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Memory Care vs. Nursing Home: What Are the Differences?

| By Dr. Sandra Petersen

Memory care communities provide specialized care designed to enhance quality of life for people living with dementia, while nursing homes provide the highest level of long-term care available outside of a hospital.

If someone you care for is living with Alzheimer’s disease or dementia, it’s natural to want to provide care at home for as long as possible. Caregiving can be a rewarding experience. But when it comes to dementia, providing that care will become increasingly difficult as capabilities decline.

Knowing when it’s the right time to consider memory care is never easy. The decision to seek care is deeply personal and is influenced by many factors like the progression of memory loss, the safety and well-being of the person with dementia and the caregiver’s ability (and availability) to provide care and support.

Once the difficult decision to seek help has been made, it’s important to understand your options so you can determine what type of care is best for your loved one. We’ll help  you get started.

In this article, we’ll explore the differences between memory care communities and nursing homes, the two most common senior living options for those living with dementia.

Memory Care Community vs Nursing Home

Memory care communities can be a free-standing facility, or a secure neighborhood or unit located within a continuing care retirement community or assisted living community. Many nursing homes or skilled nursing facilities also have secure memory care units. When more complex medical care is required, these facilities may be a better option.

The level of care offered is the main difference between memory care and nursing home care.  Memory care communities provide specialized care designed to enhance quality of life for people living with dementia, while nursing homes provide the highest level of long-term care available outside of a hospital.

“Memory care communities and nursing homes both provide around-the-clock long-term care, but they serve distinct purposes and cater to different needs,” says Dr. Sandra Petersen, Senior Vice President of Health and Wellness at Pegasus Senior Living.

“Memory care communities focus on preserving independence through memory-enhancing programming, social engagement and personalized support. These communities are more homelike and offer a variety of amenities and services,” adds Dr. Petersen. “Nursing homes also provide care to people with dementia, but these individuals usually have other health conditions requiring more intensive medical care.”

Memory care communities are often equipped to address needs throughout the different stages of the disease, but if a resident’s overall health needs worsen, a move to a nursing home may be necessary to ensure they have access to comprehensive medical care.

Memory Care – What to Expect

Some key features of memory care:

Purpose-built design: Dementia care facilities provide a safe and supportive environment. Entrances and exits are secure to prevent wandering and promote safety. The design often has enclosed gardens and courtyards and includes features designed to reduce confusion like way-finding cues and personalized memory boxes outside of resident apartments.

Trained staff: Caregivers in memory care facilities complete specialized dementia training so they understand and know how to manage and anticipate the behaviors and challenges associated with dementia and Alzheimer’s disease, while fostering a sense of familiarity and comfort for residents.

Person-centered care: Many memory care communities promote person-centered care with an emphasis on understanding who residents were before a dementia diagnosis. The focus is on current skills and interests, rather than lost abilities. Daily life unfolds according to individual preferences, not predetermined schedules or staff convenience.

24/7 care and support: Residents in memory care receive around-the-clock supervision to ensure their safety and well-being. Staff members monitor residents’ health, manage medications and assist with daily tasks such as bathing, dressing, and eating.

Structured programming: Memory care programs offer structured activities and therapies aimed at stimulating cognitive function, reducing anxiety, promoting social engagement and preserving independence. Activities may include memory games, as well as music, art and pet therapy.

Family involvement: Memory care facilities encourage family involvement and provide support to family members coping with their loved one’s cognitive decline. They may offer educational resources, support groups, and opportunities for family participation in care planning.

What is a Nursing Home?

Nursing homes – also known as skilled nursing and long-term care facilities – provide skilled nursing care and rehabilitation services, assistance with personal care and activities, meals and around-the-clock supervision and care. Nursing home care requires a physician’s prescription and physical exam before a resident can move in.

“Nursing homes and skilled nursing centers are more clinically focused than memory care communities. They are a better long-term option for those who have serious health issues or chronic conditions,” says Dr. Petersen. “Like most memory care communities, they offer activities, but they’re typically not as personalized and robust,” says Dr. Petersen.

Here are some distinguishing features:

Medical care: Nursing homes are staffed with registered nurses, licensed practical nurses, and certified nursing assistants who provide complex medical care under the supervision of physicians. They administer medications and IVs, monitor vital signs, manage chronic conditions and provide wound care as needed.

Rehabilitation services: Rehabilitation services such as physical therapy, occupational therapy, and speech therapy designed to help residents regain functional abilities are offered in most nursing homes.

Regulatory requirements: Nursing homes must be licensed by their state and are regulated by the federal government to ensure the safety, quality of care and rights of residents.

Memory Care vs Nursing Home: Comparing Costs

The costs of memory care communities and nursing homes both vary depending on factors such as location, level of care needed, amenities offered and individual preferences. Generally, a memory care community will cost less than a nursing home primarily due to the broad range of medical services and support offered in nursing homes.

The National Council on Aging (NCOA) states that the average monthly cost of a memory care community is $6160 compared to $9733 for a private room in a nursing home (reported in the 2023 Genworth Cost of Care Study).

How to Pay for Care

Care may be paid for through a combination of private funds, long-term care insurance and public assistance programs.

Medicare may cover certain medical services that residents of dementia care facilities might need including doctor visits, hospital care, medical equipment (Part B) and prescription drugs (Part D).

Since nursing homes provide more intensive medical and rehabilitative care, Medicare may cover more services under specific conditions. Part A covers up to 100 days of skilled nursing care per benefit period following a qualified hospital stay.

Medicaid covers many nursing home and long-term care services in Medicaid-approved facilities. To qualify, certain income requirements must be met. Requirements vary by state.

Veterans’ benefits for qualified veterans and/or their spouses may also help offset costs.

When To Choose Memory Care?

Put simply, if your loved one is living with Alzheimer’s disease or a related dementia, a memory care facility will provide the specialized support and programming they need to help them manage the illness and enjoy a better quality of life. Memory care communities are typically private pay, so cost is something else to consider.

When To Choose a Nursing Home?

Since extensive medical support is available in nursing homes and skilled nursing facilities, these facilities are best for those with a debilitating medical issue. It’s also important to consider the length of time professional support is required because most nursing homes offer both short and long-term care support.

How to Choose the Right Facility

Whether it’s memory care or skilled nursing that is required, here are some tips to help you with your search.

  • Research Options: Look for communities in your area. Consider factors such as location, reputation, services offered and accreditation. Recommendations from healthcare professionals or friends and family can also be helpful.
  • Reviews and Rankings: Medicare’s overall star rating for nursing homes lets you compare nursing homes on topics you consider most important and gives you a snapshot of the quality of each nursing home. The rating, between 1 to 5 stars, combines results and data from 3 important sources, including: health inspections, staffing and quality measures. U.S. News & World Report also reviews and evaluates over 15,000 nursing homes nationwide.
  • Visit: Schedule visits to assess their environment, cleanliness, safety measures and overall atmosphere. Talk to staff members, observe interactions between staff and residents and ask questions about their programming and  approach to care.
  • Staff Training: Inquire about the qualifications and experience of the team. If you’re considering a memory care facility, ask if caregivers are dementia certified and if care is provided by licensed professionals around the clock. Check the qualifications of the care teams in nursing homes to ensure they have expertise in dealing with the specific needs of your loved one.
  • Amenities and Services: Evaluate meal options, recreational activities, social support, and access to medical care. If memory care is needed, be sure the community has the latest safety technology and that the design supports the unique needs of those living with dementia.
  • Consider Insurance Coverage: Check to see what your long-term care insurance plan covers and if the center you are interested in accepts your insurance and/or Medicare or Medicaid. Understand any out-of-pocket costs and financial arrangements associated with the chosen center.
  • Seek Feedback: Ask for feedback from current or former residents and their families about their experience with the community.
  • Trust Your Instincts: Trust your gut. Select a center where you feel confident in the quality of care and comfortable entrusting your well-being or that of a loved one.

Helpful Tools

To assist you in making informed decisions, Medicare’s nursing home checklist is a convenient tool that helps you evaluate nursing home options. Visit our memory care resource page for tips on how to choose a memory care community, as well as questions to ask during visits.

Where You Live Matters

Where You Live Matters is a senior living resource offering research-based, unbiased guidance on senior living topics. Consider exploring our database of articles on finding appropriate care for a loved one with dementia or learning more about advancements in memory care technology.

To learn more memory care communities and nursing homes, use our Where You Live Matters community finder. Or reach out to us directly with your questions. We’re here to help.

Where You Live Matters is powered by the American Seniors Housing Association (ASHA), a respected voice in the senior housing industry. ASHA primarily focuses on legislative and regulatory advocacy, research, and educational opportunities and networking for senior living executives, so they can better understand the needs of older adults across the country.

By Dr. Sandra Petersen

Pegasus Senior Living

Dr. Sandra Petersen received her most recent years of education from Rush College in Chicago, Illinois, where she obtained a Doctor of Nursing Practice degree. She successfully completed three residencies and holds certifications in family practice, geriatric medicine, and psychiatric-mental health. Dr. Petersen was also inducted (2016) as a Fellow of the American Academy of Nurse Practitioners, an elite group of providers who are recognized by their peers for their impact on the nation’s healthcare. She was a founding member of the Assisted Living Federation of America’s Nurse Action Committee and has been involved in the industry for many years. Dr. Petersen is a professor at The University of Texas at Tyler. Most recently, Dr. Petersen completed a privately-funded study utilizing the PARO robotic pet seal as a non-pharmacological intervention in symptom management in elderly clients with dementia. A journal article reflecting the study’s outcomes was published in the Journal of Alzheimer’s Disease. Dr. Petersen has been in active practice since 1993 and currently has a private house calls practice in the Dallas area that exclusively serves seniors in assisted living, independent living, and memory care settings. She is a popular speaker and consultant both nationally and internationally. Over a decade ago, a stroke left her unable to use the left side of her body and connect with language skills; she even had trouble completing a sentence. “The whole experience gave me not only sympathy, but empathy for those that struggle with cognitive decline,” says Dr. Petersen. We are grateful for her experience and insight that help us improve residents’ physical and mental health every day.

Learn more about Dr. Sandra Petersen