Memory Care at Home vs. a Memory Care Facility

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What each option is

Memory care at home means a person with dementia stays in their own home while trained caregivers come in to help. With non-medical home care, our caregivers help with personal care such as bathing, dressing and toileting, meals, medication reminders, companionship, supervision and light housekeeping. Care can be a few hours at a time, long day or overnight shifts, or 24-hour care with caregivers scheduled in shifts around the clock.

A memory care community is a residential setting designed for people living with dementia. The Alzheimer's Association describes memory care (also called special care units) as settings that can exist within assisted living and other residential communities, and says they may or may not be locked or secured. In California, Alzheimer's San Diego explains that memory care communities are a specialized type of assisted living licensed and regulated by the California Department of Social Services. According to the National Institute on Aging, assisted living residents usually have their own room or apartment, share common areas, and have meals, help with personal care, social activities and staff on site around the clock.

Medical questions belong with your loved one's doctor.

What changes for the person living with dementia

The biggest differences usually come down to setting, routine and attention:

• Surroundings. At home, the person stays with their own bed, kitchen, chair, garden and neighborhood. In a community, they move to a new room, often with familiar belongings brought along, and shared spaces designed for safety.

• Routine. At home, the day can follow the person's lifelong habits: when they wake, what they eat, the walk they like. A community follows its own daily schedule, with meals and activities at set times and some flexibility depending on the setting.

• Attention. At home, one of our caregivers is with your loved one one-to-one during the shift. In a community, staff care for a group of residents, and there are other people around for company.

• Social life. Communities offer group activities and other residents to spend time with. At home, social time looks more like family visits, outings and activities a caregiver plans around what the person enjoys.

• Overnight. Communities have staff on site around the clock. At home, nights are covered by family or by an overnight caregiver who stays awake and ready to help.

Questions that help families decide

The Alzheimer's Association suggests families ask themselves a few honest questions when thinking about a move. These are the same ones we talk through at a free assessment:

• Can the home be made safe? Think about stairs, bathrooms, the stove, pools, and doors to the street. A walk-through can show what's workable.

• Is wandering a concern? If your loved one tries to leave, especially at night, ask whether a caregiver in the home plus door alerts would cover it, or whether a secured setting is needed. See our page on dementia wandering supervision.

• What are nights like? Sundowning and frequent waking are often what wear families down first.

• How is the family caregiver doing? If you're exhausted, your own health is slipping, or you're stretched thin at work and at home, that matters just as much as your loved one's needs.

• What does the person need beyond daily help? If needs are mostly supervision and personal care, home care may cover them. If the doctor says your loved one needs more than non-medical care, plan around that.

• What would they want? Some people have always said they want to stay home. Others enjoy company and structure. Their wishes and personality belong in the decision.

When staying home often works well

Care at home tends to fit when:

• The home can be set up safely, or already is

• Your loved one is calmer in familiar surroundings and follows a long-held routine

• Their needs are non-medical: supervision, personal care, meals, reminders and companionship

• Family wants to stay closely involved and can help coordinate care

Many families start with a few shifts a week and add hours as dementia progresses. Learn more about 24-hour dementia care at home and our Alzheimer's and dementia care.

When a memory care community may be the right fit

A move can be the right, loving choice. A memory care community may fit when:

• The home can't be made safe, even with changes and a caregiver present

• Wandering or exit-seeking calls for a secured setting

• Your loved one needs more than non-medical care can provide, as advised by their doctor

• The family can't sustain care at home, physically, emotionally or in other ways

• Your loved one is lonely at home and would enjoy the company and structure of a group setting

If you're leaning this way, the Alzheimer's Association and Alzheimer's San Diego both suggest visiting several communities, going at different times of day, and asking about staffing, dementia training, activities and how they handle changing needs. Alzheimer's San Diego offers free guidance at 858-492-4400. Feeling guilt or doubt is common, and it doesn't mean you're making the wrong choice.

Try care at home before deciding

You don't have to decide everything at once. Some families use care at home as a trial, or as a bridge while they tour communities:

• Start with respite care: a few 4-hour visits, a full day or a weekend so the family caregiver can rest

• Add overnight shifts a few nights a week and see how nights go with a caregiver awake in the home

• Try longer shifts of 8 to 12 hours to cover the hardest part of the day

• Move to 24-hour coverage with caregivers scheduled in shifts around the clock if needs grow

How our shifts work

• Shift lengths from 8 to 24 hours, plus overnight shifts, for families focused on dementia care

• 24-hour coverage built from scheduled shifts, with caregivers rotating so someone is always awake and ready to help

• A 4-hour visit minimum for shorter visits and respite

• No long-term contracts, so you can add hours, cut back or pause care

• One written care plan that every caregiver on the schedule follows

• A consistent team: we work to keep the same small group of caregivers on the schedule, because familiar faces matter

Our caregivers are W-2 employees of Heritage Senior Care, Inc. We hire, train, schedule and supervise them ourselves. Gayle Mayben founded Heritage Senior Care in 1983, and we're still family-owned today. Our care is non-medical. We do not provide nursing or medical treatment.

Where we provide dementia care at home

All scheduling is handled from our one office at 2111 Palomar Airport Road in Carlsbad, and our caregivers work in homes across North County San Diego. City pages: Carlsbad, Encinitas, Escondido, Vista, Poway and Rancho Bernardo.

Questions to ask when choosing between home care and memory care

What is the difference between memory care at home and a memory care facility?

With memory care at home, your loved one stays in their own home and caregivers come in for scheduled shifts, from a few hours up to 24-hour coverage. A memory care community is a residential setting for people with dementia, usually with private or shared rooms, group activities and staff on site around the clock.

Is in-home memory care the same as assisted living?

No. Assisted living is a residential community where people move in and get help with daily tasks. In California, memory care communities are a specialized type of assisted living. In-home care brings non-medical help to the person's own home instead.

Is home care or a memory care community the right choice for my parent?

It depends on safety at home, wandering, what nights are like, how the family caregiver is holding up, and what your parent would want. Many families find one fits at one stage and the other later. A free assessment can help.

Can someone with dementia get 24-hour care at home?

Yes. We provide 24-hour coverage with our caregivers scheduled in shifts around the clock, so someone is always awake and ready to help. See 24-hour dementia care at home.

When is it time to consider a memory care community?

When the home can't be made safe, when wandering calls for a secured setting, when your loved one needs more than non-medical care, or when the family can't sustain care at home. Talk with the doctor about medical needs.

Do your caregivers provide medical or nursing care?

No. Our care is non-medical. Our caregivers help with personal care, meals, supervision, companionship and medication reminders. They can work alongside a home health or hospice team.

Can we try care at home before deciding on a move?

Yes. Many families start with respite visits, overnight shifts or a few long day shifts and see how things go. Visits have a 4-hour minimum, and there are no long-term contracts.

Who are your caregivers?

Our caregivers are W-2 employees of Heritage Senior Care, Inc. We hire, train, schedule and supervise them ourselves, and every caregiver follows a written care plan built around your loved one's routines.

What happens during the free assessment?

We meet you and your loved one at home, walk through the house for safety, and talk about daily routines, nights, wandering and how many hours of help you need. Then we put together a care plan. Call (760) 720-7740, available 24/7, or request a free assessment. You can also send us a note.

Honest help deciding what's next, from a family that has been doing this since 1983. Free assessment · (760) 720-7740 (24/7) · Office Mon–Fri 9 am–4 pm · 2111 Palomar Airport Rd Ste 120, Carlsbad, CA 92011