Memory Care 101—What its about
There are different approaches to dealing with the living situation of someone with dementia—itself a catch-all phrase, in general referring to an elderly person who is behaving abnormaly in a way that is not beneficial (and may be judged harmful) to himself/ herself and who, in a professional opinion, is not expected to return to normal but to continuously deteriorate until death. this is not a biological definition but a social one as you will find even in the medical profession there is not a clear biological definition and there does not need to be one.
Categories of severeness, degrees of incompetence and length of onset are three important factors determining how these events evolve to affect the life of a person who is increasingly losing control of their life and their ability to make decisions. For some it develops over a period of time while for others like my mother who suffered a stroke, it happened in one afternoon.
Dementia may come on slowly, the elder person or couple lives alone, the family helps out, increasingly more help is needed/given, the elder person moves in with the family, outside professional help is brought in and the elder person may even die in peace there. This may work out well, or the family may find that its not working out and seek an outside living situation. Or the elder person themself may choose this option or have left legal instructions to do this.
Regarding the elderly couple, for the one who is not affected by dementia (the care giver) the process may take many years until finally the care giver can no longer function in the situation, usually beyond the optimum time for both people.
Three types of residence facilities for elderly
Independent living is a retirement residence complex where people live in a community with their own apartment, take care of all of their own needs with perhaps a common center room and a schedule of events. In independent living the person has an apartment in a building with common rooms for dining, games, computers, library, etc. a staff which may help with housekeeping needs and usually some available transportation for medical needs and social events. Assisted living is like independent living but in addition there is a staff to assist the resident with personal needs inside their room.
The common element in each of these is that the person’s mind is still functioning normally, and they are capable of making decisions and acting in their own interest. While the difference is a matter of degree, in each situation there is a door where the resident, of their own choice, at their own will, choosing their own time, can leave and enter the residence.
In memory care, the third type of residence facility, the door to the outside world is locked—the resident will never again, of their own choice and will, open that door, walk out and do something they want to do.
Why I chose a memory care facility
To be a full time or even a part time care giver to some one who cannot behave in their own interest is an overwhelming task for a family member. Often a spouse will get there via a slow evolutionary process culminating in a horrible incident, while for others, often children, an outside residence may not be, or seem to be, a financial option. My parents had both a good pension and long term care insurance.
Taking care of someone who cannot behave in their own interest is not just being a nice person to someone, it can be a full time commitment, involving intense emotional conflicts, multiple times everyday cleaning up someone’s poop, feeding them, and much more. It a breeding ground for intense emotional situations which may be damaging and hurtful to both care giver and loved one. Some still may choose it and do ti well.
But you may not be helping your loved one if every time you clean up poop you hate it and start doing a poor job.
In a good residence facility there are trained care givers who do this for a living. They can do it well without the kind of emotional problems a spouse or a child may encounter. And you pay them to do this, and it is not just an important job, it is one of the most important jobs o this earth—much more important than than being a US president or CEO of a big company.Everyday these caregivers must do a great job, and they are judged everyday while presidents and CEOs regularly make poor or wrong decisions that cost others their lives or jobs, while never suffering financially for these mistakes.
My wife or I visited with my mother everyday. Generally we went for lunch and then spent time with her. Often we took her out, such as every Sunday we went out for lunch and to a park, a store, a drive, etc. The whole time we spent with her had the option to be quality time. We did not have to clean her up, make her food, constantly be there watching that she did not hurt herself, etc. The residence staff took care of that.
On Sunday I would call a few hours before letting the staff know I would be there to pick her up for lunch and when I arrived mom would be clean, dressed up and ready.
This does not mean that I did not have situations which were unpleasant, but they were reduced and were more tolerable. It did mean that I had the opportunity to make my time with mom quality time.
Of course when choosing a memory care facility, it is important to judge the staff, both director, the staff and especially the caregivers on the floor—at a facility they are the most important. If the director thinks his/her position is more important than the caregivers on the floor, I would think that is a negative—it is the director’s job, first and foremost, to enable the caregiver on the floor to do the best job they can do.
You may visit a facility and get a tour, but also I suggest “dropping in” at least 5-6 times at different hours and walk around by yourself, see what is happening. Watch the relationship between the care givers, the residents, and the director. At the residence where my mother was, it was clear every staff member placed the resident first. When the maintainence person was working on something in the garden and a resident came up and started diddling around, it was ok, even if it meant an extra hour to finish the job.
On Sundays when we took mom out for lunch, on our return the care giver would cheerfully greet mom . These little things everyday make a big difference.
In summary, for some placing your loved in a (quality) memory care residence may enable you to give better care and enrich that person’s last few years of their life.