it down to the room. When a TV repairmen came to repair a TV, there was Peggy’s iPhone, mistaken for a TV remote in another resident’s room. These things happen. All you can do is take it in stride.
