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aggiemom Asked October 2014

What is the difference in the care for dementia compared to Alzheimer's?

I am looking for a memory care unit for my mother inlaw with dementia. I keep finding places with alz care and some with memory care. I want to make sure she is getting the correct care. She has her good moments and bad moments but still very physically fit so i know she needs to be in one stable spot as to not wonder around. Very confused and concerned. Thank you

gladimhere Oct 2014
Aggie, are you concerned that she will be strapped to the bed? That is against the law except for extreme cases and then only of ordered by the doctor after all other avenues have been tried. Memory Care is for all sorts of dementia but primarily those that are at risk to wander. It does not mean strapping to the bed or chair. Rather they are secure units with doors that lock to reduce risk of wandering. Many memory care facilities, I would even say most, also have areas outside that are fenced where residents with dementia are able to walk the gardens and paths. These facilities normally offer a wide range of activities to keep residents entertained though it often takes work by staff to get some to participate.

jeannegibbs Oct 2014
aggiemom, I responded to your concern in another thread. I won't repeat that, but share some additional thoughts.

Dementia is caused by a defect in the brain. After death the brain can be examined, the defect identified, and a name given to the kind of dementia. Sometimes an autopsy reveals more than one kind of brain defect was present.

While the patient is living the medical profession does its best to identify the kind of brain defect by noting symptoms, viewing various scans, and administering tests. Sometimes the results are pretty conclusive. Sometimes what was diagnosed doesn't match what is found after death. I believe we are moving closer to some conclusive diagnostic tests for living patients.

As it stands now, even if you have a diagnosis for the kind of dementia your MIL probably has, it is only "probable." So selecting a "memory care facility" based on a particular diagnosis probably isn't really meaningful. You VERY DEFINITELY want to stay away from places that think all dementia is the same. Each patient has to be treated as unique and his or her specific symptoms and behaviors need to be dealt with as they appear.

Many dementia patients can be handled very well in regular assisted living or nursing home facilities. The fine ALF my daughter works at has a wing for "memory care" but also has more than half of their "regular" rooms held by persons with dementia. The nursing home where my mother is has a floor for memory care, but a large portion of their regular floor residents also have dementia.

Why are some people with dementia segregated into a separate wing or floor? The primary reason is wandering. Residents who are at risk for "elopement" -- leaving the grounds unassisted -- need more security measures. I think my Mom's NH keeps a pretty careful watch on the comings and goings of residents, but it would not be impossible for someone to wander out and be at risk for accidents or getting lost, etc.

Other than wandering, behavioral symptoms that would be disturbing to other residents and take additional time from staff, are the other common reason for placing someone in memory care.

Wandering is most common in Alzheimer's. It is very seldom an issue in LewyBody Dementia, for example. So it stands to reason that many memory care units (or dementia units -- the terms are pretty interchangeable) will have mostly Alzheimer's patients. That is not a problem unless they don't really understand that there are differences about the types of dementia.

One of the residents at Mom's NH told us, half embarrassed and half bragging, that he was wearing an "ankle bracelet" because he was leaving the building alone. I wonder if your MIL's current facility can do anything like that, to help keep track of her? If she is otherwise happy where she is, and just needs a little better security, could that be a partial answer?

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aggiemom Oct 2014
Her safety is what we are having issues with at this time. She is in assisted living and verrrrrry physically fit but not so mentally (at least not all of the time) everyone around her is not real mobile but she heads outside to see the ducks etc... not good. I want her to be safe at the same time not strapped to a bed.

MaggieMarshall Oct 2014
First of all, I'd like to say that, in my opinion, Alzheimer's Disease is over-diagnosed. There is no scientific test for Alzheimer's. If I'm not mistaken, it's actually found if/when an autopsy is done.

My own personal (albeit probably wrong) thoughts about when it's Alzheimer's and when it's simply dementia rests with the age at onset. The symptoms, I believe, are the same.

Memory Care / Alzheimer's Unit -- the level of care is probably the same. If I were lookinng for a memory care unit for my mom, I'd probably assess the level of impairment the current resident population had on the floor and see if mom would fit in. Of course, mom's level of impairment would change -- so I'm not even sure that'd be helpful in the long run.

Safety. Safety. Safety. That's what I'd be concerned with.

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