Tips for Choosing A Memory Care Facility in California

Considering the move to a residential memory care facility can be a difficult decision and choosing the right facility can feel like an overwhelming task. There are many options to consider and details to understand about residential care.

Memory care communities are a specialized type of assisted living facility. These communities are licensed and regulated by the State of California, Department of Social Services. Facility staff are able to provide supervision and assistance with Activities of Daily Living (ADLs) such as bathing, dressing and personal care. They are not required to have nurses or doctors on staff and are limited in the types of medical assistance they can provide. Monthly fees are paid privately. Neither Medicare nor private insurance covers the cost of Assisted Living.

Resources to Assist in Choosing a Care Facility

These organizations can provide additional assistance in making your choice:

• Community Care Licensing Division
• California Advocates for Nursing Home Reform: 800-474-1116
• Alzheimer’s San Diego: 858-492-4400

Checklist to Help Evaluate Facilities

When visiting a residential care facility, ask many questions and try to see as much of the facility as possible. Keep the needs and preferences of the individual living with dementia in mind.

CHECK THE LICENSE

• Is the license prominently displayed?
• The license will show the number of residents allowed in the facility. How many residents are there?
• Is information on the Long-Term Care Ombudsman Program and Community Care Licensing consumer information readily available to residents and families (as required by law)?
• Review recent evaluations on the CCLD website. These will tell you what areas were found to need improvement and whether there were any serious deficiencies.

PHYSICAL FACILITY

• Does the facility appear to be well maintained overall?
• Are the common areas clean, comfortable, and pleasant for residents?
• Are there walking paths and other enjoyable outdoor areas?
• Are residents able to enjoy outdoor areas on their own or do they have to wait for staff to escort them?
• Have proper precautions been taken to avoid falls?
• Do resident rooms have both privacy and the ability to call for help when needed?
• Are residents allowed to bring their own furniture or pictures for their rooms?
• Will the length of halls or distance to a dining area be a problem for the resident?

QUALITY OF CARE

• Does the staff receive ongoing training and education to work with people living with dementia?
• How do staff get to know the residents?
• How does the staff deal with symptoms such as agitation and wandering?
• What are the facility’s policies regarding medications, doctor visits, trips to ER?
• Observe staff interacting with residents; do they treat them with kindness and respect? Do they know their names? Are they aware of their likes/dislikes?
• Observe residents; do they appear well cared for? Are they engaged in stimulating activities?
• How would the facility handle any special needs of the person living with dementia?
• What is the staff to resident ratio?
• How many direct-care staff work during various shifts: Day, Evening, & Weekend
• Are there visiting hours?
• Does the facility allow hospice care to be provided if/when needed?
• How many hospice beds can the facility accommodate? What happens if there aren’t enough beds?
• Does the facility have an active “Family Council” in which care partners can meet with the administration to address concerns?

MEALS AND ACTIVITIES

• Ask to see a menu; does the food appear healthy and appetizing? Is there a good variety?
• How does the facility accommodate different dietary needs?
• How do they help those that require assistance at meals?
• Are the activities tailored to the abilities of people living with dementia? Where do activities take place? Request a copy of the activity schedule.
• Are residents observed to be engaged in some type of stimulation?
• Are religious services available at the facility?

CONTRACT/FEE STRUCTURE

What is included in the monthly fee? What services may require an additional fee?

• Meals (special diets?), activities / outings, incontinence supplies & care, assistance with bathing/dressing, personal laundry, medication assistance, transportation to doctor, other assistance

Under what circumstances might the fees change and how much notice is given if there is a fee increase? Does the contract clearly state under what conditions a resident might be required to move? (For example: change in behavior, change in health status, and/or change in financial status).

Making the Final Decision

Before making the final decision, consider revisiting the care facility unannounced at different times of the day, and continue to make observations. It may be helpful to bring a friend or relative for another set of eyes and ears. Some facilities may also provide referrals to families that have someone already living at that facility.

For personalized dementia support, call us at 858.492.4400 to speak with one of our Dementia Care Coaches who are here to help San Diego County residents and/or those caring for someone living in San Diego County (Spanish speakers available). Also check out our free education classes, social activities, caregiver support groups, & more.