Is it Time for Memory Care?
As many of you know I write about what I experience each week with our patients; this week is about memory care! When is it really needed?
Memory care is a specialized, secured care environment designed to be frustration free and with trained staff in place to effectively meet the changing and long term care needs of those with dementia or other types of progressive cognitive impairments. Not every one with cognitive impairments requires memory care and memory care should only be recommended when truly needed. Memory care is needed for those with specific dementia related challenges including:
Safety concerns relating to wandering and being an abatement risk with routine exit seeking.
The lack of the ability to understand and recognize dangers impacting safety. Judgment issues relating to safety.
Aggression, difficult repetitive behaviors, hallucinations, delusions, resistance to care and hygiene related aspects, or exhibiting other behavioral challenges requiring redirection and other specialized intentions.
Progression of dementia requiring total assistance with ADL's, incontinence care, eating. Progressive difficulties forming in terms of ambulation or needing total assistance with transfers.
Structured routine, specialized recreation and socialization needs
Those who require more frequent monitoring and changes in collaboration with geriatric psychiatry, or neurology.
Again, not all individuals with cognitive impairments need to be in a memory care environment. Being in memory care when you do not require it can from my perspective and experience be detrimental to overall health and cognition. It is clearly difficult and discouraged for couples to be separated, but when one individual truly needs specialized dementia care and the other does not this is often the best situation for both parties. I am therefore dismayed that some care communities are encouraging families to have a non-dementia spouse live within memory care. To put a competent individual in a locked environment with limited opportunities for socialization on their terms in my opinion is cruel and highly inappropriate. The stress of the environment and at times reliance on the caregiver for onsite 24 hour care support can also lead to the caregiver predeceasing their cognitively impaired loved one. A care community where the competent individual can live in general assisted living and have regular visits onsite with a loved one in memory care onsite is ideal for this type of situation.
In addition, some individuals have age related cognitive impairments that do not require memory care. They can perhaps have cueing for meals and activities, medication over sight, and otherwise navigate assisted living well and live a full and vibrant life. Unfortunately there are some care communities out there that will for a variety of reasons recommend memory care for most individuals that they assess with cognitive impairments, which I also do not feel appropriate or in the best interest of the resident. We can provide a detailed cognitive evaluation with recommendations for these types of situations to provide clarity and to avoid an incorrect move to a care community.
A memory care environment needs to focus on the care of residents with memory-impacting conditions and encompass these five key areas in doing so:
1. Coordination of Care: Staff collaboratively assess, plan, and provide care that is consistent with current advances in dementia care practices.
2. Staff specialization, knowledge and competency: Staff have the training, qualifications, skills, and education to assess and provide care for a patient or resident population with memory impairment.
3. Specialized activity programming based on abilities: Staff provide activities that match the patient’s or resident’s cognitive ability, memory, attention span, language, reasoning ability, and physical function.
4. Behavior management expertise: The care community places emphasis on the use of non-pharmacological interventions as an alternative to antipsychotic medication use.
5. Supports a flexible, safe and supportive physical environment: The organization modifies the physical environment to promote safety and minimize confusion and overstimulation. This should done in an individualized manner to meet ALL resident needs!
If you or your loved one requires guidance on memory care or assisted living please feel free to reach out via our contacts area. A move to a care community is much more than a simple move, it is something that requires careful consideration along with proper planning and guidance from a clinician to determine the best and clinically most appropriate fit.