Choosing a Nursing Home for Someone With Dementia
Good dementia care depends on people, routines and environment as much as medical care. Here is what to look for and what to ask.
Many nursing home residents live with Alzheimer’s disease or another form of dementia. Most nursing homes care for residents with dementia, and some have a separate memory care unit. The quality of that care varies widely, so it is worth looking closely.
Memory care units
A dedicated memory care unit is usually a secured area, designed to prevent residents from leaving unsafely, with staff who work there consistently and activities planned for people with cognitive impairment. Ask whether the unit has its own staff, how residents are assigned to it, and what happens if a resident’s needs change.
Staff training and consistency
Federal rules require nursing homes to train nurse aides in dementia care and abuse prevention. Beyond that minimum, look for:
- The same aides caring for the same residents most days (“consistent assignment”). Familiar faces reduce distress for people with dementia.
- Staff who can explain how they respond to agitation, wandering or refusal of care without rushing to medication.
- Enough staff on evenings and weekends, not just during weekday business hours.
Each facility’s profile in this directory shows its CMS staffing information, and Medicare’s Care Compare also publishes staff turnover for each home.
Antipsychotic medications
Antipsychotic drugs are sometimes used to manage behaviors in people with dementia, but they carry serious risks for older adults, and federal regulators have long worked to reduce their unnecessary use. Medicare’s Care Compare publishes each home’s percentage of long-stay residents who received an antipsychotic medication. A rate well above the state average is worth asking about.
What to look for on a visit
- Residents engaged in activities, or calmly occupied, rather than sitting unattended in hallways.
- A calm environment: manageable noise, good lighting and clear signs or cues that help residents find their way.
- Safe outdoor space residents can actually use.
- Staff speaking to residents with patience and respect, at eye level.
Questions to ask
- How do you learn about a new resident’s routines, preferences and history?
- How do you handle behaviors such as agitation or wandering? When do you consider medication?
- How will you keep our family updated, and how can we take part in care planning?
- If my loved one’s needs increase, can they stay, or would they need to move?