Questions to Ask a Memory Care Facility: A Tour Checklist for Families

The most important questions to ask a memory care facility are not about the lobby, the activity calendar, or the brochure. Ask about staffing, dementia training, care plans, night and weekend coverage, costs, discharge rules, and what happens when your person’s needs increase. Then watch the floor. A good memory care community should feel calm, personal, and alert — not just polished during a scheduled tour.

We toured six memory care communities before choosing one for my mother-in-law. By the third tour, I had stopped listening to the sales pitch and started watching the hallways.

That is the shift families need to make. A tour is not just a tour. It is a chance to see how the community treats people who are confused, tired, frightened, or moving slowly. The right questions help. Careful observation helps more.

Key takeaways

• Ask about staff-to-resident ratios during the day, overnight, and on weekends — not just “overall staffing.”
• Ask whether memory care aides are dedicated to memory care or float between assisted living and memory care.
• Get costs, level-of-care tiers, and discharge rules in writing before you sign anything.
• Watch how staff approach residents. Skilled dementia care is patient, respectful, and unhurried.
• Call the Long-Term Care Ombudsman and check inspection records before your first tour.
• Visit at least once outside the scheduled sales tour window.

What should you do before touring a memory care facility?

Before you tour, define what your person actually needs. The Alzheimer’s Foundation of America notes that memory care is usually for people whose dementia needs have moved beyond what standard assisted living or family caregiving can safely provide. That distinction matters because memory care should offer secure space, dementia-trained staff, structured engagement, and more supervision than general assisted living.

Write down your person’s current needs before you walk into a building:

• Do they wander, seek exits, or get lost?
• Do they need help bathing, dressing, toileting, eating, or transferring?
• Do they become anxious, agitated, suspicious, or aggressive?
• Do they need medication management, diabetes care, wound care, or other clinical support?
• Are falls, nighttime confusion, or incontinence part of daily life?
• Do they need 24-hour supervision?

Do this first because the community’s answer to every question depends on the level of care your person needs now — and the level they will likely need later.

Also call people who see these communities from the inside but have no financial stake in where your parent moves.

Start with the Long-Term Care Ombudsman. Ombudsmen are resident advocates who investigate complaints and understand patterns across long-term care communities. They may not say, “Choose this one.” But they can tell you what kinds of complaints have come up and what to watch for.

Ask:

• “Have there been complaints about these communities in the past two years?”
• “What types of problems do families report most often?”
• “If you were touring memory care, what would you pay attention to?”

Then check the inspection record. In Virginia, assisted living and memory care inspection reports are searchable through the Virginia Department of Social Services. The question is not whether a community has ever been cited. Most have. The question is whether the same issues repeat: staffing problems, medication errors, safety incidents, or failures to correct prior violations.

What should you ask about staffing and dementia training?

Staffing is the heart of memory care. A beautiful building with thin staffing is still thin staffing.

Ask these questions directly:

• Are memory care aides dedicated to memory care, or do they float between memory care and assisted living?
• What is the staff-to-resident ratio during the day?
• What is the ratio overnight?
• What is the ratio on weekends?
• How many people are on the floor during meals, bathing, and shift changes?
• What is the annual turnover rate for memory care staff specifically?
• How long have the executive director and director of nursing been here?
• Are staff trained in dementia-specific communication, redirection, and de-escalation?
• How often does training repeat?
• Do housekeepers, dining staff, and front desk staff receive dementia training too?

The Alzheimer’s Foundation of America recommends asking how staff are trained to manage dementia behaviors such as distress, anger, and aggression. That is exactly right. The question is not whether the staff “care.” Most do. The question is whether the organization gives them the training, time, and stability to care well.

Watch for this during the tour:

• Do staff approach residents from the front and at eye level?
• Do they speak to residents like adults?
• Do they redirect gently instead of correcting or arguing?
• Do they slow down when a resident needs more processing time?
• Do they know residents by name and preference?
• Are residents doing things where they are able, or are things simply being done to them?

Before your first tour, watch a few Teepa Snow Positive Approach to Care videos. Her demonstrations make good dementia care visible: approaching from the front, offering a hand, matching the person’s pace, and responding to the feeling behind the words. Once you see it, you can spot the difference between skilled care and rushed task completion.

What should you ask about safety and the physical environment?

Memory care safety is more than locked doors. A secure community should reduce wandering risk, prevent falls, support wayfinding, and feel calm enough for someone with dementia to live there. The 2024 CDC STEADI fall-prevention materials are a useful reminder that falls are not random events; good environments reduce risk through lighting, footwear, mobility support, medication review, and safer movement patterns.

Ask:

• Is the memory care area secured with alarms, keypads, or monitored exits?
• When was the last time a resident left the secured area without authorization?
• What changed after that incident?
• Are outdoor spaces enclosed and accessible?
• Are hallways easy to navigate?
• Are rooms, dining areas, and bathrooms clearly marked?
• Are there grab bars, low thresholds, non-slip floors, and good lighting?
• What happens during a power outage, severe weather event, or evacuation?
• Is a nurse on site 24/7? If not, what are the nursing hours?
• What medical support is available on site?

The answer to “Has anyone ever eloped?” may be yes. That does not automatically disqualify a community. What matters is whether they are honest, whether they documented the incident, and whether they changed the system afterward.

Also pay attention to the layout. Some communities are designed in small pods or households, with their own dining table, living room, and familiar walking loop. Others are long corridors with a large common room in the middle. A grand lobby may impress adult children. It may do very little for a person with dementia trying to find breakfast.

The question is: does this place help residents orient themselves, or does it ask them to adapt to a confusing building every day?

What should you ask about care plans and changing needs?

Dementia is progressive. You are not choosing care only for what your person needs today. You are choosing the place that may need to care for them after a fall, after incontinence begins, after agitation increases, after they need two-person assistance, or after hospice becomes appropriate.

Ask:

• Does every resident have an individualized care plan?
• Who creates the care plan?
• How is family input included?
• How often is the care plan reviewed?
• What triggers an immediate reassessment?
• Can I see a sample care plan?
• How do you document changes in behavior, appetite, sleep, mobility, and medication response?
• How are families notified when needs change?
• What happens if my person needs more help than they need today?

Ask about level-of-care assessments too. These assessments often determine pricing tiers. Every community uses its own system. Get the full spread in writing: the lowest tier, the highest tier, what each tier includes, and what would move your person from one tier to another.

This is where families get surprised. The quoted monthly rate is not always the rate they end up paying six months later.

What should you ask about daily life, activities, and meals?

Activities matter because people with dementia still need purpose, rhythm, movement, pleasure, and connection. The goal is not to keep people busy. The goal is to help them live a day that still feels like a day.

Ask:

• What does a typical weekday look like?
• What does a typical Saturday look like?
• How are activities adapted for different stages of dementia?
• Do residents have options for quiet one-on-one engagement?
• How do staff encourage participation without forcing it?
• Do you offer music, art, reminiscence, movement, gardening, cooking, or sensory activities?
• Can I see this week’s actual activity schedule?
• How much time do residents spend in their rooms?
• Are residents grouped by cognitive or functional level?

Ask about meals with the same specificity:

• How many meals and snacks are provided each day?
• Can residents eat in a dining room, in a small group, or privately?
• How do staff help residents who forget to eat or need cueing?
• Are adaptive utensils available?
• How do you handle weight loss, swallowing concerns, diabetes, or special diets?
• Can families join for meals?

During the tour, watch meal service if you can. Meals reveal a lot. Are residents rushed? Is anyone sitting without help? Do staff notice when someone is struggling? Does the room feel chaotic or calm?

What should you ask about family communication?

A good memory care community should not disappear the family once the move-in paperwork is signed. Your role changes after move-in, but it does not end.

Ask:

• Who is our primary point of contact?
• How often will we receive updates?
• How are medication changes communicated?
• How are falls, behavior changes, infections, or weight loss reported?
• How often are care conferences held?
• Can family members attend activities or meals?
• Are there family support groups or education sessions?
• What is the process if we have a concern?
• Who resolves problems when floor staff and management give different answers?

Also ask the executive director how issues are handled. Not “Do families ever complain?” They do. Ask: “When a family raises a concern, what happens next?”

That answer tells you whether problems are treated as threats to manage or signals to fix.

What should you ask about costs and contracts?

The contract is the relationship. Do not compare brochures to brochures. Compare contracts to contracts.

Ask:

• What is included in the base monthly rate?
• What is charged separately?
• Are personal care supplies included?
• Are medication management, incontinence care, escorts, showers, laundry, transportation, or special diets extra?
• Is there a community fee, move-in fee, or deposit?
• How often do rates increase?
• What is the maximum annual increase?
• How does level-of-care pricing work?
• What is the current range from lowest to highest level of care?
• Can we bring in private-duty aides if needs increase?
• Does the community accept Medicaid now or in the future?
• What happens if funds run out?

Medicare generally does not pay for room and board in assisted living or memory care. It may cover eligible medical services, but not the residential cost of living there. Medicaid rules vary by state and by community. Ask early, and get the answer in writing.

What is the most important question to ask a memory care facility?

The most important question is this: What would require my person to leave this community?

Ask it exactly that way.

Then ask follow-ups:

• Can you manage two-person transfers?
• Can you manage wheelchair dependence?
• Can you manage incontinence?
• Can you manage aggression or exit-seeking?
• Can hospice come in here?
• Can we hire private aides to supplement care?
• How much notice do you give before discharge?
• Who decides that a resident’s needs exceed what you can provide?
• Can I see the discharge policy in writing?

An unexpected move for someone with dementia is not a logistical inconvenience. It can be devastating. Families need to know the limits before they sign.

What should you observe during the tour?

Observation tells you what the sales presentation cannot.

During the tour, look for:

• Residents who are awake, engaged, and treated with respect.
• Staff who speak calmly and use residents’ names.
• Aides who notice small needs before they become problems.
• Meals that are supported, not rushed.
• Common areas that feel lived in, not staged.
• Hallways that are easy to navigate.
• Residents who can move safely without being over-restricted.
• A calm response when someone is confused or upset.

Red flags include:

• Residents sitting unattended for long periods.
• Staff correcting, scolding, or talking over residents.
• Strong odor that suggests poor continence care.
• No visible staff in common areas.
• A tour guide who cannot answer staffing or cost questions directly.
• Vague answers about discharge, reassessment, or added fees.
• A beautiful front lobby and a neglected memory care wing.

Trust your instincts, but do not rely on instincts alone. Write down what you saw in the parking lot before you drive away. After three tours, the details blur.

Should you visit more than once?

Yes. Visit once during the scheduled tour. Then visit again at a different time.

Try a weeknight, a weekend morning, or a mealtime. You are not sneaking in. You will sign in and follow the rules. But you will see a more realistic version of the community when the sales team is not controlling the pace.

Ask to speak with the evening nurse or a floor aide if appropriate. They often understand the real culture better than anyone in the front office.

How should you compare memory care communities after touring?

Use three comparisons.

First, compare contracts to contracts. What is included? What is extra? What triggers a higher care tier? What requires discharge?

Second, compare observations to observations. Which community had staff who knew residents? Which one felt calm? Which one had residents doing things instead of waiting through the day?

Third, compare current leadership to current leadership. A community’s reputation from five years ago may not match the building today. Executive directors, nursing directors, and ownership changes matter.

Do not choose based on the nicest lobby. Choose based on the care your person will receive on an ordinary Tuesday night when no one is touring.

Memory care tour checklist

Bring this list on every tour.

Before the tour

• [ ] Call the Long-Term Care Ombudsman.
• [ ] Check state inspection records.
• [ ] Write down your person’s current care needs.
• [ ] List wandering, falls, agitation, toileting, mobility, and medical needs.
• [ ] Watch a few dementia care training videos so you know what good care looks like.
• [ ] Look up staff reviews on Glassdoor or Indeed for patterns of turnover or short-staffing.

During the tour: ask

• [ ] Are memory care aides dedicated or floating?
• [ ] What is the staff-to-resident ratio by shift?
• [ ] What is the memory care staff turnover rate?
• [ ] What dementia training does every staff member receive?
• [ ] Is a nurse on site 24/7?
• [ ] How often are care plans reviewed?
• [ ] What does a typical Saturday look like?
• [ ] What happens when a resident becomes agitated?
• [ ] When was the last elopement incident, and what changed afterward?
• [ ] What is included in the base rate?
• [ ] What costs extra?
• [ ] What would require my person to leave?

During the tour: observe

• [ ] Do staff approach residents from the front and at eye level?
• [ ] Do staff speak to residents like adults?
• [ ] Are residents engaged?
• [ ] Are meals calm and supported?
• [ ] Does the building support wayfinding?
• [ ] Are outdoor spaces secure and accessible?
• [ ] Do staff know residents by name and preference?
• [ ] Does the memory care area feel like a home or an institution?

After the tour

• [ ] Write notes before leaving the parking lot.
• [ ] Visit again at a different time.
• [ ] Compare contracts line by line.
• [ ] Compare discharge policies.
• [ ] Compare level-of-care tiers.
• [ ] Ask for anything unclear in writing.
• [ ] Put your name on waitlists earlier than feels necessary.

What if you are comparing memory care with care at home?

If your family is weighing memory care against in-home support, Alula Connect can help you understand what care at home would actually require — staffing, schedule, cost, and backup coverage — before you make a facility decision. Learn more about finding a caregiver through Alula Connect.