When is it time for memory care?

More than 55 million people worldwide have developed some form of dementia, with 10 million newly diagnosed every year. And many dementia patients will eventually require full-time memory support. 

But where is the line between managing memory care at home and a facility that provides around-the-clock support?

You’ll need to watch for signs of cognitive decline and seek recommendations from medical professionals in order to know when it’s time for memory care. 

What is dementia?

Dementia is the blanket term for progressive conditions that lead to declining skills in memory, logic, and cognition. Alzheimer’s disease is the most common form of dementia, accounting for 60% to 80% of all dementia cases.

Dementia’s progression can be subtle, so it’s important to consult a trusted doctor when the first signs of cognitive decline appear, including:

  • Difficulty concentrating
  • Getting lost in otherwise familiar places
  • Inability to find the right words during conversation
  • Short-term memory lapses, such as forgetting names after an introduction
A man and woman talk to a doctor.

Only a medical professional can accurately diagnose and monitor a dementia patient’s progression. 

They can also work with a dementia patient and their loved ones to create a care plan, including guidance on when to seek around-the-clock residential care.

Stages of dementia

There are some visible signs that it may be time to consider 24-hour memory care — or, at the very least, closer monitoring from a trusted doctor, who will perform a clinical exam to determine their stage of dementia and what care plan to pursue.



Stage 1: No cognitive decline


Changes in the brain may have begun, but there is no visible cognitive impairment.

Stage 2: Very mild cognitive decline


Occasional, mild forgetfulness that could be considered normal in the aging process.

Stage 3: Mild cognitive impairment


  • Mild ongoing cognitive impairment that may affect work performance
  • Difficulty concentrating
  • Memory loss that doesn’t meaningfully hinder everyday activities or functioning
  • Getting lost in places that should be familiar
  • Inability to find the right words during conversation
  • Forgetting names shortly after being introduced

Stage 4: Mild dementia


  • Short-term memory lapses, including recent and current events
  • Decreased ability to travel and manage personal finances
  • Denial or lack of awareness of symptoms
  • Withdrawal from difficult situations

Stage 5: Moderate dementia


  • Forgetting critical facts of current life (for example, a longtime address or phone number, or relatives’ names)
  • May forget important relatives’ names but still remember their own names and their spouse’s
  • Disorientation around time or place

Stage 6: Moderately severe dementia


  • Profound memory loss
  • Occasionally forgetting the name of their spouse or main caregiver
  • General unawareness of all recent events and experiences in their lives
  • General unawareness of surroundings, date, time of year, etc.
  • Some retention of earlier life memories, but narratives are unreliable
  • Requires some assistance with activities of daily living
  • Changes in emotions and personality, including delusions, obsessive behavior and agitation

Stage 7: Severe dementia


  • Total cognitive decline
  • Inability to care for themselves, including eating and toileting
  • Inability to speak
  • Inability to walk without help

Other signs a dementia patient may need 24-hour care

Beyond the clinical definitions of the stages on the Reisberg Scale, above, there are several visible red flags to keep an eye out for.

Risk to themselves or others

Risk to themselves or others

Steadily progressing dementia can put both the patient and those around them at risk.

It’s time to talk with a doctor about seeking full-time memory support if you notice any of the following:

  • A heightened tendency to slip or fall
  • Unexplained bruises and cuts
  • Wandering or getting lost
  • Inability to keep up with medication scheduling or dosage


Nutritional concerns

Nutritional concerns

Steeper cognitive decline can also lead to ignoring hunger cues and missing meals, which may appear as warning signs like:

  • Rapid weight loss (or dramatic weight loss over time)
  • Forgetting meal time
  • Letting fresh or healthy foods spoil in the refrigerator or pantry

Any of these signs are cause for concern in a dementia patient.

Inability to perform routine activities

Inability to perform routine activities

If you’re wondering whether it’s time for memory care versus assisted living, start with activities of daily living (ADLs).

These activities of daily living (ADLs) include:

  • Walking
  • Transferring (from bed to a chair, into a wheelchair or walker, etc.)
  • Feeding
  • Dressing 
  • Grooming
  • Bathing
  • Toileting

If you notice your loved one is having significant difficulties performing routine activities with no signs of memory loss or other cognitive decline, assisted living may be the next best step for them. 

However, if your loved one requires help with a number of ADLs in addition to showing signs of cognitive decline, it may be time to seek around-the-clock memory support.

A caregiver’s physical, mental and emotional bandwidth

A caregiver’s physical, mental and emotional bandwidth

Many family members, especially adult children, step in to provide caregiving services to loved ones in cognitive decline.

Caregiving responsibilities can be a lot to shoulder, though, particularly while trying to juggle a career, other family, and other aspects of everyday life.

If you’re currently acting in a caregiving capacity and feel overwhelmed, burned out or even concerned for your safety, it may be time to think about moving your loved one into 24-hour memory care.

Attending to your own needs — and showing compassion for your own limitations as a caregiver — may be one of the best ways to take care of your loved one.

How to smooth the transition to memory care

Witnessing a loved one in the midst of cognitive decline can be challenging on the best days.

The thought of transitioning them to full-time memory support can bring up feelings of guilt and dread — but the right memory care facility will offer a supportive, nurturing environment and collaborative care that keeps family and loved ones in the loop.

If a move to full-time memory care is on the horizon, here are some tips to smooth the transition wherever possible.

A man and woman smile, while the woman's head rests on his shoulder.

Before a move

  • Find a medical ally. Work alongside your loved one’s doctor to get the right diagnosis and monitor their dementia’s progression.
  • Talk early and openly. The sooner you begin a conversation about memory support, the greater the likelihood that your loved one will be able to aid in decisions about their own care. As you discuss options, listen to your loved one’s concerns and validate their emotions.
  • Get family involved. Include adult siblings and other loved ones in as many discussions as possible, so no one is in the dark or caught off guard about big decisions.
  • Stick to a script. Get everyone on the same page, and keep family discussions centered on getting your loved one the best possible care. 
  • Ask for tours. Visit the facilities on your shortlist to get a feel for where your loved one could spend the next phase of their life. Go both on your own and with your loved one.
Women visit while drinking coffee.

During and after a move

  • Make the move simple. Help with downsizing and packing if you can, and ensure arrangements are made for movers, estate sales and more. (Not sure where to start? Read our room-by-room tips for downsizing.)
  • Create a homey space. Encourage your loved one to choose some special items to bring with them to their new home, or select some for them. Personal items can often spark memories and send good memories flooding in.
  • Visit after move-in. Even if your loved one’s memory of your visits is fleeting, you may bring them great joy in the moment with your presence. Plus, you can speak with the care team in person and ensure your loved one is getting the care they need.
  • Seek support for yourself. There are plenty of dementia caregiver support groups out there, as well as therapists who can offer specialized one-on-one care for those coping with the transition from the outside looking in.

Around-the-clock memory support in Vi care centers

Nine of Vi’s 10 communities across the United States are Continuing Care Retirement Communities that offer residential memory support within our continuum of care.

In most CCRCs, including Vi communities, seniors start out in resort-style independent living residences. But they also have access to assisted living, skilled nursing and memory care on the same campus, often with little to no increase in monthly costs. 

Vi’s memory support facilities are staffed with licensed caregivers who are on site 24 hours a day, seven days a week. We take a collaborative approach to care across our entire continuum of care, including independent living. 

Our staff gets to know each resident over time and can discreetly monitor their cognitive function on an ongoing basis to ensure they’re getting the right level of care. In the care center, caregivers work with residents and their loved ones to shape a dynamic care plan. Vi’s specialized caregivers are invested in residents’ well-being and can help determine when it’s time for assisted living vs. memory care.

Our team understands both the informational and emotional complexities of memory care, and we’re here to answer your questions about memory support, including when it’s time for a memory care facility.

We’d love to talk to you about how our holistic approach to memory care fits into our CCRCs’ continuum of care

Reisberg, B., Ferris, S.H., de Leon, M.J., and Crook, T. The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 1982, 139: 1136-1139.