Questions to Ask a Memory Care Facility: What I Learned Touring Six Communities

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.

If you are trying to figure out how to choose a memory care facility, here is what I wish someone had told me before our first tour: the most valuable information will not come from a brochure or a sales coordinator. It will come from the people who work inside these buildings every day and from a few minutes of careful observation on the floor.

A note on language: the industry still calls these places "facilities," and that is what most families type into Google when they start searching. Throughout this article, we use "community" instead. People live in communities, not facilities. They live in homes, not units. The language matters because it reflects how we think about the people inside — and how the people running these places think about them, too.

This article covers two things: what to watch for when you visit, and where to find the people who will give you the real story.

Start with the people who know: Finding trusted local experts

Before you tour a single community, talk to the people who see these buildings from the inside — but who have no financial stake in where your parent moves.

This was the most useful thing we did during our search, and I wish we had done it earlier. A single conversation with the right person will tell you more than a dozen glossy brochures.

The Long-Term Care Ombudsman

The ombudsman is a state-appointed advocate for residents of long-term care communities. They investigate complaints, mediate disputes, and know which communities have patterns of problems. In Virginia, the program operates through the Department for Aging and Rehabilitative Services. Call them before your first tour.

They cannot tell you "Community A is better than Community B." But they can answer questions like:

• "We're looking at three communities in our area. Can you tell me whether any of them have had complaints filed in the past two years, and what the general nature of those complaints was?"
• "What kinds of issues do you see most often in memory care communities in our area?"
• "If I were touring a community for the first time, what would you tell me to pay attention to?"

An ombudsman told me something early in our search that reframed how I thought about all of this:

That stuck with me. Every community will have problems. What separates a good one from a bad one is what happens next.

Hospice agencies

Hospice nurses and aides are in and out of these communities every day, serving their own patients. They see the building at 7 AM and at 9 PM. They see it on weekends. They know which communities are well run and which ones struggle, and they have no financial interest in where your parent lives.

They also have professional boundaries. But they can answer questions like:

• "My mother has dementia and we are looking at memory care. Based on what you have seen, what should I be looking for when I tour?"
• "Are there communities in the area where you feel like your hospice patients are particularly well cared for?"
• "What is the biggest difference you notice between well-run communities and ones that struggle?"

Most hospice workers I have talked to will give you more useful information in ten minutes than a sales team will give you in an hour.

Local dementia support groups

If there is a dementia caregiver support group in your area — through the Alzheimer's Association, a local church, or a hospital system — go. The people in that room are living this. Some of them have parents or spouses in the exact communities you are evaluating. They do not have professional boundaries. They will tell you things the brochure will not.

Online caregiver communities

Dementia-focused groups on Facebook and Reddit in your region often have threads where caregivers share experiences with specific communities. Take any single review with a grain of salt — online forums tend to attract the best and worst experiences. What you are looking for is patterns over time. If multiple people over multiple years are describing the same problems — high turnover, poor communication, medication issues — that is not one person having a bad day. That is the culture.

Glassdoor and Indeed reviews

This is one most families never think of: look up the community as an employer. What do current and former staff say about working there? High employee ratings usually correlate with better care. If the reviews describe chaotic management, constant short-staffing, or leadership that does not listen — those are the people taking care of your parent.

What to observe on your tour

When you visit a memory care community, the scheduled tour will show you the building at its best. That is normal — every organization puts its best foot forward when someone is watching. Your job is to look past the presentation and pay attention to the care.

Before your first tour, spend twenty minutes calibrating your eye. Teepa Snow's free videos on her Positive Approach to Care YouTube channel are the most accessible starting point. Her demonstrations make the universal principles of good dementia care visible and concrete:

• **Dementia 101** — What is actually happening in the brain. Watch this first.
• **Using Hand-under-Hand to Assist with Getting Dressed** — What respectful, skilled physical assistance looks like.
• **Challenging Behaviors and Dementia** — How trained staff respond to agitation and resistance.
• **Meaningful Activities and Dementia** — What real engagement looks like.

Whether a community teaches Teepa Snow's Positive Approach to Care, Naomi Feil's Validation Therapy, Montessori-based programming, or Tom Kitwood's person-centered care model, the same things show up on the floor when the training is working. For more on what a geriatrician looks for during a memory care evaluation, read what a geriatrician looks for in memory care. You do not need to evaluate each of these individually. Watch the staff for ten or fifteen minutes and form an overall impression. The question you are trying to answer is: do the people who work here treat residents as whole people who are still here, still feeling, and still capable of more than you might assume?

Do staff approach residents from the front, at eye level? A person with dementia can be startled by someone appearing suddenly from behind or above. Trained staff make themselves known before making physical contact. They offer a hand before reaching for someone. When you see it, it looks natural and unhurried.

Do staff speak to residents like adults? Are they patient when a resident asks the same question for the fifth time? Do they redirect gently when someone is confused, or do they correct them? Every major dementia care framework agrees on this: meet the person in their reality, respond to the feeling behind the words, and never argue about facts. A trained caregiver who hears "I want to go home" understands that the person is expressing loneliness or fear — and responds to that, not to the geography.

Do staff match the resident's pace? Dementia care done right is slow. The person needs time to process what is happening, to participate in their own care where they can. If staff are rushing residents through meals or transitions, that is efficiency, not care.

Are residents doing things, or having things done to them? This is the one most people miss. Good dementia care means letting residents do things for themselves when they are still able to — feeding themselves, walking independently, making choices. It is slower. But every credible dementia care framework agrees that preserving autonomy and function is a core principle.

Are residents engaged? Look at what residents are actually doing. Are people involved in activities that seem meaningful — conversation, art, music, small tasks? Or are they sitting in a semicircle in front of a television with nobody talking? The specific programming approach matters less than the result: are people here living their day, or waiting through it?

Do staff know residents as individuals? Do aides call people by name — their preferred name, not "sweetie" or "honey"? Can a caregiver tell you something specific about a resident's preferences, background, or routine? When staff know their residents, care is tailored. When they do not, it is one-size-fits-all.

The inspection record tells a story

Every state inspects memory care communities. In Virginia, that is the Department of Social Services under 22VAC40-73. These inspection results are public — you can search them by community name or locality.

The question is not whether a community has ever been cited. Every community has been cited for something. The question is: what pattern do the citations show?

A community that received a minor documentation citation three years ago and nothing since is probably fine. A community with a pattern of staffing violations, safety incidents, or repeated findings on the same issue — that tells you something about how the organization responds to problems. Look at whether issues get resolved or whether they recur.

Virginia's staffing minimums for memory care are already low:

• 20 or fewer residents: at least 2 direct care staff
• 23–32 residents: at least 3
• 33–40 residents: at least 4

Those are minimums. If a community has been cited for not meeting minimums that are already this low, that tells you something important.

Questions to ask a memory care facility during your tour

Observation tells you more than interrogation. But there are things you genuinely need to ask because you cannot see them:

• Are the memory care aides dedicated to memory care, or do they float between memory care and assisted living? This matters more than people realize. Dedicated aides build relationships with residents, learn their routines, and recognize changes in behavior. Staff who float are covering a shift. A resident with dementia who sees a different face every day is starting over every day.
• What is the staff-to-resident ratio during the day? At night? On weekends? Best practice daytime is 1:5 or 1:6. If they will not give you a number, that is your answer.
• What is the annual turnover rate for your memory care staff specifically? Not the overall community number — memory care specifically. Industry average for assisted living is around 40 percent, but memory care turnover can run higher because the work is harder. If they can only give you an overall number, they may not be tracking it at the memory care level.
• How long has your executive director been here? Your director of nursing? Leadership tenure and stability matter enormously in a community where frontline staff turn over regularly.
• Who owns this community? Privately owned, part of a regional chain, or owned by a private equity firm? This is context, not a disqualifier. Privately owned communities often have more flexibility. Larger organizations can bring resources and standardized training. The ownership structure will not tell you everything, but it tells you where the decisions are being made.
• Do you have onsite primary care or medical services? Some communities have affiliations with local healthcare organizations that bring primary care physicians or nurse practitioners directly to the residents. This is a significant quality-of-life advantage. Ask who provides it, how often they are onsite, and whether it is included or an additional cost.
• What exactly is included in the base rate, and what is extra? Get it in writing — a line-item list, not a brochure. The gap between the quoted rate and the actual monthly bill is larger than most people expect.
• How does your level-of-care assessment work? How often do you reassess? Every community uses different criteria. There is no standard. The assessment determines your pricing tier, and dementia only goes one direction. Ask what the spread is between their lowest and highest tier — it can be $3,000 to $5,500 per month.
• What does a typical Saturday look like? Not Tuesday. Saturday. This tells you whether the community staffs and programs for weekends or whether weekends are a different experience.
• How often do you review and update each resident's care plan? Good communities reassess regularly — every two to three months, or whenever there is a significant change in condition. If they only reassess annually or when families push for it, that tells you how closely they are paying attention.
• What happens when a resident becomes agitated? You want de-escalation and redirection, not medication as a first response.
• When was the last time a resident left the secured area without authorization? This happens. What matters is how the community responded and what they changed.
• What would require my person to leave this community? This might be the most important question on this list. You are not buying care for what your person needs today. You are buying it — or you think you are — for the remainder of their life. But every community has limits, and those limits are not standardized. Make them spell out what their highest level of care includes. Can they handle two-person assists? Hospice? Behavioral escalation? If your person's needs exceed their highest tier, can you bring in private-duty aides, or does your person have to leave? How much notice do they give? Get this in writing. An unexpected move for someone living with dementia is not an inconvenience. It is devastating.

Visit at different times

This is what the ombudsman and hospice workers we talked about earlier do every day. They see these communities at 7 AM and 9 PM, on weekdays and weekends, across months and years. They can spot patterns that no family touring two or three times will catch. That is why talking to them first matters so much — their perspective covers the ground you cannot.

That said, you can still get a fuller picture than a single scheduled tour will give you. After your visit, come back at a different time of day. A weeknight. A Saturday morning. When the sales coordinator is not guiding your attention.

You are not going in covertly. You will need to sign in and be let through the secure door. Just let them know you toured earlier and you would like to take another look at the common area, or that you had a few more questions. They will let you in.

What you are looking for is whether the community feels the same in different conditions — different staff, different energy, different time of day. Are residents being attended to? Is someone at the nursing station? Does the building feel calm?

And while you are there, talk to the people on the floor. The aides. The evening nurse. Most of them care deeply about the residents and will share perspectives you will not get from the front office. They do not have an agenda. They just do not often get asked.

How to actually compare communities

When you are evaluating multiple communities, the most important thing I can tell you: do not compare marketing materials to marketing materials. Every brochure looks good.

Compare contracts to contracts

Compare what is included and what is extra, line by line, in the actual agreements you will sign. Compare level-of-care tier pricing and reassessment schedules. Compare discharge policies. The contract is the relationship.

Compare observations to observations

What did you see the staff doing at Community A vs. Community B? Were the aides approaching residents correctly? Were residents engaged? Did staff know names?

Compare current leadership to current leadership

Do not compare what Community A was like three years ago to what Community B is like today. Leadership changes everything. If a community has new management, that is a factor you are evaluating in real time.

The only honest comparison is apples to apples: what is in the contract, what you observed with your own eyes, and who is running the place right now.

Memory care vs. assisted living: Know the difference

Within a residential setting, memory care differs from standard assisted living in several important ways:

• Security: Memory care is a secured environment — locked or alarmed to prevent residents from leaving unsupervised. Standard assisted living is not. This is a non-negotiable if your loved one wanders or is at risk of elopement.
• Staffing: Memory care should have higher staff-to-resident ratios and dementia-specific training requirements. Staff should be trained in de-escalation, redirection, and person-centered communication — not just general personal care.
• Programming: Memory care should offer structured cognitive engagement — Montessori-based activities, music therapy, reminiscence therapy, art programs, and sensory stimulation. The goal is maintaining function and quality of life, not just keeping residents safe. If the activity calendar looks like standard assisted living with bingo and movie nights, ask what makes their memory care programming different.
• Cost: Memory care typically runs 15 to 25 percent more than standard assisted living. The national median is roughly $5,300 to $6,900 per month, but level-of-care add-ons can push that significantly higher. Plan for the cost trajectory, not just the starting rate — dementia only progresses in one direction, and your pricing tier will move with it.

For a more detailed look at what distinguishes these care settings, read our guide to independent living, assisted living, and memory care.

If your parent has dementia and needs more than what home care can provide, you are looking at memory care, not general assisted living. The secured environment and specialized care are the whole point.

The building matters — but not the way you think

I want to tell you about the community we chose for my mother-in-law, because it illustrates something important.

The community is designed in small pods of eight residents. Each pod has its own dining table, kitchen, and living room. It feels like a home, not an institution. She built relationships in that pod quickly. She can get out of her room, walk around her pod, and if the larger activity area feels overwhelming — which happens with dementia — she can find her way back to a space that feels familiar and safe.

Other communities we toured were arranged as long corridors with rooms along the outside walls and one large common area in the middle. Some had grand lobbies with tall ceilings. Impressive to walk through on a tour. Less clear whether they felt like home to anyone living there.

The point is not that pods are the only good design. The point is that the physical environment shapes daily life in ways that matter enormously for someone with dementia — wayfinding, overstimulation, sense of belonging, ability to retreat. When you are touring, ask yourself: does this place feel like somewhere my parent could live?

Get on the waitlist before you think you are ready

Our search happened in crisis. My father-in-law broke his hip. My mother-in-law's dementia had progressed further than we realized — he had been covering for her, the way spouses often do when they are the primary caregiver. Suddenly memory care was an emergency. We had no time to research because we were simultaneously managing a hospital discharge for an 82-year-old man with Parkinson's.

We took the first available room. It did not work out. We moved her a couple of months later to the community she is in now — the one we actually chose instead of being forced into.

If you are even thinking about memory care — even if it feels too early — narrow it down to two or three communities and put your name on the waitlist. You will pay a deposit for each. A thousand dollars, maybe more. It is worth it. Because when the crisis comes, the cost of those deposits is nothing compared to the pain of having to take whatever is available.

The waitlist is not a commitment. It is an option.

After move-in: Your role changes, it does not end

I need to say something that nobody in the sales office will say: if you expect any memory care community to replicate the care you would provide at home, you will be disappointed.

The aides are not going to know that Mom likes her toast cut diagonally, or that she gets anxious when it rains. They are caring for a dozen people at once. They are doing their best within a system that does not give them enough time or enough pay. Some of them are extraordinary. None of them are you.

That is not a reason to avoid memory care. It is a reason to understand what your role becomes afterward.

You go from being the person who does everything to the person who makes sure everything gets done right. You become an advocate. You are watching the care plan, talking to the nurses, building relationships with the aides who work the shifts when your parent is most vulnerable. You are the one who notices when something changes and makes sure the right people know about it.

Your presence matters. The staff will rotate. You will not. The families who show up regularly and build relationships with staff get better outcomes. That is how organizations work.

A small thing that goes a long way: keep a candy bowl in your parent's room. Bring coffee for the night shift sometime. Drop off pizza on a weekend. These are people doing hard work for not enough money. A small, unexpected gesture builds the kind of relationship that helps your parent when you are not there. And if you start to feel like the weight of it is too much, read what we have written about recognizing and recovering from caregiver burnout. You cannot advocate for your person if you are running on empty.

Memory care tour checklist

Print this list and bring it on every tour. Fill it out in the parking lot before you drive away.

Before the tour:

• [ ] Talk to the Long-Term Care Ombudsman about complaint history
• [ ] Look up the community's inspection record (Virginia: dss.virginia.gov/facility/search/alf.cgi)
• [ ] Watch 2–3 Teepa Snow videos so you know what good dementia care looks like
• [ ] Check Glassdoor and Indeed reviews for the community as an employer

During the tour — observe:

• [ ] Do staff approach residents from the front, at eye level?
• [ ] Do staff speak to residents like adults and redirect gently?
• [ ] Are residents engaged in activities or sitting unattended?
• [ ] Can residents do things for themselves where they are able?
• [ ] Do staff know residents by name and preferences?
• [ ] Does the building feel like a home or an institution?

During the tour — ask:

• [ ] Are memory care aides dedicated, or do they float to assisted living?
• [ ] What is the staff-to-resident ratio — day, night, weekends?
• [ ] What is the annual turnover rate for memory care staff specifically?
• [ ] How long has the executive director been here? Director of nursing?
• [ ] Who owns this community?
• [ ] What is included in the base rate vs. what is extra? (Get it in writing.)
• [ ] How does the level-of-care assessment work? What is the tier spread?
• [ ] How often is each resident's care plan reviewed and updated?
• [ ] What does a typical Saturday look like?
• [ ] What happens when a resident becomes agitated?
• [ ] When was the last time a resident left the secured area without authorization?
• [ ] What would require my person to leave this community? (Get it in writing.)

After the tour:

• [ ] Visit at a different time — a weeknight, a weekend morning
• [ ] Talk to aides and evening staff
• [ ] Compare contracts line by line, not brochures
• [ ] Compare what you observed, not what you were told