Choose a memory care facility by matching its security, staff training, and costs to your family member's needs, then verifying every promise in writing before you sign. Memory care is residential long-term care with a secured unit and dementia-trained staff for people with Alzheimer's or another dementia, so your questions should probe exactly how each of those elements works day to day.
The 25 questions below cluster into five areas: specialized care, safety, staffing, cost and contracts, and how to verify quality. Ask them on a tour, in writing, and again before you sign. The National Institute on Aging advises confirming a facility has a dedicated dementia unit and asking exactly what services it provides.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Does the facility truly specialize in dementia care?
- How does the facility keep residents safe?
- Who provides care, and how are they trained?
- What will it cost, and what does the contract actually say?
- How do you verify quality from the outside?
- Frequently Asked Questions
Does the facility truly specialize in dementia care?
Start here, because specialization changes outcomes. The NIA reports that nursing-home residents with Alzheimer's or related dementia have better outcomes when the facility specializes in dementia care.
A "memory care" label alone does not guarantee that depth. Ask these first five questions: Listen for specific protocols, not reassurances. A strong facility describes what it does when a resident wanders toward an exit at 2 a.m., not just that it "keeps everyone safe.".
- Is there a physically separate, secured dementia unit, or are residents mixed into general assisted living?
- What is your care philosophy for behaviors like agitation, sundowning, or refusal to eat?
- How do you build and update an individual care plan?
- How do you handle a resident whose dementia advances — do they stay or transfer?
- What medical and behavioral changes trigger a call to the family or doctor?
How does the facility keep residents safe?
Wandering drives the secured design of memory care. The Alzheimer's Association states that most people with dementia will wander at some point, which is why entries, doors, and alarms matter as much as the decor.
Ask about the physical and human safety systems: Walk the perimeter yourself during the tour. Check whether staff notice you near an exit and how quickly they respond.
- Are entries and exits secured with keypads, alarms, or delayed-egress doors?
- What is your protocol and response time if someone does leave the unit?
- How is the outdoor space enclosed so residents can go outside safely?
- How do you prevent falls, and how are injuries reported to families?
- How do you manage medications and prevent errors?
Who provides care, and how are they trained?
Staffing is the substance behind a good tour. The Alzheimer's Foundation of America's touring checklist prioritizes staff-to-resident ratios, dementia-specific training, activity programming, and care philosophy.
These are the questions families most often forget to ask in writing. High turnover and thin overnight coverage are warning signs. Consistent caregivers who know a resident's history deliver calmer, safer care.
- What is the staff-to-resident ratio on day, evening, and overnight shifts?
- How many hours of dementia-specific training do caregivers receive, and on what topics?
- Is a licensed nurse on site or on call, and when?
- What is your staff turnover rate?
- What activities run each day, and how are they adapted for different stages?
What will it cost, and what does the contract actually say?
Cost is a core before-signing factor. Genworth's CareScout Cost of Care data put the 2024 national median for a dedicated memory care unit at roughly $6,160 a month, typically 20% to 30% above standard assisted living.
Get every number in writing. Before signing, the NIA advises you to read the contract carefully, get itemized costs, and verify who pays. Note that Medicare generally does not pay for custodial memory care.
- What is the base monthly rate, and exactly what does it include?
- Which services cost extra — incontinence care, medication management, higher care levels?
- How much can rates rise each year, and with how much notice?
- What triggers a move to a higher (costlier) care level?
- What are the deposit, refund, and discharge terms if care no longer fits?
How do you verify quality from the outside?
Independent ratings help, but they have a critical limit for memory care. The federal CMS Five-Star ratings on Medicare Care Compare cover only Medicare/Medicaid-certified skilled nursing facilities — not state-licensed assisted living or standalone memory care, which states regulate separately. So a standalone community may have no federal quality score at all.
Where memory care sits inside a certified nursing home, the CMS rating combines health-inspection results, staffing, and quality measures; ask which of those apply to the specific unit. For everything else, request the state licensing and inspection reports directly. Ask these last verification questions: The Alzheimer's Association offers free CareFinder and Community Resource Finder tools to match a person's needs to care options before you commit.
- Are you a standalone community or part of a certified nursing home?
- Can I see your most recent state inspection or survey results?
- May I speak with two current families?
- Can I visit again unannounced, including during a meal or evening?
Frequently Asked Questions
Does Medicare pay for memory care?
Generally no. Medicare does not cover custodial long-term memory care; families typically rely on private pay, long-term care insurance, or Medicaid where eligible, so confirm coverage in writing before signing.
Can I trust a facility's star rating?
Only if it is inside a certified nursing home. CMS Five-Star ratings exclude standalone assisted living and memory care, so request state inspection reports for those communities instead.
