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How to Choose an Assisted Living Facility When Someone You Love Has Dementia

Photograph by Blend Image/Alamy

When Arden Courts opened in Potomac more than two decades ago, it was somewhat unusual among assisted-living facilities: one of the first in the country dedicated solely to people with dementia. It wasn’t atypical for long. Other area providers such as Sunrise and Brookdale soon followed, opening dedicated wings for memory-care residents, then entire buildings.

It turns out they were ahead of the curve. With the number of Alzheimer’s patients on pace to triple by 2050, the specialty—centered around individually tailored routines, secure environments, and mentally engaging activities—is the fastest-growing segment of the senior-care industry. Because Washington joined the memory-care trend early, you’ll find plenty of options for loved ones suffering from dementia.

Not surprisingly, this type of advanced care is costly. Facilities in our area range from about $5,000 a month for a room in a residential group home to $11,000-plus for an apartment in an upscale, hotel-like building. No matter the setting, expect to hear a lot about “person-centered care,” a term in the industry for customizing meals, activities, and regimens for each resident.

“Person-centered care means taking a long, deep look at the life a person led, both recently and in the past, so that you have clues for how to reach them now,” says Jennifer Brown, director of admissions and marketing at Forest Side, a 33-apartment memory-care property near Rock Creek Park in upper Northwest DC.

For example, one of Forest Side’s residents was sometimes difficult and uncooperative, but the staff knew from family interviews that his father had been a professional opera singer. When the resident became agitated, the staff played opera and he immediately calmed down.

Cedar Creek, which operates five memory-care homes in Montgomery County, prepares lifelong bios of all residents. Staff memorize and get quizzed on them. “We learn what scares them, what makes them happy, what they have spent the last 75 years doing,” says operations director Ruthie Fishman.

Arden Courts now has five locations throughout Washington’s suburbs. Its Heart’s Desire program finds residents opportunities to recreate their past experiences. Staff arranged for a man who once operated the elevator at a ballpark to go back to the same place to run the elevator once again. For a woman who’d been president of a local Virginia chamber of commerce, staff got the chamber to hold a meeting at Arden Courts so she could participate.

Allowing people with dementia to enjoy experiences and sensory memories—such as favorite foods or songs—from their distant past alleviates agitation because they can often remember them better than events that occurred just moments earlier.

This might not seem like much of a conceptual leap, but recreating such experiences is the type of thing that general nursing homes and assisted-living communities don’t usually do, even if they accept people with Alzheimer’s and other forms of dementia. By comparison, memory-care programs focus intensively on these methods.

Arden Courts worked with neurologists and geriatric psychiatrists to develop its dementia-specific programming and caregiver training. Many communities have gardens, clerical areas, workbenches, and usable kitchens so residents can relive careers and hobbies. They’re also more secure than typical nursing homes because their residents still tend to be physically capable of wandering off.

That’s not to say you won’t encounter activities like those in other assisted living. “Research shows that music preferences and spirituality endure,” says Rebecca Kosgei, Arden Courts’ program-services coordinator. “So we have lots of musical entertainment and offer Catholic, Jewish, and nondenominational services.”

At Forest Side, residents spend time with teenage volunteers from St. John’s College High School, who join them for gardening, cooking, puzzles, painting, and visits from therapy dogs. Memory-care residents at Olney Assisted Living and Great Falls Assisted Living participate in music and crafts sessions with children from neighboring daycare centers.

The 220-acre Sandy Spring campus of Brooke Grove Retirement Village includes housing for about 80 memory-care residents. The mission is to connect them with their pasts and help them build self-esteem.

Achieving that goal sometimes requires going beyond usual care. One resident is a stained-glass artist, but the community’s existing work areas didn’t suit the medium. So management funded a new art studio, the woman moved in her equipment, and she continued her passion.

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■ Given the expense and importance of choosing the right facility, it’s worth considering hiring a specialist—social workers, care managers, and elder-care attorneys are all familiar with the local memory-care landscape—to help you choose. While touring communities, keep the following tips and questions handy.

When You Visit

1. Observe residents’ appearance. Are they groomed, clean, and content?

2. Pay attention to the interaction between staff and residents. Is it warm or coolly efficient? Are staffers looking residents in the eye, especially those in wheelchairs? Are they full-time?

3. Watch the demeanor and behavior of staff. Are they spending a lot of time talking with one another? Do they seem frantic?

4. Talk to people visiting family members. If that isn’t possible, ask for a few phone numbers.

5. Bring the prospective resident with you if you can. Ask staff to find a current resident with similar interests, and set them up together for a meal or activity.

6. Try to visit during mealtime, a good opportunity to evaluate whether residents are well attended.

Questions to Ask

1. What does management do to retain staff?

2. What is the access to medical care like on-site? For example,are nurses and doctors on staff?

3. Even if fees are all-inclusive, what are possible additional charges?

4. Under what circumstances would the facility ask a family to hire a private supplemental caregiver?

5. Under what circumstances might a resident have to move out?

6. Are there shared rooms that are more economical?

7. Can the facility provide recent evaluations by the state health or consumer-affairs department?

Memory Care Communities

  • AlfredHouse Assisted Living, nine homes in Montgomery County; 301-260-2080; alfredhouse.com.
  • Arbor Place Dementia Care, 4413 Muncaster Mill Rd., Rockville; 301-924-0666; arborpl.com.
  • Arden Courts, five communities in the DC area; 888-478-2410; arden-courts.com.
  • Brightview Senior Living, four communities in the DC suburbs; 301-250-1628;
    brightviewseniorliving.com.
  • Brooke Grove Retirement Village, 18131 Slade School Rd., Sandy Spring; 301-924-2811; bgf.org.
  • Brookdale Senior Living, eight communities within 50 miles of D.C.; 855-350-3800; brookdale.com.
  • Cedar Creek Associates, five homes in Montgomery County; 301-384-4017; cedarcreekassoc.com.
  • Forest Side Memory Care, 2701 Military Rd., NW; 202-966-7623; forestsidedc.org.
  • Great Falls Assisted Living, 1121 Reston Ave., Herndon; 703-421-0690; greatfallsassistedliving.com.
  • Olney Assisted Living, 16940 Georgia Ave., Olney; 301-575-0525; olneymemorycare.com.
  • Sunrise Senior Living, 25 communities in DC area; 703-854-0234; sunriseseniorliving.com.
  • Williamsport Retirement Village, 154 N Artizan St, Williamsport; 301-223-7971; bfg.org.

Other Resources

This article appears in the March 2017 issue of Washingtonian.

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