Choosing a memory care facility for a family member with Alzheimer's or dementia is a major decision — and it often has to be made under pressure, when a family is already stressed and exhausted. The more you can prepare in advance, the better the outcome will be.
This step-by-step guide will help you evaluate your options systematically so you can choose with confidence.
Step 1: Define What You Need
Before you tour a single facility, write down your loved one's current and likely near-future needs:
- Level of cognitive impairment: Mild, moderate, or severe? What behaviors are present (wandering, aggression, sundowning)?
- Physical care needs: Can they walk independently? Do they need help with toileting, bathing, dressing, eating?
- Medical needs: Do they have diabetes, heart conditions, wounds, or other conditions requiring skilled nursing oversight?
- Behavioral needs: Are there safety concerns — wandering, aggression, self-harm risk?
- Social and emotional needs: Do they still enjoy music, art, being outdoors? Are they social or prefer quieter environments?
This profile will help you quickly rule out facilities that aren't equipped for your loved one's needs — and zero in on those that are.
Step 2: Check CMS Quality Ratings
The Centers for Medicare & Medicaid Services (CMS) publishes quality ratings for nursing homes and skilled nursing facilities on a 1–5 star scale. Higher-rated facilities have better inspection records, staffing levels, and quality measures.
On MemoryCareFind, every facility listing shows its CMS rating. Filter by minimum rating to narrow your search. A 4- or 5-star facility is a good starting point, though it's not the only factor.
What CMS ratings measure:
- Health inspections: Recent state inspections for health and safety violations
- Staffing: Registered nurse and nurse aide hours per resident per day
- Quality measures: Clinical outcomes like fall rates, pressure ulcer incidence, and weight loss
Step 3: Narrow Your List by Location
Memory care facilities should be close enough for regular family visits. Research consistently shows that family involvement improves quality of life for residents with dementia. Being far away makes it harder to advocate for your loved one and harder to catch problems early.
Aim for facilities within a 20–30 minute drive if possible. Search by city or zip code to find options near you.
Step 4: Tour In Person
Never choose a memory care facility without visiting in person. Schedule tours at two or three facilities to compare. If possible, visit at different times of day — morning is often the most active time, but an evening visit will show you how the facility operates when staffing is lighter.
During the tour, pay attention to:
The physical environment
- Is it clean and free of odors?
- Is the space designed specifically for dementia — clear pathways, visual cues, safe outdoor areas?
- Is the lighting good? Poor lighting can worsen disorientation.
- Does it feel institutional, or does it feel like a home?
The residents
- Are they engaged and interacting, or are they sitting alone in front of a TV?
- Do they appear clean and well-groomed?
- Are they in safe, supervised spaces?
The staff
- Do staff greet residents by name? Do they seem to genuinely like their residents?
- What is the staff-to-resident ratio, especially at night?
- How long have key staff members been at the facility? High turnover is a red flag.
The culture
- Do staff walk past residents without engaging, or do they stop to interact?
- How do staff handle a resident who is distressed? Watch for calm, patient responses.
Step 5: Ask the Right Questions
Come prepared with a list of questions. These are the ones that matter most:
About staffing:
- What is the staff-to-resident ratio during the day, evening, and overnight?
- How do you handle staff shortages? Do you use agency staff?
- What dementia-specific training do your caregivers receive?
- How long has your memory care director been in their role?
About care:
- How do you handle behavioral symptoms like agitation, wandering, or aggression?
- What is your approach to pain management and end-of-life care?
- How do you manage medications? Who oversees this?
- What happens if my loved one's needs exceed what you can provide?
About programming:
- Describe a typical day. What activities are scheduled?
- How do you accommodate residents who can no longer participate in group activities?
- What happens on weekends and evenings?
About family involvement:
- What is your visitor policy?
- How do you communicate with families about changes in condition?
- Are family members included in care planning meetings?
About finances:
- What is the base monthly rate and what does it include?
- What triggers a care-level increase and how much does each level cost?
- Do you accept Medicaid? What is the process if private pay runs out?
- How much notice do you give before a rate increase?
Step 6: Review the Inspection Reports
Every skilled nursing facility and nursing home is required to undergo state inspections. You can request inspection reports from the facility itself, or find them on your state's Department of Health website. Look for:
- The number and severity of deficiencies cited
- Whether deficiencies have been corrected
- Any patterns of recurring violations
A few minor citations over several years is normal. Repeated violations of the same type — especially anything related to resident abuse, neglect, or serious safety failures — is a serious concern.
Step 7: Trust Your Instincts
After you've checked ratings, asked questions, and reviewed reports — trust what you observed. If a facility looked good on paper but something felt off during the tour, that feeling matters.
The best facilities are places where the staff seem to genuinely care about the residents, where the residents seem calm and engaged, and where the environment feels like a home rather than a warehouse.
Making the Final Decision
If you find a facility that meets your criteria, consider placing your loved one on the waitlist even if they don't need to move immediately. Good memory care facilities often have waiting periods of months.
When you're ready to make the transition, involve the care team, have realistic expectations for the adjustment period (it can take weeks), and plan to visit frequently in the early days.
Search memory care facilities near you to compare options by CMS rating, location, and bed count. Browse by state to find the right facility for your loved one — no broker fees, no referral fees.