Supportive Care: How to choose assisted living or memory support

Community Life, Resources

assisted living

Ten steps to finding the right community for someone you love

If someone you love is struggling with some of the basic activities of daily living — whether due to physical limitations, general cognitive decline or memory problems associated with the early stages of dementia — you may be concerned about whether it’s safe for them to continue living on their own. And for good reason. What may seem like minor struggles on the surface can turn into bigger problems. For example, difficulty preparing meals can lead to malnutrition. Trouble with bathing or dressing may cause an individual to become isolated. And forgetting to take prescribed medications can lead to worsening of existing conditions. In any of these cases, you may be wondering what kind of care and environment would help your loved one thrive — and how to find it.

Let’s begin by defining the two main options: assisted living and memory support.

Assisted Living is a level of residential care that seeks to empower individuals to maintain their independence, while also providing assistance with activities of daily living. The specific types of personal assistance provided will depend on what the individual needs and wants, but may include things such as help with bathing, toileting, dressing and grooming, meal preparation and remembering to take medications. A medical evaluation is conducted to help determine what types of assistance will be most beneficial to the resident and to guide the development of a care plan.

In addition, assisted living communities offer a variety of social, cultural and recreational programs that encourage residents to engage with each other, challenge their minds, stay physically active and live a full and enriched life. Other services typically include meals, laundry and housekeeping, and transportation for medical appointments, shopping and events.

An assisted living community may also be appropriate for people in the early stages of Alzheimer’s disease or dementia. Most are basically independent but are experiencing periods of memory loss and related cognitive decline that make it difficult or unsafe for them to live on their own.

Memory Support is appropriate for those people in the early- to mid-stages of Alzheimer’s disease or another form of dementia, and provides specialized care tailored to their unique needs. Memory support communities usually offer a secure environment where residents can move about freely without worry of wandering off or getting lost. Here, too, a medical evaluation will inform decisions about the types of care and assistance that will be most appropriate for the individual resident. If you have noticed changes in your loved one’s behavior, including disorientation and confusion — and if these changes are creating an unsafe environment for the individual or their caregiver — specialized memory support may be the answer.

It’s important not to overlook one significant benefit of an assisted living or memory support community: the sense of security and peace of mind it provides, not only for residents but also for their family members. Knowing trained staff members are available to provide care and assistance, and to respond to any emergency 24 hours a day, seven days a week, helps individuals live to their highest potential each day and removes the weight of worry for family members. That’s why it’s important to find a community that’s the right fit for your loved one and your family.

How to choose an assisted living or memory support community

It’s not an overstatement to say that choosing an assisted living or memory support community for someone you love is one of the most important decisions you will help them make or, in some cases, make for them. Every community is different in its culture and philosophy, so finding one that’s the right fit will go a long way toward ensuring your loved one’s happiness and your peace of mind. Following are ten steps to take when choosing an assisted living or memory support community.

1 — Start Early

Whenever possible, consider your options and begin your search before care is actually needed. Having the time to gather information, ask questions and tour communities will help ensure you’re making a well-thought-out decision rather than one in which you’re rushed into choosing a community in a crisis.

2 — Learn all you can

As with any big decision, doing your research is key. This article is a good start and an indication that you’ve probably already started searching the internet for information or to find communities in your desired location. Take your time to read and consider ratings and reviews, and don’t forget to ask friends, relatives and neighbors for suggestions and referrals if they’ve had personal experience with a community. In Massachusetts, resources and information are also available through your local Area Agency on Aging or elder services organizations.

3 — Visit communities in person

Nothing can tell you more about a community than a personal visit. Pay attention to everything from how your request is handled when you call to schedule your visit, to your first impression when you walk into the community. While on your tour, take notice of everything going on:

  • Are staff and residents interacting in a positive way?
  • Do residents seem happy?
  • Do staff members seem to enjoy their jobs?
  • What about the environment? Does it feel like a place where your loved one would be happy and comfortable, or does it feel cold and institutional?
  • Is the building clean and well-maintained inside and out?
  • Does the community have a reputation for being well-managed? Do you see evidence of that?
  • If you can, make a return visit in the evening to get a feel for how the environment and staffing are different.

4 — Eat a meal at the community

Food is such an important part of everyday life, affecting not only nutrition and physical well-being but also quality of life. Pay attention to the quality of the food and ask yourself:

  • Are ingredients fresh and well-prepared?
  • Are meals visually appealing?
  • Does the food taste good?
  • Can you imagine being happy eating there every day?

Also be sure to ask if residents are required to follow a set schedule for dining or whether they can eat when they choose. Are snacks available at any time? If a resident does not feel up to eating with others, will a meal be taken to his or her room?

5 — Explore the amenities

You know your loved one best but remember that what may be important to you may not be as important to them. Enlist his or her input as much as possible and then look for the things they would enjoy. Most communities offer social events and celebrations, educational and recreational programs, and daytrips. Ask the community you’re considering if they can accommodate any special interests your loved one has such as hobbies, the ability to play a musical instrument, spiritual activities or transportation to religious services, and so on. If your loved one would like to take a pet along, be sure to ask about the community’s pet policy. All of these things play a big part in helping residents engage in their new community and greet each day with a sense of purpose.

6 — Learn about assistance and health care options

The best assisted living and memory support communities will provide personalized care and assistance based on the needs and desires of each individual resident. In this way, residents can enjoy both a sense of security and the confidence that comes with maintaining as much independence as possible. Be sure to ask questions about how the care plan is developed as well as whether higher levels of care are available on campus, if needed.

  • How are staff trained and what are their credentials?
  • Is a medical professional on site and available 24 hours a day?
  • How does the community assess each resident’s needs?
  • How often are needs reassessed?
  • Does the community offer wellness programs? If so, what types?
  • What kinds of health care services are offered to assisted living and memory support residents?
  • What if a resident needs a higher level of care than what is offered in assisted living or memory support? Are skilled nursing and short-term rehabilitation available on site?
  • Can residents continue to see their personal physicians?

If possible, speak with residents and their family members about the quality of care they receive at the community. The long-term care ombudsman for the state in which the community is located can also provide an objective assessment, and ratings for skilled nursing providers can be found on

7 — Find out about safety and security measures

Don’t take for granted that a community has adequate safety and security measures in place; ask questions.

  • How does the community proactively help residents avoid falls and other accidents?
  • What kinds of procedures and systems are in place to ensure resident security?
  • Is there an emergency call system?
  • Are there smoke detectors and overhead sprinklers? Is the inspection up to date?
  • How are residents evacuated in the event of an emergency?
  • What infection control measures are in place?

8 — Study the contract

When you’ve narrowed your choices, ask each community for a sample contract to review. You’ll want to make sure you understand how services are billed, what services may incur an additional fee, the community’s rules and regulations, and what they do and don’t provide. Also, be sure to ask about fee increases and what additional fees you should expect if your loved one requires a higher level of care in the future. If there’s anything in the contract you don’t understand, talk to the community representative or have an attorney review the contract before you sign. You can also find information about a community’s history and financial stability by consulting your local Area Agency on Aging.

9 — Understand the value

There’s no doubt that assisted living or memory support is a significant expense. The best way to understand the value is to consider the cost of this 24-hour care in relation to the costs of maintaining a residence and hiring an aide or home health nurse to provide similar care. Be sure to talk with the community you’re considering about whether Medicare, long-term care insurance or other payment programs may help cover the cost of your loved one’s stay.

10 — Put yourself in your loved one’s shoes

If your loved one is unable or unwilling to participate in the selection process — and especially if they do not tour potential communities with you — you’ll have to use your imagination. Can you picture your loved one enjoying life in the community? Do you think they will be happy there and take advantage of the available amenities and services? Is it a place you can feel good about and that will give both of you a sense of security and peace of mind?

The Woodlands Inn at Edgewood’s innovative, small-house model of assisted living and memory support in North Andover, MA is setting a new standard for resident-centered care. To learn more, call us at 978-738-6104. We’ll be happy to answer all your questions and schedule a personal tour.