Understanding Dementia Care

What Dementia Care Really Involves

Dementia care in a nursing home is not just “memory support.” It requires staffing, structure, training, and environmental design that reduce distress while preserving dignity.

Staffing & Training

Dementia care requires more than minimum staffing ratios.

What it includes:
Staff trained in redirection techniques, behavioral approaches, communication strategies, and non-pharmacologic interventions.

How to evaluate:
Ask how many staff are dementia-trained. Inquire about turnover rates. Observe how staff speak to residents — tone matters.

Supervision & Safety

Residents with dementia may experience wandering, confusion, agitation, or impaired judgment.

What it includes:
Secured units when appropriate, visual monitoring, structured routines, and clear environmental cues.

How to evaluate:
Ask how they prevent elopement. Observe if staff redirect calmly. Notice whether doors, hallways, and common areas feel organized and supervised.

Evaluating a Dementia Unit Effectively

Dementia care requires more than minimum staffing ratios.

Observe the Environment

Is it calm or chaotic?
Look for adequate lighting, minimal clutter, clear signage, and safe walking paths.

Watch Staff Interactions

Do staff kneel to eye level?
Do they redirect gently?
Are call lights answered promptly?

Behavioral & Medical Management

Behavior is communication in dementia. Medication should not be the first solution.

What it includes:
Care planning around triggers, sleep patterns, pain management, nutrition changes, and structured engagement.

How to evaluate:
Ask how they handle agitation. Review antipsychotic use rates. Look for individualized care plans, not generic behavior notes.

Review Care Planning

Care should evolve as cognition changes.

Ask:

• How often are care plans updated?

• Are families notified of behavioral changes?

• Who leads interdisciplinary meetings?

Ask About Nutrition & Weight Loss

Dementia often affects appetite and swallowing.

Ask:

• How do you monitor weight changes?

• What happens if intake declines?

• Do you offer adaptive utensils or finger foods?

• Dementia is progressive. Care needs increase over time.

• Not all facilities are equipped for advanced behavioral symptoms.

• Staffing consistency matters more than décor.

• A calm unit is usually the result of strong leadership and adequate staffing — not luck.

• The best dementia care feels structured, predictable, and respectful.

Important Realities to Know

• Medicare Nursing Home Compare: Review staffing and antipsychotic usage rates

• Your State Survey Agency: Inspection reports and complaint findings

• Long-Term Care Ombudsman: Advocacy and resident support

• Alzheimer’s Association: Education on stages and progression

Additional Resources