When Should You Consider Memory Care for a Patient With Dementia?
Last Updated: November 2025
When cognitive decline, daily living challenges or safety concerns escalate, Dr. Jessica Knape of HealthSpan Internal Medicine in Boulder, CO outlines when transitioning to memory care becomes critical
Overview
Memory care becomes necessary when safety, medication management, or daily functioning can no longer be maintained at home.
Warning signs include wandering, missed medications, kitchen or driving hazards, personality changes, or caregiver burnout.
Early transition—before crisis—helps preserve comfort and reduce trauma.
Medical evaluation can help determine the right timing and level of care (home support, assisted living, or memory care).
HealthSpan Internal Medicine helps families navigate both medical and emotional aspects of this decision.
Key Points
Dementia is progressive; care needs increase over time.
Early planning prevents safety emergencies and caregiver exhaustion.
Medical, behavioral, and environmental factors all guide the right timing.
Transitioning before severe decline supports smoother adjustment and better outcomes.
Ongoing medical management and emotional support are essential even after placement.
Summary
Deciding when to move a loved one—or yourself—into memory care is one of the hardest decisions families face. Dementia progresses gradually, and early on, many people can live safely and independently with the right support. But as memory, judgment, and self-care decline, specialized care becomes essential for safety, health, and quality of life.
At HealthSpan Internal Medicine in Boulder, CO, we guide families through this transition with empathy, medical insight, and a focus on preserving dignity and connection at every stage of cognitive change
Understanding Dementia Progression
Dementia typically unfolds in stages, from mild cognitive impairment (MCI) to moderate and then severe disease.
Early Stage (Mild): Subtle memory lapses, getting lost in familiar places, difficulty managing finances or appointments.
Middle Stage (Moderate): Confusion about time and place, repetitive questioning, withdrawal, or mood changes.
Late Stage (Severe): Dependency in daily activities, trouble recognizing loved ones, difficulty eating, walking, or communicating.
Memory care isn’t needed for everyone at the same time—but it becomes crucial once cognitive, behavioral, or safety issues outgrow the support that can be provided at home.
Signs It May Be Time to Consider Memory Care
You may need to explore memory care options if you notice:
1. Safety Concerns
Wandering or getting lost outside the home.
Forgetting to turn off the stove, lock doors, or take medications.
Increased falls or unexplained bruises.
Unsafe driving or traffic accidents.
2. Health and Hygiene Changes
Skipping meals or major weight loss.
Dehydration or medication errors.
Decline in bathing, grooming, or clothing choices.
Incontinence that’s difficult to manage at home.
3. Behavioral or Psychological Symptoms
Agitation, paranoia, or aggression.
Nighttime wandering or “sundowning.”
Hallucinations or frequent confusion.
Withdrawal or depression that worsens with isolation.
4. Caregiver Burnout
Family or primary caregivers are exhausted, anxious, or unwell.
The home environment feels unsafe or emotionally strained.
Constant supervision is needed, making independent living unsustainable.
If two or more of these categories are present, it’s time for a medical evaluation and care planning discussion.
How Medical Evaluation Guides the Decision
At HealthSpan Internal Medicine, we help determine when memory care is appropriate by assessing:
1. Cognitive Function
Testing (e.g., MoCA or SLUMS) tracks memory, attention, and problem-solving.
Comparing current scores with prior results shows progression over time.
2. Functional Independence
Assessing activities of daily living (ADLs): bathing, dressing, eating, and toileting.
Evaluating instrumental ADLs: managing finances, cooking, and medication adherence.
3. Medical Stability
Identifying treatable contributors to decline (infection, dehydration, medication side effects, thyroid or B12 issues).
Coordinating ongoing management for diabetes, heart disease, and depression.
4. Behavioral and Safety Risk
Screening for agitation, wandering, or caregiver strain.
Reviewing home safety modifications and support systems.
This evaluation allows families to make informed, confident decisions about timing and level of care.
Levels of Care: What to Know
Home with Support:
Early-stage dementia may be managed at home with structured routines, medication reminders, and part-time caregivers.Assisted Living with Memory Support:
For moderate impairment, specialized assisted living communities provide supervision, meals, and social activities designed for cognitive health.Dedicated Memory Care Units:
These facilities offer 24-hour supervision, staff trained in dementia behaviors, secure environments to prevent wandering, and personalized activities.Skilled Nursing or Hospice Care:
For late-stage dementia, when full assistance and medical monitoring are needed, skilled care or hospice focuses on comfort and dignity.
Transitioning earlier—while the patient can still form relationships with staff and adapt to the environment—usually results in a smoother adjustment and less anxiety.
Emotional and Family Considerations
The emotional side of moving a loved one into memory care is often harder than the practical side. Families experience grief, guilt, and uncertainty.
It helps to remember:
You’re ensuring safety and comfort, not abandoning them.
Memory care environments provide structure, social engagement, and medical oversight that’s impossible to replicate at home 24/7.
You can remain involved through visits, personal touches, and advocacy.
Caregiver counseling or support groups can make this transition less isolating and more manageable.
How HealthSpan Internal Medicine Supports Families
We partner with families throughout the dementia journey by providing:
Comprehensive cognitive and medical assessments.
Identification of reversible causes of decline (e.g., sleep apnea, medication, infections).
Coordination with local memory care facilities and geriatric specialists.
Ongoing management of sleep, nutrition, behavior, and mood.
Education and support for caregivers navigating the transition.
Our approach emphasizes compassion, clear communication, and evidence-based guidance at every step.
When to Start Planning
Ideally, begin exploring memory care options early—before a crisis occurs.
Signs that it’s time to start planning include:
A new diagnosis of moderate dementia.
Increasing caregiver stress or safety incidents.
Medical providers noting decline despite home support.
Early tours and discussions give families time to find the right environment without pressure.
Sources
WebMD: 8 Signs It’s Time for Memory Care — https://www.webmd.com/alzheimers/signs-time-memory-care WebMD
Alzheimer’s Society (UK): Care options: When is the right time to move someone into a care home — https://www.alzheimers.org.uk/get-support/help-dementia-care/care-homes-who-decides-when Alzheimer's Society
Harvard Health Publishing: Memory care: A senior living option for those with dementia or Alzheimer’s disease — https://www.health.harvard.edu/mind-and-mood/memory-care-a-senior-living-option-for-those-with-dementia-or-alzheimers-disease Harvard Health
River Oaks Memory Care blog: Expert Tips to Know When Is It Time for Memory Care — https://riveroaksmi.com/when-is-it-time-for-memory-care/ River Oaks
A Place for Mom: Signs It’s Time for Memory Care — https://www.aplaceformom.com/caregiver-resources/articles/is-it-time-for-memory-care
Medically reviewed by
Dr. Jessica Knape, MD, MA Board Certified in Internal Medicine and Integrative and Holistic Medicine
Healthspan Internal Medicine — serving patients in Boulder, CO
Book a Discovery Call | About Dr. Knape
This content is for educational purposes and does not replace personalized medical advice.
