Memory care vs. home care for dementia: Learn the key differences

As Alzheimer’s or dementia progresses, there often comes a point at which folks can no longer take care of themselves. In those situations, a doctor might recommend that the person move into a memory care unit or receive in-home memory care to receive full-time help.

Naturally, this is an emotionally weighty decision for any family to face, and it can be difficult to determine which living situation is best. As Lauren B. Parker, an advanced practice registered nurse and owner of NDO Wellness in Henderson, Nevada, notes, there’s really no right or wrong option — the best fit will depend on individual circumstances.

According to Parker, home care for dementia involves an aging adult staying in their home while either a family caregiver or an outside caregiver attends to their needs. Out-of-home memory care involves an older adult moving into a facility that provides professional caregivers 24/7. “Therefore, the staff takes over most of the care and the family visits and participates in more of an advisory capacity,” she notes.

If you’re trying to determine which option is right for your loved one, it helps to compare home care for dementia versus memory care. Read on for expert insight on the key differences.

Key differences between home care vs. memory care

Again, the decision to have a loved one with dementia reside in a memory care unit or remain at home is extremely personal and highly variable. Here are a few main ways each type of care differs.

Environment

The most obvious (and central) difference between home care for dementia and memory care is the environment, notes Kyle Bossung, president and CEO of Senior1Care in Mishawaka, Indiana. “Home care allows individuals to stay in the environment they know best,” he explains. “That sense of comfort often helps reduce confusion and anxiety.” 

Alternatively, memory care facilities are designed for safety and structure, says Bossung. Units are equipped with staff well-versed in the ins and outs of progressive memory diseases, which can be a help when, say, a person with dementia starts to wander off or get confused and agitated. However, Bossung says that some memory care facilities can “feel clinical” to individuals who are in the early stages of dementia. 

The level of care 

When it comes to in-home memory care, your loved one receives personalized, one-on-one attention, explains Ron Schulman, owner of SYNERGY HomeCare of Columbus, Ohio. This is important, he notes, as not all people with cognitive decline will show the same symptoms or show that decline at the same pace.

Bossung agrees. “With a consistent caregiver and a strong care plan in place, many families find the quality of care at home exceeds their expectations,” he says. Here are some tips on hiring a memory caregiver from start to finish. 

On the other hand, memory care facilities have staff well-versed in dementia and Alzheimer’s, which can be beneficial in advanced stages of the diseases. However, Bossung notes that facilities generally follow a standardized model of care. For example, they’ll set standardized safety protocols within the facility to curb accidents and require that residents follow consistent, structured routines. While there’s a case for these protocols, standardization means that facility care tends to be less tailored to the individual.

“Some memory care units are tremendous, but the business model prohibits them from providing consistent one-on-one care,” Schulman adds. “The limits on direct care are not because the administrators and medical staff don’t want to provide the best care; the model is the model.”

“There is nothing easy about the severe cognitive decline of a loved one; it can be brutal and heartbreaking. Any decisions you make in the best interests of those you love, made from love, are good.”

— Ron Schulman, owner of a home care company

Social interaction

Since an aging adult with dementia or Alzheimer’s is in their own residence with in-home care, their social interaction — be it with family, friends or their caretakers — will remain relatively the same as it was before the switch. “Home care provides personalized, one-on-one engagement and the flexibility to incorporate activities based on the individual’s interests,” notes Bossung. “It also allows family and friends to visit on the person’s terms.”

On the other hand, Schulman says that one “undeniable” benefit to memory care facilities is that they allow for plenty of socialization among members and staff. “Depending on where people may be on the continuum of their cognitive decline, the socialization between residents can be very beneficial,” he says. 

Family involvement

With home care for dementia, a person’s natural schedule is (relatively) unaffected. So, if their family frequents the residence, they can continue doing so. “Whether it’s dropping by for lunch, helping with decisions or just being present, families often feel more connected to the day-to-day care,” Bossung says. The frequency of visits depends on the family’s desire for involvement. If family members want to actively participate in providing care, they’re welcome to, explains Schulman.

Factors to consider when choosing between home care vs. memory care

From the stage of dementia  an aging adult is currently in to the cost of memory care, you’ll need to consider a variety of factors when deciding between home care and memory care. Here are some factors to consider when making the choice. 

Stage of dementia

In the early stages of dementia, a person may benefit most from home care for dementia, Bossung notes. Being in a location that’s familiar can be comforting and helpful in combating the progression of cognitive decline. 

That said, if a person is at a very advanced stage of the disease, a memory care facility may be the best choice, Bossung says. This is to avoid any injuries or dangerous situations, like them wandering off and getting lost. 

Family support

Someone with cognitive decline could be cared for at home by family members alone as well as by a hired nurse or professional memory care provider. That said, home care for dementia requires at least some involvement from family as at least one family caregiver will need to be available to attend to a loved one even if it is alongside a professional caregiver. 

Financial resources

While home care for dementia can cost less at first, notes Parker, as the needs of your loved one progress with their disease, you may need a caregiver to work more hours, leading to costs that add up quickly. At that point, you might do well to move your loved one into a memory unit for financial reasons. 

Either way, here are some tips to navigate the expenses associated with memory care. 

Personal preferences

Your older loved one’s preference should definitely factor into the decision, if possible. “My father and I had a running joke from the time I was a teenager: ‘Dad, there will always be a closet in my house for you,’” he recalls. “He did not want to move into a facility of any kind. It is important to know what your loved one’s intentions and desires are and then understand if there is financial wherewithal to execute them.” Here are a few things to include in a dementia care plan. 

How to make a decision when deciding between home care vs. memory care

There are pros and cons associated with both in-home and out-of-home care for cognitive decline. Families she works with often choose in-home care at first, and then, as cognitive decline progresses, they move to a facility, explains Parker. “This can be due to cost, household changes or burnout,” she explains. “The priority is the health and safety of the senior and the caregiver when determining this next step.”

Parker says she personally chose in-home care for her grandfather. “Providing respite, I helped my aunts care for him right in his own home,” she describes. She says her aunts were able to quickly recognize his various needs quickly. She recalls, “As his Alzheimer’s disease progressed — he became bed-bound and had a feeding tube — we still kept him comfortable, safe and surrounded by love.” 

Ultimately, Schulman points out how important it is to acknowledge what a tough and trying decision it can be. “There is nothing easy about the severe cognitive decline of a loved one; it can be brutal and heartbreaking,” he says. “Any decisions you make in the best interests of those you love, made from love, are good.”