What is memory care in California, and what must a home provide?

What is memory care in California?

“Memory care” is a name, not a license. In California it means a licensed residential care facility for the elderly that cares for people with dementia. A home’s dementia program may cover the whole home or only part of it. Title 22 §87706(a)(1)(F)

Every home caring for a resident with dementia must follow Title 22’s dementia rules. They apply to residents diagnosed with dementia; mild cognitive impairment does not count as dementia under them. Title 22 §87705(a)

A home that advertises dementia care must also describe its program to anyone who asks. Health and Safety Code §1569.627

What must every home do for a resident with dementia?

• Train its staff in dementia care: hydration, nutrition, skin care, communication, activities, and daily help. Staff also learn to spot what can change behavior, such as dehydration or a urinary infection. Title 22 §87705(b)(1)
• Keep someone awake at night when needed. In a home for fewer than 16 residents, one staff member must be awake at night when a resident with dementia needs it. Title 22 §87705(b)(2) Homes of 16 to 100 residents already need one person awake every night. Title 22 §87415(a)
• Alert staff at the exits. A home must have an alarm or other alert on exits that a resident at risk of wandering could use. Title 22 §87705(d)
• Ask before tracking. Devices that alert staff or track a resident need the resident’s written approval, or their conservator’s, first. Title 22 §87705(c)

A home with no designation on file shows “not on file” on its page. Not on file is not a no — most homes have not yet been asked.

What must a home that advertises dementia care tell us?

A home that advertises dementia care must describe its program in writing to anyone who asks. Health and Safety Code §1569.627 Title 22 §87706(a)(3) The description covers its staff training, activities, the building, and what happens when a resident’s condition changes. Health and Safety Code §1569.627

That includes the conditions that would mean a resident has to move:

A home that stops advertising dementia care must tell residents in writing at least 30 days before. Title 22 §87706(b)(1)

Are the doors locked?

Some homes use doors that delay or lock to keep residents safe. The rules protect the resident’s rights:

• A door that delays exit must be approved in the home’s fire clearance. A resident who still wants to leave after staff try to redirect them must be allowed to, with staff. Title 22 §87705(e)
• With locked exterior doors or gates, the home keeps a paper for each resident. For a conserved resident it is a court order; for anyone else, their own signed consent. Title 22 §87705(f)(4)
• Residents must have space inside and outside to walk freely and safely. Title 22 §87705(f)(5)
• Locks and alarms never replace enough trained staff. Title 22 §87705(e) Title 22 §87705(f)(6)

How do families pay for memory care?

Mostly from income and savings. Medicare does not pay for long-term care. Medi-Cal’s Assisted Living Waiver may pay for care, not room and board, in participating homes in 15 counties. Medicare pays for hospice care where your family member lives, if they choose hospice.

No survey we found gives a California price for memory care, so we give none. Ask each home for its all-in monthly rate, and whether its dementia program costs more. Read Paying for care in California.

Can they stay if dementia progresses?

It depends on their needs and on the home. Dementia itself is no bar: any licensed home may care for a resident with dementia, under the rules above. Title 22 §87705(a) A home may give notice if a reappraisal finds a need it cannot meet. Title 22 §87224(a) Before the move, ask the home to put in writing what needs it cannot meet. Health and Safety Code §1569.269(a)(15)

Some health needs that can come with late dementia are on Title 22’s list a care home may not keep. The exception is hospice, in a home with the state’s hospice care waiver. Title 22 §87615(a) Title 22 §87616(c) Read Hospice in a care home.

What should we ask on a visit?

• Who is in the building at night, and are they awake?
• What dementia training do your caregivers have, and who gives it?
• May I see the written description of your dementia program?
• Are the doors locked or alarmed? How do residents get outside?
• What changes in their condition would mean they have to move?

Print them with the visit checklist.