How to choose a memory care facility — the questions that matter most

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

Choosing a memory care facility feels like the heaviest decision you'll make in your caregiving process. You're not just choosing a place for your parent to live. You're acknowledging that your parent's mind is changing in ways you can't slow or stop. You're putting them in a place built for people whose judgment can't be trusted, whose memories are unreliable, who need the kind of specialized care that's coded to mean your parent is losing themselves.

The guilt here is crushing sometimes. You're going to feel like you're giving up. You're going to feel like if you just loved them more or tried harder or had more time, you could keep them home. You might feel like you're abandoning them to a facility because you're tired or because you have your own life. None of that is true, but you're going to feel it anyway.

Here's the thing: you're not abandoning them. You're recognizing that dementia is a disease that requires specialized care. You're putting them in a place where people are trained to handle what you can't handle alone. That's not failure. That's wisdom and love and, honestly, it's one of the hardest decisions you'll ever make because you're making it while you're already exhausted and grieving.

Before you choose a facility, you need to understand what's already happened to your parent and what's still ahead. You need to grieve that, because the grief is real and it doesn't go away if you ignore it.

From Independence to Assisted Living

Your parent used to be independent. They used to manage their own life. They used to remember things. They used to make decisions and live with consequences and basically be the person you've always known. That person is changing, and the changes are permanent.

Early in dementia, your parent might not even realize anything's wrong. They're just becoming a bit forgetful. They forget appointments or repeat stories or lose things. You start helping them manage things they should be managing themselves. You check in more. You start to notice that their judgment is off. Your parent probably doesn't notice this yet. They might be annoyed that you're hovering.

As dementia progresses, your parent's inability to manage life becomes undeniable. They can't remember if they took their medication. They can't remember appointments. They can't manage finances. They can't remember to eat. They can't drive safely. They might not remember you, or they might remember you but not remember that you just visited an hour ago. This is when things get really hard because now your parent is in decline and they might not understand why, and you're in grief watching it happen.

At some point, they need more care than you can provide at home. Maybe they wander and you can't leave them alone. Maybe they become aggressive and you're afraid of them. Maybe they become completely dependent and you can't physically manage their care. Maybe they're going to hurt themselves because they don't understand danger. This is when you need memory care.

Transitioning from your parent managing to you managing to a facility managing is a series of losses for your parent. They're losing independence. They're losing home. They're losing the life they knew. Your parent might not understand any of this. They might not understand why they're not at home anymore. They might not understand why you're not staying with them. They might think you've abandoned them, even when you're visiting regularly.

Your Own Grief

You're grieving too, and you need to be honest about it. You're grieving the parent you had. You're grieving that you can't fix this. You're grieving the time you're losing with them while they're still here but not really here anymore. You're grieving the relationship you had and the different relationship you're having now. This is deep and it doesn't have a timeline.

Some of the grief is mixed with relief, and that creates guilt. You might feel relieved that you don't have to monitor them constantly at home anymore. You might feel relieved that you can have your life back. You might feel relieved that you don't have to make impossible decisions about their care every day. And then you feel guilty for feeling relieved because that seems like you wanted them in a facility. That's not how relief works. You can want your parent to be well and also be relieved when something becomes someone else's responsibility. Both things are true.

You might also be grieving the failure, real or imagined, that memory care represents. You tried to keep them home. It didn't work. Now they're in a facility. Somewhere in your head, this is a failure. It's not. It's a recognition of reality. But that doesn't prevent the grief. You thought you'd be able to keep them safe at home, and you couldn't. That's sad. That's worth grieving.

Some of your grief is anticipatory. You're thinking about what comes next. You're thinking about the day your parent doesn't recognize you at all. The day they don't speak anymore. The day they decline to the point where it's clear that the person you knew is mostly gone. You're standing at the edge of that and it's terrifying. This grief is real and it's worth acknowledging. You don't have to pretend you're just making a practical decision about housing. You're making a decision about the end of your parent's life unfolding differently than you hoped.

Building a New Normal

When your parent moves to memory care, your relationship with them is going to change. It has to. You can't be their primary caregiver anymore. You need to become someone else in their life.

Some people find their role by visiting on a schedule and being the person who ensures they're happy. Some become the person who advocates when something's wrong. Some become the storyteller who reminds staff who your parent was before dementia. Some visit and try to have whatever conversation is possible, knowing that your parent might not remember you were there. There's no one right role. Your role is the one that fits your parent's needs and your capacity.

Visiting without managing is especially important with memory care. You're not there to check on whether staff is doing things right, though if you see real problems, you address them. Mostly you're there to be present with your parent however they are in that moment. If they're having a good day and they're engaged with activities, you might just sit with them. If they're having a bad day and they're agitated, you might sit with them through that. You're not fixing anything. You're just being there.

Some people visit every day. Some visit once a week. Some visit less frequently because the visits are emotionally draining or because their parent doesn't seem to recognize them anyway. You need to find a visiting pattern that's sustainable for you. If you promise daily visits and you can't deliver, your parent might feel abandoned and you'll feel guilty. If you visit weekly and consistently show up, that's better than sporadic daily visits interrupted by your absence.

Your parent might do better than you expect. Some people with dementia seem to settle into the structure of memory care. They have activities. They have meals on time. They have staff who know them. They make friends with other residents. You might see your parent calmer and happier than they've been in years, even though they don't remember you. That's painful and also okay. If memory care is better for your parent than struggling at home, it's the right choice, even if it feels wrong.

Your parent might also struggle. They might always be angry that they're there. They might always seem confused and distressed. They might always cry about wanting to go home. You can't fix that by bringing them home because home doesn't exist anymore in their memory or their understanding. They're going to be sad and confused either way. At least in memory care, someone's trained to manage that and you can actually live your own life rather than drowning in it.

The new normal is that your parent is somewhere safe and you're not managing their daily care. The new normal is that you're visiting and loving them and also letting go of control. The new normal is you grieving while you're also making sure staff treats them well. The new normal is hard, but it's also, in some ways, more livable than what came before.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different — what works for one may not work for another.