On average, it is estimated that 70% of Americans 65 and older will need 2 to 4 years of long-term care. Different residential long-term care options range from assisted living facilities specializing in dementia care to nursing homes. With the range of options, the decision can be confusing as to which environment will best support your loved one. To boil it down, the difference between nursing homes and memory care is that memory care communities are exclusively for people with dementia while nursing homes are for people with medical issues and care needs that make living at home impossible. Nursing homes offer a more clinical, hospital-like setting while memory care communities can provide a more home-like environment.
Both memory care and nursing home residences provide room, board, healthcare, and personal care. Both nursing homes and memory care facilities are intended for people who cannot live at home because of medical needs. What differentiates them is the type of specialized care they provide.
The services provided in a nursing home are comparable to a long-term stay in the hospital. Nursing home staff are trained to help residents with the activities of daily living. Activities of Daily Living include bathing, grooming, dressing, eating, and mobility. Nursing homes normally offer less privacy than memory care because residents need continuous care. Nursing homes are not specifically designed to care for people with dementia, whereas memory care facilities are designed to help people with Alzheimer’s disease or another form of dementia. A nursing home normally provides activities for residents, but they might not be right for your loved one. For example, classic movies or cooking classes are entertaining for most adults but frustrating for someone with dementia. Sticking to a scheduled routine is important for dementia patients and memory care communities focus on this.
Cost is another difference between the two and an important factor that needs to be considered in long-term care. Memory care can be advantageous because it is less expensive, but there are additional costs for extra care provided. Nursing homes provide constant care that does not change as the disease progresses.
If your loved one has a debilitating medical issue in addition to dementia, a nursing home may be the only option. Assisted living is state-regulated, and in many states memory care communities cannot admit someone who is unable to walk from room to room, evacuate by themselves in an emergency, cannot self-administer medications, or needs medical equipment to breathe or eat. Because of this, someone who has multiple medical problems may not be eligible to live in a memory care facility.
Nursing homes offer long-term living and care solutions. Some also accept patients who are short-term residents that are rehabilitating from an accident or staying in the hospital. This is called “skilled nursing care.”
Both nursing home care and memory care are expensive, but there is greater financial assistance for nursing home care. Medicaid can assist in paying for memory care, but receiving these benefits is more complicated than those living in a nursing home and waiting lists are common. Medicaid will not pay for room and board in memory care but can help with the additional care costs. Unfortunately, due to how the system is designed, many people with dementia end up in a nursing home because it can be challenging to get financial assistance from Medicaid for those living in memory care communities.
There are interventions and activities that can slow the advancement of dementia. This level of specialization is not provided in nursing homes. For instance, walking outside at regular times of the day has been shown to help people with dementia. A nursing home might discourage going outside while memory care residences normally have secure outdoor areas. Another example is music. A nursing home probably allows playing songs in rooms, but someone with Alzheimer’s needs to be encouraged to listen to music for therapeutic benefits. This involves being approached and spoken to in a gentle manner, and probably at certain times of the day. Memory-care staff are usually better trained and more skilled at these interactions.
People with dementia present other specific challenges, like delirium and aggression, that nursing homes may not specifically train employees to deal with. A nursing home that houses residents with many types of medical problems might handle aggression in a person with dementia by applying chemical or physical restraints.
What percentage of staff is specially trained to help people with dementia? In a memory-care residence, the number will be close to 100%, while in a nursing home, it will be much less. Nationwide regulations state that staff who work with dementia patients must have undergone a certain number of training hours annually. In memory care, it is easier to know that these guidelines are followed. Staffers who work every day with people who have dementia will be more skilled in proper communication techniques like approaching from the front, remaining patient, and anticipating dropped words.
Administrators, like the activities directors, in nursing homes may not be specifically trained for dementia, whereas in a memory care home, they almost always are.
Memory care communities are designed to assist in what is best for people with dementia. Because residents with dementia may be more stressed and confused, memory care units emphasize relaxation by creating gathering areas like a TV room. The walls are also typically painted with bright colors and there is a lot of natural light. There might also be a fish tank in the dining area because people with dementia often lack appetite and watching fish swim can stimulate appetite.
The cost of memory care differs nationwide. As of 2022, it averaged $5,430 monthly. This can change dramatically across the United States with a low of $4,000 in Georgia to $12,000 in Washington D.C.. Medicare does not pay for memory care and depending on what state you are in; Medicaid will pay for part of it.
|Memory Care Residences vs. Nursing Homes for Persons with Alzheimer’s / Dementia
|Level / Type of Care Provided
|Care for people in every stage of dementia including assistance with ADLs, medication management, and therapies proven effective for symptoms (like music).
|Most residents receive intermediate-level care they cannot get living at home. Usually, this is medical (IVs, catheters, etc.) or functional (help with ADLs like dressing and eating).
|Activities and Therapies
|Activities that relieve dementia symptoms are typically brief and relaxing. Maintaining a routine is extremely important in memory care. Socialization and exercise are encouraged. Therapies can include art, pets, and music.
|Nursing home residents are often unable to leave for health reasons, so staff will offer optional activities within the residence, like musical events, games, or movie nights. Socialization is encouraged but may be limited for non-ambulatory residents.
|Building and Rooms Design/Layout
|Dementia-specific designs include hallways that run circular so wanderers don’t encounter dead ends, common areas for socialization, secured outdoor areas for walking, bright paint on walls, and special locks and monitoring devices.
|Natural lighting and outdoor views make the spaces less institutional. Rooms might need more square footage for medical equipment. Making spaces easier to navigate encourages autonomy.
|Freedom of Movement
|Because of wandering, memory care facilities will have doors with special locks to keep residents from leaving in a confused state. Increased surveillance also limits wandering. When compared with a nursing home, residents experience greater freedom within the residence, but less so outside the residence.
|To encourage health and feelings of dignity, residents are as autonomous as possible. Mobile residents may be able to leave with staff, family, or friends.
|Average Number of Residents
|Medium-sized communities house between 11 and 25 people. Larger memory care residences usually do not have more than 100 residents.
|Usually larger than memory care, averaging more than 50 to 200 residents per nursing home.
|Dementia-specific staff training is required annually which includes communication techniques to minimize anxiety.
|Staff includes registered nurses and medical professionals. Nursing home staff who work directly with people with dementia usually must have completed dementia-specific training, but this is not true for all working in the residence.
|Average cost of memory care in the US as of 2022 is $5,430 monthly. Nationwide differences are significant and can range from $4,000 a month in Georgia to $12,000 per month in Washington DC.
|The average cost of nursing home care in the US in 2022 for one month is $8,000 to $9,000 depending if it is a shared or private room. Regional and state differences extend from a monthly low of $6,000 in Missouri to a high of $32,000 in Alaska.
|Medicare & Medicaid Benefits
|Medicare will not cover any of the cost of memory care or assisted living. In some states, Medicaid will pay for a portion of the monthly cost but never for the room and board.
|Medicare will pay part of the cost for up to 100 days. As of 2022, days 1 to 20 are fully covered with zero copay, and days 21 to 100 have a copay of $194.50 daily. Medicare is not intended for long-term care. Medicaid, on the other hand, will pay for 100% of the cost of nursing home care for those who qualify.
|Use of Antipsychotics?
|Antipsychotics are used in memory care but are discouraged because of side effects. Staff should be trained to calm an anxious resident using communication rather than drugs.
|Antipsychotics are discouraged but more commonly used in nursing homes than memory care to control disruptive behavior.
|Possibility for Eviction
|Memory care evictions are legal if the admissions and retention policies are not violated by the residence. The most common reason for eviction is that the resident requires a higher level of care than can be provided.
|Nursing home evictions are legal if the admissions and retention policies are not violated by the residence. Lack of payment and dangerous behavior are the most common reasons for eviction.
|Who Gets In
|People with dementia, usually in the middle and later stages of the disease.
|Non-ambulatory patients who require full-time nursing care, need help with more than one activity of daily living, and cannot live independently.