How to Choose a Memory Care Facility: A Step-by-Step Guide for Families

Choosing a memory care facility for someone you love is one of the most important and stressful decisions you'll make as a caregiver. You're not just picking a place for them to live. You're choosing the people who will care for them during their most vulnerable years, the environment where they'll spend their days, and the community that will become their world.

The options can feel overwhelming. Every facility you tour will have a nice website, a warm tour guide, and promises of excellent care. But how do you know which one is truly the best fit? How do you see past the marketing to understand the quality of care your loved one will actually receive? And how do you make this decision when you're already exhausted, emotional, and running out of time?

In this guide, you'll learn exactly what to look for when evaluating memory care facilities, the questions that reveal the truth about quality of care, red flags to watch for, and how to compare your options to make a confident decision. You'll also get practical tools for organizing your search and making sure nothing falls through the cracks.

If you're still deciding whether memory care is the right option, start with our guide on how to know when it's time for memory care. For broader context on care options, see our article on nursing homes and care options.

Step 1: Understand What Makes Memory Care Different

Before you start visiting facilities, it's important to understand what separates good memory care from other types of senior living and what specific features matter most for someone with dementia.

Memory care is not the same as assisted living or nursing homes. Assisted living provides help with daily tasks but isn't designed for people who need constant supervision or specialized dementia support. Nursing homes focus on skilled medical care and rehabilitation. Memory care sits in between: it provides 24/7 supervision in a secure environment with staff specifically trained to care for people with Alzheimer's disease and other dementias.

Key Features of Quality Memory Care Include

Understanding these core elements will help you evaluate facilities more critically and ask better questions during tours.

Step 2: Start Your Search and Create a Shortlist

The first step is creating a manageable list of facilities to visit. Don't try to tour every memory care community in your area. Focus on finding three to five strong candidates you can compare carefully.

Where to Find Memory Care Options

• Ask for referrals. Talk to your loved one's doctor, a geriatric care manager, hospital social workers, or other families who've been through this. Personal recommendations from people you trust are invaluable. For preparing for these conversations, see our guide on questions to ask the doctor.
• Search online. Websites like A Place for Mom, Caring.com, or your state's department of aging can help you find licensed memory care facilities in your area. Read reviews, but take them with a grain of salt. Very angry or very glowing reviews may not represent the typical experience.
• Check state inspection reports. Most states publish inspection and violation reports for long-term care facilities. Look up each facility's history of citations, complaints, and how quickly they corrected problems. This is public information and can reveal patterns of neglect or poor care.
• Consider location. Do you want your loved one close enough for frequent visits? Near other family members? In a familiar neighborhood? Location affects how often you'll visit and how connected your loved one will feel to their community.
• Narrow by cost. Memory care typically costs $5,000 to $10,000 or more per month depending on location and level of care. Be realistic about what you can afford, and ask about what's included in the base rate versus what costs extra. For more on costs, see our guide on financial planning after dementia diagnosis.

Once you have a shortlist, call each facility to check availability (many have waitlists), confirm they accept your loved one's payment method (private pay, Medicaid, long-term care insurance, Veterans benefits), and schedule tours. Try to visit at different times of day so you can see morning routines, mealtimes, and afternoon activities.

Step 3: Know What to Look for During Your Tour

The tour is your chance to see beyond the marketing materials and understand what daily life will actually be like for your loved one. Go prepared with questions, and pay attention to details the tour guide might not highlight. Understanding dementia symptom progression helps you evaluate whether the facility can meet your loved one's needs as they change.

Observe the Environment

• Is the facility clean and well-maintained? Look for cleanliness in resident rooms, bathrooms, dining areas, and common spaces. Check for unpleasant odors (urine, feces, or heavy air freshener covering odors). A slight smell isn't a dealbreaker, but pervasive odors suggest inadequate staffing or hygiene protocols.
• Is it safe and secure? Check that exits are monitored or locked, but residents can move freely within the community. Look for handrails, non-slip flooring, good lighting, wide hallways for wheelchairs or walkers, and emergency call buttons in rooms and bathrooms.
• Is the layout simple and easy to navigate? People with dementia do better in settings where they can find their way around. Look for clear sight lines, color-coded areas, large signs with pictures, and circular walking paths that don't lead to dead ends.
• Is it calm or chaotic? Notice the noise level, the pace of activity, and the overall atmosphere. Memory care should feel calm, structured, and peaceful, not loud, rushed, or disorganized.

Watch Staff Interactions with Residents

This is the most important thing to observe. Don't just listen to what the tour guide tells you. Watch how staff members actually interact with residents.

• Do staff members make eye contact, use names, and speak respectfully? Or do they talk over residents, ignore them, or speak in a condescending, childish tone?
• How do staff respond when a resident is confused, upset, or asking for help? Do they redirect gently and patiently, or do they dismiss the person or respond with frustration?
• Are residents engaged, or are they sitting alone? Look at residents in common areas. Are they participating in activities, talking with each other or staff, or are they mostly sitting alone staring into space or at a TV?
• Do staff members seem rushed, stressed, or understaffed? If you see call lights going unanswered for long periods, staff running from room to room, or residents calling out for help repeatedly, those are red flags.

If possible, visit during a mealtime. Watch how staff assist residents who need help eating. Are they patient and encouraging, or are they rushing through meals? Are residents eating in a pleasant environment, or is mealtime chaotic and impersonal? For more on feeding concerns, see our guide on nutrition and feeding challenges.

Evaluate Activities and Daily Life

• What activities are offered, and are they appropriate for people with dementia? Ask to see the activity calendar. Look for music, art, reminiscence therapy, gentle exercise, sensory activities, and outings (if appropriate). Avoid facilities where the only activities are bingo and movies.
• Are activities actually happening, or just on paper? If you visit when an activity is supposed to be taking place, is it actually happening? Are residents engaged, or is one staff member half-heartedly leading an activity while most residents sit uninvolved?
• Is there outdoor space? Access to safe outdoor areas (secure gardens, walking paths, patios) improves quality of life. Ask how often residents go outside and whether there are staff available to supervise.
• What does a typical day look like? Ask the tour guide to walk you through a typical day from morning wake-up through bedtime. How much choice do residents have about when they wake up, eat, or participate in activities? The best facilities balance structure with individual preferences.

Step 4: Ask the Critical Questions About Staffing and Care

After the tour, sit down with the administrator or director of nursing and ask detailed questions about how care is actually delivered. Don't be afraid to ask tough questions. This is your loved one's life.

Staffing Questions

• What is your staff-to-resident ratio during the day, evening, and overnight? Lower ratios (like 1:6 or 1:8 during the day) mean more individualized attention. Ratios of 1:15 or higher are red flags. Ask specifically about overnight staffing, when many facilities are understaffed.
• What training do your staff receive in dementia care? Look for facilities where caregivers complete dementia-specific training beyond basic CNA certification. Ask about ongoing training, not just initial orientation.
• What is your staff turnover rate? High turnover (anything over 30-40% annually) disrupts continuity of care and suggests poor working conditions, low pay, or bad management. Residents do better when they're cared for by familiar faces.
• Who is on-site overnight? Are there licensed nurses on-site 24/7, or only during daytime hours? What happens if there's a medical emergency at 3 a.m.?
• How do you handle challenging behaviors? Ask specifically how they respond to aggression, sundowning, or resistance to care. The answer should involve de-escalation, redirection, and individualized approaches, never restraints or heavy sedation as a first resort. For context on these behaviors, see our guides on sundowning syndrome and middle-stage dementia.

Care and Communication Questions

• How do you create and update care plans? Ask how often care plans are reviewed, who's involved, and how families are included in decision-making.
• How do you communicate with families? Will you get regular updates about your loved one's condition, behavior changes, falls, or medication adjustments? How quickly will you be notified if something happens? Can you call anytime to check in?
• What happens if my loved one's needs increase? Will they need to move to a different unit or facility, or can they age in place? Some memory care communities have different levels within the same building, while others require transfers as dementia progresses.
• How do you handle medical appointments and hospitalizations? Who transports residents to outside appointments? What support is provided during hospital stays? How is the transition back to the facility managed?
• What is included in the base cost, and what is extra? Be very clear about what you're paying for. Some facilities charge extra for medication management, incontinence supplies, escort to meals, one-on-one assistance, or higher levels of care. Get everything in writing.
• Can residents bring their own furniture and belongings? Familiar items reduce anxiety and help your loved one feel more at home. Ask about size restrictions and whether rooms can be personalized.

Step 5: Recognize Red Flags and Deal Breakers

Some issues are serious enough that you should cross a facility off your list immediately, no matter how nice the lobby looks or how charming the tour guide is. Understanding signs dementia is getting worse helps you evaluate whether facilities can handle changing needs.

Trust your instincts. If something feels wrong, even if you can't quite put your finger on it, keep looking.

Step 6: Compare Your Options and Make a Decision

After you've toured multiple facilities, it's time to sit down and compare them systematically. Don't rely on memory. Use a comparison tool to evaluate each option against the same criteria.

Create a Simple Comparison Chart with These Categories

• Overall atmosphere and cleanliness (rate 1-10)
• Staff warmth and competence (rate 1-10)
• Staffing ratios (specific numbers for day, evening, night)
• Activities and engagement (quality and frequency)
• Safety and environment (secure, well-lit, easy to navigate)
• Communication with families (how often, what methods)
• Cost (base rate and what's included vs. extra)
• Location and convenience for visits
• Availability (waitlist, move-in timeline)
• Your gut feeling (rate 1-10)

Look for patterns. One facility might have the lowest cost but also the worst staffing ratio. Another might have beautiful amenities but cold, disengaged staff. The right choice is rarely the cheapest or the fanciest. It's the one where your loved one will be safe, treated with dignity, and engaged in meaningful ways.

Involve other family members in the decision if possible. Tour facilities together if you can, or at least share your notes and impressions. If siblings or other relatives are skeptical, invite them to visit the top choice with you so they can see what you see. For more on family coordination, see our guide on how to coordinate a dementia care team.

Don't wait too long to decide. Many memory care facilities have waitlists, and the best ones fill up quickly. If you find a place that feels right, ask about securing a spot even if you're not ready to move your loved one in immediately. Some facilities will hold a room for a deposit.

Step 7: Prepare for the Transition and Stay Involved After Move-In

Once you've chosen a facility and secured a spot, the real work of transitioning your loved one begins. How you handle the move and the first few weeks can make a big difference in how well they adjust. For communication strategies during this transition, see our guide on how to talk to someone about memory problems.

Before Move-In

• Meet with the care team to complete a detailed intake assessment. Share everything about your loved one: their history, personality, preferences, routines, triggers, and what comforts them. The more the staff knows, the better they can care for your loved one.
• Bring familiar items from home: photos, a favorite chair, a quilt, cherished decorations. Personalize the room as much as possible.
• Create a one-page "about me" sheet with your loved one's life story, career, hobbies, family, and important memories. This helps staff see them as a whole person, not just a diagnosis.

During the First Few Weeks

• Visit regularly, but not constantly. Frequent short visits are better than long daily visits during the adjustment period. Your loved one needs time to bond with staff and settle into the routine.
• Communicate openly with staff about how your loved one is eating, sleeping, and adjusting emotionally. If you have concerns, raise them immediately rather than letting them fester.
• Be patient. The first two to six weeks are usually the hardest. Most people adjust once they become familiar with the routine, staff, and other residents.

Stay Involved for the Long Term

Even after your loved one has settled in, you're still their advocate. Visit regularly, attend care conferences, and stay in close communication with the nursing and activities staff.

If you notice changes in your loved one's condition, behavior, or mood, speak up. You know them better than anyone.

Use a tool like CareThru to track visits, log observations, store contact information for key staff members, and share updates with family members who can't visit as often. Staying organized helps you stay on top of your loved one's care and advocate effectively when needed. For more on staying organized, see our guide on using technology to organize dementia care.

Step 8: Know Your Rights and How to Address Concerns

Once your loved one is in memory care, it's important to know what you're entitled to as a family member and how to address problems if they arise. Understanding legal planning after dementia diagnosis helps ensure you have the authority to advocate effectively.

You Have the Right To

• Visit at any reasonable time. While facilities can have quiet hours or ask you to avoid certain times (like during shift change), they cannot prohibit visits or severely restrict when you can see your loved one.
• Access medical records. If you have healthcare power of attorney, you can request copies of care plans, medication records, incident reports, and medical notes.
• Participate in care planning. You should be invited to care conferences and included in decisions about your loved one's treatment and daily care.
• File complaints. If you have concerns about care quality, safety, or staff conduct, you can file a complaint with the facility's administrator, and if necessary, with your state's long-term care ombudsman.

If You Have Concerns

1. Document everything. Keep notes on what you observed, when, and who was involved. Take photos if appropriate (falls, injuries, unsafe conditions).
2. Raise concerns with staff first. Many issues can be resolved with direct communication. Talk to the charge nurse, activities director, or administrator.
3. Follow up in writing. After verbal conversations, send an email summarizing what you discussed and what actions were promised. This creates a paper trail.
4. Escalate if needed. If the facility doesn't address your concerns, contact your state's long-term care ombudsman, file a complaint with your state's licensing board, or consult an elder law attorney.
5. Consider moving your loved one. If problems are serious and not being corrected, you may need to move them to a different facility. This is disruptive, but sometimes necessary to ensure their safety and wellbeing.

How CareThru Can Help You Stay Organized During Your Search

Searching for memory care involves managing a huge amount of information: facility names and contacts, tour notes, cost breakdowns, pros and cons lists, and questions you forgot to ask. It's easy to lose track of details or mix up which facility said what.

CareThru can help you centralize all of this. You can create entries for each facility you're considering and store tour notes, contact information, and cost details in one place. You can share your notes with siblings or other family members so everyone has the same information when it's time to make a decision.

Once your loved one moves in, CareThru becomes even more valuable. You can log updates from care conferences, track medication changes, note behavior patterns, and keep a record of incidents or concerns. If you ever need to advocate for better care or move your loved one to a different facility, you'll have a detailed history at your fingertips.

By staying organized throughout the search and transition process, you'll make better decisions and feel more confident that you're doing everything you can for your loved one.

Frequently Asked Questions About Choosing a Memory Care Facility

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