Assisted living communities are often the first step for seniors who can’t live alone anymore. Through assisted living, residents get support with daily tasks, allowing them to fully enjoy the activities and social life of the community. This type of senior living can also be helpful to people in the early stages of dementia. However, for those individuals, there may come a time when assisted living no longer meets their needs and they may need to move to memory care. Here, we’ll show you crucial signals for when assisted living may no longer be enough, plus what your loved one might need next. 

Understanding state and community rules

Before reviewing the signs of when to move to memory care, it’s important to remember that each state and even each assisted living community has its own rules about what level of care can be provided. These regulations may limit how much hands-on support, medical care, or behavioral management each community can offer. In addition, each community sets its own policies about the types of needs it can safely accommodate.

Because of these variations, families should review their community’s care level definitions and state regulations and revisit them regularly. Doing so helps ensure you can anticipate when a move might be required due to legal or policy limits.

Differences in timing

There is no single correct time to make the transition to memory care. The timing is determined by an interplay among state rules, facility policies, and the senior’s needs. As such, it varies from one situation to the next. Still, you can get a sense of the timing from the areas we highlight in this article.

While this can be an emotional topic, it’s important to be open to the idea. It may be best to make the move to memory care early rather than holding out for as long as possible. Doing so provides the most safety and support for the resident and may also make the transition easier, as changes to living situations often become more challenging as dementia progresses.

Assisted living vs. memory care

Assisted living and memory care have some similarities and differences. Assisted living focuses on providing assistance with activities of daily living (ADLs), like bathing, dressing, and using the toilet. Residents tend to be fairly independent in other areas, so they can choose their own activities, make friends, and be safely left alone.

Assisted living communities are often designed to be as familiar and homelike as possible, as this helps foster a sense of comfort and independence. 

Memory care is much more specialized. Features can include:

• 24/7 supervised care.
• Staff trained in dementia-specific communication and care strategies.
• Secured environments to prevent wandering.
• Design features to help with navigation and reduce confusion.

Such features help ensure the person with dementia remains safe and well cared for.

A move to memory care doesn’t always require changing communities, as some assisted living facilities have dedicated memory care wings. The resident may simply be able to move from regular assisted living to the assisted living memory care wing. 

At other times, seniors might need to move to an assisted living wing in a nursing home or a dedicated memory care facility. 

The following sections highlight why seniors might need to make this transition.

There are behavioral issues

Dementia can be associated with some rough behavioral and psychological symptoms, like:

• Aggression.
• Wandering.
• Delusions, hallucinations, or paranoia.
• Late-day confusion or anxiety, known as sundowning.
• Social withdrawal.
• Resistance to care.
• Inappropriate sexual behavior.

Such behaviors are typically beyond the scope of regular assisted living. The staff simply might not have the training or resources to provide enough support, which creates an unsafe environment for everyone. 

In contrast, memory care staff have dementia-specific training. This includes being taught how to respond to difficult behaviors using approaches like redirection. 

Memory care often has a higher staff-to-resident ratio as well, making it easier to respond to complex care needs. 

Your loved one needs significant help with activities of daily living

Assisted living often focuses on scheduled care, plus urgent responses when problems arise. This style works well when residents are largely independent, but the communities aren’t designed to provide 24/7 support for residents. 

As the condition progresses, people with dementia become less independent and may not even be safe when left alone. Such declines in independence are a key signal that assisted living is no longer the right choice. 

Some states even have limitations on the amount of care they can provide. For example, in Iowa, assisted living programs offer support for up to four activities of daily living (which include tasks like bathing, dressing, and eating). 

At other times, facilities themselves may have rules regarding their maximum care levels.

They need close supervision 24/7

Sometimes the biggest issue isn’t care but the amount of supervision required. Many people with dementia get to the point where they can no longer keep themselves safe, even in a familiar environment. 

Assisted living naturally provides some degree of supervision, but they don’t focus on constant supervision since residents are somewhat independent outside of the assistance they require. As the condition progresses, people with dementia become less independent and may not even be safe when left alone. 

In addition, assisted living facilities don’t tend to be secured, as residents are allowed to come and go as they please.

Such declines in independence are a key signal that assisted living is no longer the right choice. This is particularly true when seniors get to the point of needing near-constant supervision.

Assisted living can’t support them anymore

Residents may need to transition to memory care because assisted living can’t provide enough support. This is often related to community or state policies, which define the types and levels of care that can be offered. 

Sometimes dementia-related symptoms will be the reason for the transition, while other times the limits of assisted living itself may be a factor. 

Potential situations include:

• The facility does not have the required licensing or training to support residents with dementia.
• The resident has significant medical needs.
• They are a risk to the health and safety of other residents.
• They experience incontinence at a level where the resident needs to be checked or bathed frequently.
• Staff feel that the resident’s needs can’t be effectively met.
• Care tasks require more than one person.

Deciding to move from assisted living to memory care is never easy, but it’s an important step in ensuring your loved one receives the safety, structure, and specialized support they need as their dementia progresses. By paying attention to changes in behavior, care needs, and the limits of what assisted living can provide, families can make the transition before a crisis occurs. Memory care communities are designed to offer both compassionate support and a more secure environment, helping residents maintain their quality of life while giving families greater peace of mind.

Senior care facility rules and requirements vary based on company-specific policies and state-level regulations. The content above represents common guidelines but may differ from a particular facility’s policies or requirements. To learn the regulations that apply in your state, contact your local Oasis Senior Advisor.