en to consider memory care for your loved one
Consider memory care for a loved one when their dementia or Alzheimer's disease progresses to the point where they can no longer safely live independently. This may occur when they experience significant memory loss, difficulty with daily living activities (like bathing or dressing), exhibit unpredictable or aggressive behaviors, wander frequently, or pose a danger to themselves or others. Memory care provides specialized 24/7 care, a secure environment, and social interaction tailored to their specific needs.
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The following is a video transcript based on the section of Willow Cordain's recent live presentation (*video above) given at the Temple Beth Israel in Eugene, Oregon.
Okay, so I think it's important to know what memory care communities are because my suspicion, especially folks who are in a little bit of an older generation, I come across folks sometimes who think of it much more like a long-term nursing home. That sort of scary thing back 30 years ago. And it's so not that.
I have been the admissions director in a memory care community, and it can be a beautiful thing for loved ones to move their family into this because it offers so much. So what is it? I'm going to jump from my analogy of our large ships, and I'm going to think back to college dorm rooms.
So we're coming back to a smaller type of setting. When somebody has memory loss, they need their world to be smaller. Their ability to process is lower and to make them as independent as long as possible, we need to give them little bits of information, not lots.
And so what that means is you're not renting an apartment, just like you would be renting in an assisted living or independent living. You're renting a bedroom, basically, and you might even be sharing a room. But a lot of times you can have your own - you may have your own bathroom, you may not.
Maybe it's a building with just 16 people. Or maybe it's a building with ten people, or maybe up to about 32 is the highest I see it. 32 is getting a little bit outside my comfort zone, but it can work depending. So oftentimes they're cottages. There might be five cottages on a campus. There might be ten cottages on a campus, there might be one.
So in that world, when you walk out of your door from your bedroom, you're in a very common area where you're going to hang out and watch TV with other people. You're going to hang out and eat with 15 other people. It's much smaller, but they're going to bring in some live music. They're going to have some activities that are designed specifically for memory care.
I can tell you how many daughters have come to me that say this assisted living is the worst in the world and a litany of all these things that's not happening. Well, actually, what's happened is that mom's progressed with her memory loss and their staffing is 1 to 17.
Can you guess what a good memory care staff ratio might be and not Abby? Judith, you might have a good guess. Yes, that's my happy place. She gets a gold star. So Judith said 1 to 5. So 1 to 5 is my happy place for people for memory care to have a staffing ratio.
So it's kind of like going to that foster home, right? 1 to 5. Now a lot of times it's 1 to 7, 1 to 8. I've occasionally seen 1 to 10. But 1 to 5 is a really good ratio. So in that cottage of 16, there might be three care staff from seven in the morning to 11 at night. And then there'll be somebody at night.
So this is the most important. And this is where people, you know, can't be an advocate for themselves because they may not have the cognitive ability. And so this is the one where I know families are most concerned about placing their loved ones in.
One of the things you will ask if you are doing some tours on your own for your loved one is to talk about the staff ratios. Ask them. I have occasionally come across where I swear I feel like the marketer is adding in the housekeepers and the cooks to their staff ratios.
So you really got to ask how many caregiver hours are there during the first shift? How many medication aides? Sometimes I see where it's, you know, that medication aide is going to have 35 people to deal with. That's too much in my book. But that's not uncommon.
You know, there's ways and I'm going to go through a little bit of what you look for in a quality community. You can also hire somebody like me, but you can certainly do it on your own.
So it's dorm-style living. It's 24-hour staff, just like assisted living. It's got a lot of similarities to what it offers. There's housekeeping, there's cleaning, there's food, pays for utilities. It pays for that staff ratio. So you can think about that.
That staff ratio means you're going to jump up in price even more, right? So now we're going down to a much smaller real estate and the price goes up. So you're seeing a trend. And so that means that if you have a private room with care, you know, $7,500 to $10,000 easy. You can get a little less if you do a shared room.
And I can't tell you how many times I've had conversations with family. "Oh, mom would never want a shared room." Oh, well, who is mom now? And who was she a year ago? So part of my job is to help folks accept where a loved one is and actually what they would like.
I mean, sometimes I did a great job in memory care, right? I had these two little ladies and they both, like, woke up late. They were both named Betty. It worked out beautifully. They really liked each other in that room.
So we can't judge always where somebody is with memory loss. And that's where we kind of have to talk to other professionals to help us accept where things are at.
So memory care is locked. If I had a PowerPoint, I would show you what that means, because sometimes people say dad was a forester. He is going to go crazy if I lock him into memory care.
So if he's somebody like that, I'm going to talk about the community that has a big, huge garden space and has five cottages that are surrounded by fences, and it's a whole little neighborhood in this lovely, very pretty setting. That's going to be the best fit for him.
If I've got a lady who's pretty high functioning and we need to put her in memory care, she can't quite make it in assisted living and she's still very visually aware of her surroundings, and she has always had a very high aesthetic and she's still aware - then I'm probably going to have to choose a new community that's got a very visual appeal, because she's at the stage where that's important to her.
So that's when I say, what's the best community in town? Yes, the staff ratio is important. Yes, who owns the building can be important. Yes, is the management changing all the time? Those things are all important. And that's why those are things I know.
But we also have to understand what are the values of the person. It's really important for a person to have outdoor space. It's really important for a person to have a private bathroom because they're at that stage.
So that just gives you a flavor of what it is that I do and how you can start to think about it to make sure you're just accepting where your loved one is.
So when is it too late to place somebody in memory care? When will they say no? And I do come across this enough that this is one of my harder ones. Again, we go back to that two-person assist. That's pretty standard across the board because it takes two people off the floor. Now we have fewer people on the floor for the rest of the folks. So that's kind of the reasoning. I can still get people in on two-person assist, but very rarely.
The issue is with behaviors, right? So behaviors can happen whether they're paranoia, anxiety, or aggressive behaviors. If you move in just like in assisted living where you've got a little memory loss and you can kind of age in place, it's the same thing. If you move in with not the major behaviors, and then maybe some behaviors come up, they're going to really try to work with you. But if you try to get in the door with major behaviors, they're going to kibosh it.
So this is where people can wait too late. Memory care is also not specifically for hospice. So if we wait until somebody is on hospice and move them into memory care, most memory care facilities are going to say no. Because this is for living, for getting things done. They're not designed just for hospice, I guess is the main way to put it.
And I will talk about the one hospice house in town. It's amazing. And it's good. So we do have that available here in town. Way out towards Cobourg. Really? The town...
So I think that's it regarding that. Let me give you a little resident profile. Mary has been living in assisted living for over three years successfully. She has been diagnosed with Alzheimer's, but had been able to navigate the small one-floor assisted living until recently.
So when I'm moving somebody in with memory loss, but there can still be assisted living, I'm going to probably look at a small assisted living so they can navigate and kind of get an understanding a little better.
She's been going into other people's apartments at least a couple of times, so she's getting disoriented in her space. That's a common thing in dementia. The community was concerned she might get too disoriented even more and wander outside.
So if you start to wander in assisted living, guess what happens? You get an eviction notice of 72 hours, or you have to bring in 24-hour care, which I told you is about $25,000 to $30,000.
So you really want to start thinking about it when that caring community comes to you and they have a care conference with you, and you're the dad or you're the spouse, and they start to say, you know, you really need to be looking at memory care and you push it off because you don't believe that. Listen to them, I guess is the biggest advice because you can get into that scenario I just said, which is not a fun one to be in.
So she's also forgetting when to come to meals. She still likes to go to activities. This is Mary again. However, the family notes she is unable to participate well in many of the activities - she can't play cards anymore. But she's happy if she has things to do and some purpose in her days.
We are purpose-driven people. We need purpose, right? So we want to make sure that that community is offering the activities that help create purpose. Can they help at the front desk? Can they help put plates on the table if they want?
So we placed her into memory care, but one that has a high level of activities and enough high-functioning residents. So she has peers at her cognitive level. So we really have to look at who she is and not just the community, but who's living in the community. Can I say, "Oh, that looks just like mom. I can see them becoming friends," right? You want to assess that.
Here at Willow Care

Willow Care is a local women-owned senior-living advisor agency (*sometimes called senior care agents or senior referral companies) providing free assistance in finding the most suitable senior care communities for families in the Eugene/Springfield area. Their services include personalized consultations to understand individual needs and preferences, expert guidance in navigating the senior care landscape, and compassionate support throughout the decision-making process.
The process and options can be quite overwhelming, we know this! And the real value we offer goes beyond what you learn when touring facilities alone. We have been part of these communities and this industry for decades and bring that expertise to help you and your unique situation. We help you understand the differences in quality care between independent living, assisted living, memory care, skilled nursing facilities (aka nursing homes), continuing care retirement communities (CCRCs), home care, adult day care, and hospice care and what is the best option for you or your loved one.
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