Despite the appeal of aging at home, people with dementia often need more specialized support through memory care services. This type of care can be available in different settings, including assisted living and dedicated memory care facilities, but which should you choose? Here, we’re comparing these two options. While they are similar, there are distinct differences that can help you as you make your decision about where you or a loved one will receive memory care.

Memory care services in assisted living

Assisted living facilities are supportive environments where residents receive help with the practical tasks of daily living and have access to many amenities, care services, and opportunities for social connection.

While memory care isn’t a standard feature, many assisted living facilities offer memory care services. Sometimes, residents who receive these services live in a wing dedicated to serving people with dementia or other memory impairment. These environments provide support for residents with dementia, allowing them to remain at the same facility without having to move to a new community to receive memory care services.

Features of memory care wings

Staff members in memory care wings are trained in dementia care, including ways to manage problematic behavior, redirection, and how to provide stimulation.

Typically, there are dementia-friendly design elements, including controlled lighting, the use of contrast to help with orientation, secure exits and outdoor areas, and other approaches to reduce confusion.

Limits of memory care wings

Assisted living facilities may have fewer staff members per resident than memory care facilities do. Assisted living facilities that offer memory care are also supporting regular residents while providing services for people with dementia. Doing so can have multiple effects, including:

• Shared amenities and activities, resulting in areas and events that are less tailored for people with dementia.
• Training differences. Staff who don’t work in the memory care wing may not be trained in dementia care, leading to potential issues when staff members deal with both groups or if there’s a shortage of memory care staff.
• Limited resources. Assisted living facilities may not have the resources to tailor to memory care needs in the way that dedicated facilities can.
• Quality. Assisted living facilities may vary in how much they focus on memory care vs. residents without dementia. 

Stand-alone memory care communities

Stand-alone memory care communities are developed specifically for people with dementia. Residents need a dementia diagnosis to be accepted.

This focus enables the entire environment to be optimized for people with dementia, a goal that isn’t achievable in an assisted living community.

Common approaches include:

• A structured environment.
• Staff trained to respond to dementia-specific challenges.
• Layouts designed to be secure and soothing while minimizing confusion.
• The use of colors and contrast to help residents navigate.
• Secure exits and outdoor areas.
• Careful lighting choices to ease confusion without causing overstimulation.
• 24/7 support from staff.

While these strategies are similar to those in assisted living memory care units, dedicated facilities can be much more comprehensive. Staff may have a greater depth of training, and there may be an improved staff-to-resident ratio.

Cost and insurance considerations

In both cases, costs are influenced by many factors, including geographical location, level of care, amenities, and the individual facility. AARP found that the average cost of memory care in 2023 was higher than assisted living but less than nursing home care (which can also support people with dementia).

“The average memory care monthly rent is $8,399 in the U.S., according to 2023 NIC [National Investment Center for Seniors Housing & Care] statistics. That’s significantly more than the average monthly cost of assisted living of $6,694, but less than the estimated $12,240 monthly cost of a nursing home,” AARP wrote.

It’s important to consider that the assisted living prices that you might find online could be the average or base cost for a month’s rent. A facility may offer a base cost for residents who don’t need extra memory care services, then provide additional services for added fees. The price of moving to an assisted living community to receive memory care services may not reflect the base price and could be comparable to that of a dedicated memory care community.

The increased cost makes sense, as people with dementia require more support than those without.

Both types of facility may offer two main pricing structures:

• Tiered or fee-for-service involves a base monthly rate that covers basic services, then an additional level-of-care rate that considers the necessary level of care. This second rate will increase as the senior’s health declines or their dementia progresses.
• All-inclusive pricing is less common and involves a single consistent price regardless of care level. This monthly cost tends to be higher than the early prices in a tiered model, but it is more predictable and can be cheaper in the long run.

Location and the facility itself will also impact the monthly cost. You’ll need to explore the communities in your area to learn about the actual costs in the area you want to live.

Payment options

Memory care is generally paid for out of pocket, as insurance coverage is limited. In particular:

• Medicare doesn’t cover long-term care, as it isn’t considered a medical necessity. Some Medicare Advantage plans may cover a few included services, but they’re not a great source of funding for long-term care.
• Medicaid may cover some memory care costs, with amounts and specific costs covered varying between states.
• Long-term care insurance can be used to pay for memory care costs, but you’ll need to check the specifics of the plan. This is only helpful if the senior has already purchased a long-term care insurance plan in the past, as a dementia diagnosis would exclude them from getting one.

Emotional factors

There are also emotional factors to consider.

Assisted living is often the easiest choice emotionally, as it is a more well-known type of facility and may feel more homelike. Residents who already live at the facility and come to need memory care may find comfort in remaining in the same environment and continuing to see many of the same staff members.

Conversely, family members might find a dedicated memory care community to give them greater peace of mind and comfort. After all, these companies focus more on people with dementia and may provide better-targeted care.

Which setting for memory care services is more appropriate?

Assisted living memory care services may be the better option in the following situations:

• The person already lives in the community. They can simply move to a different part of the facility, minimizing disruption. Transitions can be especially stressful and traumatic for people with dementia, so maintaining a familiar environment is beneficial.
• Dementia symptoms are mild, and there are no major behavioral issues. In such situations, the individual may comfortably integrate into assisted living without overstimulating others or overwhelming staff. They may even begin in regular assisted living and transition to the memory care wing as needed, making the shift easier.
• They know people in the facility, or it is near family. You might also choose an assisted living facility because of someone who lives there or nearby. This is particularly relevant for couples, as one person may be in assisted living and want to remain near the one who needs memory care.

A dedicated memory care community might be appropriate under these circumstances:

• The person is still living at home. Since a transition is inevitable, moving directly into a specialized memory care community may offer a higher level of support. These communities typically have a stronger focus on dementia care and may deliver higher-quality services.
• There are significant behavioral problems. Individuals who wander, show aggression, or exhibit complex behaviors may benefit from staff with advanced training in dementia-specific care. Dedicated facilities are often better equipped to identify and address the root causes of behaviors, not just manage the symptoms.

That said, the individual facility may matter more than the particular type. This requires careful evaluation of facilities to find the best fit for your loved one’s needs.

Your choice for memory care services isn’t necessarily permanent

Remember that you aren’t necessarily making a permanent choice. It’s best to regularly reassess the situation and ensure that your loved one is in the best place.

For example, a senior in assisted living memory care may develop significant behavioral difficulties and need to move to a dedicated facility. A senior with growing medical needs may soon need to move to a nursing home with memory care.

It can help to talk with an experienced senior living advisor, especially one with detailed knowledge of local communities. Not only will they listen to your situation to help make tailored recommendations, but they can also visit the communities with you and help you understand all the factors that go into making a decision. Contact your local Oasis Senior Advisor to get started.

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.