What does memory care actually cost? — the premium for specialized dementia care

This article is for educational purposes only and does not constitute medical, legal, or financial advice. Every family situation is different, and you should consult with appropriate professionals about your specific circumstances.

Memory care is not a separate category that exists because someone thought it would be nice to have. It exists because someone with advanced dementia cannot live in the same setting as someone without dementia, and the costs are not negotiable. This is where the financial reality of Alzheimer's and other dementias becomes starkest.

Your parent's care costs have just gone up significantly, and you didn't get a choice about whether that was going to happen. This isn't like the other care options where you can sometimes negotiate or find a bargain or make things work if you're creative. Memory care is specialized. The facilities that provide it are expensive. The alternatives—keeping someone with advanced dementia at home—require an amount of labor and stress that usually isn't sustainable for families.

I watched my neighbor deal with this transition about four years ago. Her mother had been in a regular assisted living facility. The dementia worsened. Her mother started wandering at night, and the assisted living facility said they couldn't manage her safely anymore. They were asking the family to move her to memory care. My neighbor made the calls. The memory care facility charged almost double what the regular assisted living had been charging. She asked if there was financial assistance, scholarship programs, anything. There wasn't. She asked if they could negotiate. They said no. This is what memory care costs, take it or figure out something else.

Understanding why memory care costs what it does matters before you get into the numbers, because otherwise you spend a lot of emotional energy resenting the cost instead of accepting it and planning for it.

What You're Actually Paying For

Memory care facilities exist because someone with moderate to advanced dementia cannot be housed in a regular assisted living setting. A person with dementia might wander, might not understand safety rules, might become aggressive, might have toileting accidents, might eat things that aren't food, might not understand the difference between a roommate's belongings and their own, might not cooperate with medications or care.

A regular assisted living facility has a certain ratio of staff. A memory care unit has a much higher ratio of staff. They have specialized training. They have different physical layouts,secured units that people cannot leave without assistance, hallways that loop so people can wander safely, design elements that reduce confusion and agitation. They have programming specifically for people with dementia, different activities than a regular assisted living facility would offer. They have staff specifically trained to de-escalate behavioral issues, to communicate with people with dementia, to understand that what looks like combativeness is actually fear or confusion.

All of this costs money. The facilities aren't being greedy. They're providing a genuinely different and more labor-intensive service.

Nationally, memory care costs somewhere in the range of $6,000 to $7,500 per month for semi-private rooms, and often $7,500 to $9,000 or more for private rooms. That's roughly a 50 percent premium over regular assisted living, sometimes more. In expensive markets,New York, California, Massachusetts,you're looking at $8,000 to $12,000 or higher per month. In cheaper areas, you might find memory care in the $4,500 to $6,000 range, but that's not common for quality facilities.

And like other care options, the base rate isn't what you ultimately pay. If your parent needs additional behavioral support, that might be extra. If your parent needs medication management beyond what's standard, that might be extra. If your parent has additional medical needs that require nursing care, that might be extra. Some facilities structure the base rate to include most things. Some facilities make their money on add-ons.

What makes this particularly brutal is that memory care isn't temporary. Your parent is in memory care until they need a higher level of care (nursing home care) or until they die. This isn't rehabilitation where they get better and leave. This isn't something you do for a few months while they recover. This is the rest of the line, and you're paying that cost for years.

The Duration Problem

This is the piece that breaks families. Let's say your parent is seventy-eight years old and has been diagnosed with Alzheimer's. They go into memory care. They might live another ten years. That's ten years at $72,000 to $90,000 per year, or more. That's $720,000 to $900,000. That's a number that doesn't exist in most families.

Some families have that money. Many don't. Most people with dementia who end up in memory care will eventually need to transition to Medicaid because they'll run out of money. If your parent has some savings, the plan is usually: Pay privately for a couple years until the savings are depleted, then apply for Medicaid and hopefully transition to a facility that accepts Medicaid.

This is where the financial planning gets complicated. If you know your parent has dementia and you know memory care is in their future, how do you plan for that? If they have substantial assets, an elder law attorney can help you plan to pay for care while preserving some assets. If they have modest assets, you're looking at private pay for a while and then Medicaid. If they have minimal assets, Medicaid might be available now.

The complication is that many memory care facilities are private pay only. They don't accept Medicaid. This leaves families in a terrible position: Your parent can afford memory care privately for two years, but once the money runs out, there's no Medicaid option at that facility, so you have to move your parent to a different facility. Moving someone with advanced dementia is traumatic for them and complicated logistically. It's not something you want to do, but you often have to.

Some families try to manage dementia at home for longer to delay the memory care costs. Sometimes this works. Sometimes it doesn't. If your parent has very advanced dementia, managing them at home usually requires round-the-clock care from a family member, or paying for twenty-four-hour home care, which is often as expensive as or more expensive than memory care. So the cost isn't really avoided. It's just shifted to a different category.

Finding Resources and Making Choices

Start by understanding what memory care options exist in your area. Some are quite nice. Some are adequate. Some are poor quality and should be avoided regardless of cost. The nicer facilities are more expensive. The basic facilities are cheaper. You might find a range of $5,000 to $10,000 per month within the same city, and the differences are real. Better trained staff, better facility quality, better activities programming,those things cost more.

When you're evaluating facilities, visit them in person. Call ahead and ask to tour a unit. See what the spaces feel like. Look at the actual setup of rooms and hallways. A well-designed memory care unit has doors that are easy to manage, has windows that provide light and orientation to reality, has common areas where people can gather but can't wander off unsupervised. Poor design means more agitation for residents, which means more staff time, which means more behavioral issues and more cost for add-on services.

Talk to current residents' families if you can. If the facility allows it, ask if you can speak with a family member about what their experience has been like. Has the actual cost matched what they were quoted? Are there hidden charges? Has the quality of care held up? Has the facility been responsive when problems arise?

Ask about what the base rate includes and what's extra. Ask about whether they accept Medicaid or when they stop accepting Medicaid residents. Ask about their waiting list. A really good memory care facility might have a waiting list, which means you might need to get your parent on the list before they're actually in crisis. Some families get their parent on a waiting list even when they're not immediately planning to use it, just to secure a spot.

Call your Area Agency on Aging and ask about what programs exist to help pay for memory care. Some areas have programs, some don't. Ask about whether your state's Medicaid program covers memory care and what the rules are. Ask whether your state has any special initiatives or grants for people with Alzheimer's or other dementias.

If your parent has long-term care insurance, check what it covers. Some policies specifically exclude dementia. Some policies have limits on memory care coverage. Some policies have waiting periods before they'll cover memory care costs. You need to know before you need to use it. Call the insurance company if the policy is unclear and ask them specifically whether memory care costs would be covered and under what circumstances.

If your parent is a veteran or if your parent is married to a veteran, the VA Aid and Attendance benefit might cover memory care. This is not well known, but it can be substantial. The benefit can cover thousands of dollars per month toward assisted living or memory care costs. Not all veterans know about this, so it's worth asking about directly.

Look at whether there are any reduced-cost options. Some non-profit facilities charge less than private for-profit facilities. Some facilities have scholarship programs or financial assistance programs. Some areas have specialized support programs specifically for people with dementia. These are worth investigating, though they're not always easy to find. The Area Agency on Aging or your local Alzheimer's Association chapter might know about programs in your specific area.

Having the Difficult Conversation

The hardest conversation is acknowledging that if memory care is in your parent's future, it's going to cost a lot of money, and you're probably going to have to make difficult choices about whether and how long to pay privately, and when to apply for Medicaid. You're going to have to think about whether that very nice memory care facility in the upscale neighborhood is what you can actually afford, or whether you need to look at something more basic.

If your parent is still able to understand and participate in this conversation, it matters to include them. People with early dementia often have insights about what matters to them. Some parents will say: I don't care about a fancy place, I care about safety and kind staff. Some will say: I want the nicest place possible even if it means using all my money. You need to know what your parent actually values so you can make choices that align with those values.

This is one of the places where feelings get tangled up with finances. You love your parent. You want them in a good place. You want them to have the best care. You might feel guilty about the cost, guilty that your parent's savings will be depleted, guilty that you can't personally pay for everything. But you also have to live your own life, you might have your own retirement to protect, you might have limits on what you can actually contribute. Acknowledging those limits doesn't make you a bad child. It makes you realistic. It makes you someone who can sustain support over the years that your parent will need it.

If you're dealing with siblings, this is a critical time to have a conversation about how costs will be shared. Will siblings contribute financially? Will contributions be equal, or will they be based on income or ability? Will one sibling be making decisions about where your parent lives, and does that sibling have the authority to make financial decisions that affect the whole family? Getting clear on this before crisis hits is far preferable to discovering mid-crisis that there are completely different assumptions.

Accepting Reality and Planning Forward

Memory care is expensive. Your parent with dementia deserves good care in a safe place. Those things are both true, and you don't have to choose between them. What you do have to do is understand what's actually affordable, plan realistically about how long money will last, and make deliberate choices about what level of care you can sustain.

The financial reality is what it is, and getting ahead of it,planning while you still have time, understanding your options, making deliberate choices,is the only way through this that doesn't end in crisis. The people who are most stressed by memory care costs are usually the ones who hoped it wouldn't happen or underestimated what it would cost or didn't plan until they were already in the middle of the situation.

Early action matters. If your parent is in the early stages of dementia, you have time to understand costs, explore options, apply for programs they might qualify for, and plan how you'll manage the financial transition over time. If you wait until your parent needs memory care urgently and you don't have a plan, you're picking a facility on short notice, paying whatever it costs, and hoping that money runs out gradually rather than suddenly. That's a bad position to be in.

How To Help Your Elders is an educational resource. We do not provide medical, legal, or financial advice. The information in this article is general in nature and may not apply to your specific situation. If you are concerned about a loved one's cognitive health or safety, consult with their healthcare provider or contact your local Area Agency on Aging for guidance and support.