Types of Care
Memory Care: What It Is, Who Pays and How to Find It
What Is Memory Care?
Memory care is long-term residential care for people living with Alzheimer's disease or another dementia, usually a secured unit or building inside an assisted living community or nursing home, with staff trained in dementia care. Each state writes its own rules: 23 states require a separate memory care license, certificate or endorsement, and most others set extra rules for any community that advertises dementia care. Medicare doesn't pay for it, so families pay privately or use long-term care insurance, a Medicaid waiver where the state allows one, or VA benefits.
What Memory Care Is and Who It Serves
Memory care is a place to live, with round-the-clock help, for a person whose dementia has made home unsafe or too much for family to manage. It’s usually a secured wing, floor or small building inside an assisted living community, and sometimes a unit inside a nursing home. Residents get meals, help with bathing, dressing and medicines, planned daily activities, and supervision from staff trained in dementia care.
The National Institute on Aging (NIA) puts it simply: some residential facilities offer special programs for people with Alzheimer’s disease and other types of dementia. What makes memory care different from the rest of the building is set by state law, and it usually comes down to four things:
- Secured exits so a resident who wanders can’t leave unnoticed, with outdoor space they can use safely.
- Dementia training for every staff member, beyond what regular assisted living requires.
- Staffing that keeps awake caregivers on the unit day and night.
- Activities planned for people with memory loss, often with an individual plan for each resident.
Memory care is not a hospital and not a treatment program. It doesn’t treat the disease itself. Its purpose is safety, comfort and a good daily life as needs grow.
Memory Care Rules Are Set State by State
There’s no single national memory care license. Each state decides what a community must do before it can call itself memory care, and the rules fall into three broad patterns.
A separate license, certificate or endorsement. Twenty-three states require one. Texas requires an Alzheimer’s certification for any assisted living facility that advertises Alzheimer’s care. Georgia certifies memory care centers. Oregon adds a memory care endorsement to the facility license. Washington has barred assisted living facilities from running a memory care unit without certification since July 1, 2026. Kentucky issues a separate Assisted Living Community with Dementia Care license, and New York requires Special Needs Assisted Living certification before a residence can market dementia services.
Extra rules and a disclosure for anyone who advertises dementia care. Many other states don’t issue a separate license but still set rules for special care units and require a written description of what the unit offers. California requires any residential care facility that advertises dementia care to disclose its special features and give that information to the public on request. Illinois requires disclosure under its Alzheimer’s Special Care Disclosure Act. Ohio requires a written special care unit policy covering staffing, costs, admission and discharge.
Rules in transition. Florida created a memory care services license in 2026. Until its rules take effect (the state must adopt them by June 1, 2027), facilities that advertise Alzheimer’s care must meet the existing staffing, activity and training rules and disclose the services that set their care apart.
| State | What it’s called | A few of the rules |
|---|---|---|
| Texas | Alzheimer’s Certification (Type B facility) | 4 hours of dementia orientation before any job; 16 hours of on-the-job training for direct care staff; 12 hours of Alzheimer’s in-service a year; a disclosure statement given to families |
| Georgia | Certified Memory Care Center | 1 dementia-trained direct care worker per 12 residents while awake and per 15 at night; 2 direct care staff on site at all times; 16 hours of dementia training in the first 30 days |
| Washington | Certified Memory Care | 24-hour awake caregivers, with one in each building or cottage; a fenced outdoor area of at least 25 square feet per resident; a posted staffing disclosure |
| Oregon | Memory Care Community endorsement | Ground-floor location; secured outdoor space residents can use without staff help; a uniform disclosure statement; the state and ombudsman told within 24 hours of an elopement |
| Tennessee | Secured unit | An awake attendant on the unit 24 hours a day; a team including a physician, a registered nurse and a family member evaluates each resident before admission and every quarter |
| California | Dementia special care disclosure | 40 hours of training for staff who give personal care, 12 of them on dementia, plus 20 hours a year; exit alarms on doors and gates |
Your state page summarizes the memory care rules where your parent lives, with the licensing agency and its facility search.
What State Rules Usually Require
The details differ, but the same building blocks show up again and again in state rules.
Dementia Training for Staff
Training hours are the most common requirement. Kentucky requires 8 hours of dementia orientation for everyone on a secured unit within 30 days and 16 hours of specialized training for direct care staff, then 8 hours every year. Illinois requires 4 hours of dementia orientation before staff work without supervision and 12 hours of in-service education a year. California’s training must cover the use and misuse of antipsychotic drugs and non-drug, person-centered approaches.
Secured Doors and Safe Outdoor Space
Wandering is one of the main reasons families choose memory care. NIA notes that many people with Alzheimer’s wander away from home and advises never leaving a person with a history of wandering unattended. State rules answer this with secured exits that still meet fire codes. Alabama requires a perimeter wall or fence at least six feet high, and its locks must release automatically on a fire alarm or power loss. California requires a court order or the resident’s own signed consent before a facility locks exterior doors.
Staffing Around the Clock
Most rules require awake staff at night, not just someone on call. Tennessee requires an awake attendant physically on the secured unit at all times. Washington requires awake caregivers in every building or cottage 24 hours a day.
Written Disclosure
Thirty-two states and the District of Columbia require a memory care unit to explain in writing what it offers: staffing, training, activities, the physical setting, admission and discharge rules and fees. Ask for this document on your first call. It’s the best way to compare two communities on the same terms.
Memory Care in Assisted Living vs a Nursing Home
Most memory care operates under an assisted living license, so it follows state rules. A secured dementia unit inside a nursing home follows state rules and federal ones. Federal rules require every certified nursing home to use a registered nurse at least 8 consecutive hours a day and to give each resident who has dementia the treatment and services needed to keep their highest practicable well-being.
The practical difference is medical care. If your parent needs daily skilled nursing, for example after a stroke or with complex medical conditions, a nursing home may fit better, and you can check its CMS ratings in the nursing home finder. CMS rates 5,766 nursing homes 4 or 5 stars overall (data from August 2026). For a deeper side-by-side, read memory care vs assisted living and assisted living vs nursing home.
When Memory Care Starts to Make Sense
Only a doctor can diagnose dementia or judge its stage. NIA’s description of the stages helps explain why needs grow over time.
- Mild stage. A person may seem healthy but has more trouble making sense of the world: getting lost, repeating questions, trouble paying bills. At this stage, help at home from family, in-home care or adult day care may be enough.
- Moderate stage. NIA says more intensive supervision and care become necessary. Wandering, restlessness in the late afternoon or evening, sleep changes and trouble dressing are common. This is often when families start looking at memory care.
- Severe stage. People cannot communicate and depend completely on others for care. State rules often limit how much medical care assisted living can give. Georgia, for example, admits memory care residents only if they don’t need 24-hour skilled nursing care. Near the end of life, hospice care can come to the memory care unit.
Signs that home care is no longer enough often include repeated wandering, a caregiver who can’t get sleep, or care needs that take two people. The care options guide walks through those needs and shows which settings fit. For the full range of choices, see care options for a person with dementia.
Who Pays for Memory Care
Memory care prices vary widely by state and by community, so ask each one for its written fee schedule, including what changes as needs increase. Here is how families cover the bill.
| Payer | What it covers in memory care |
|---|---|
| Private pay | Most families pay themselves at first, from income, savings or the sale of a home |
| Medicare | Not the memory care itself. Medicare doesn’t pay for long-term custodial care or assisted living. It can still pay for doctor services, hospice and a short skilled nursing facility stay after a qualifying hospital stay |
| Medicaid | Nursing home care for people who qualify. In assisted living memory care, some states pay for care services through a home and community-based services waiver, but federal waiver funds can’t pay room and board |
| Long-term care insurance | Personal and custodial care in the settings the policy names, which often include assisted living |
| VA | No rent in assisted living, but VA may pay for added services. Aid and Attendance adds a monthly payment to a VA pension. Some VA Community Living Centers offer dementia care |
Because Medicaid waivers rarely cover room and board, families often combine sources: the resident’s income pays rent and meals, and the waiver pays for care. Waivers can have enrollment caps. Check what your state offers in the Medicaid waiver guide and the Medicaid long-term care checker. Veterans and surviving spouses should read the VA long-term care guide.
How to Check a Memory Care Community Before You Commit
Start with the state. Look up the community on your state licensing agency’s facility search, linked from your state page, and confirm it holds the memory care license, certificate or endorsement your state requires. Then use the steps in how to choose assisted living, adding these memory care questions:
- May you see the written memory care disclosure, staffing plan and fee schedule?
- How many awake caregivers are on the unit during the day, the evening and overnight?
- How many hours of dementia training do new staff get before they work alone?
- How do the doors and outdoor areas stay secure, and what happens when a resident goes missing?
- What happens when a resident’s needs grow? Which conditions would require a move?
- How do staff respond to distress or agitation before turning to medicine? The antipsychotics guide explains why that matters.
Visit more than once, at different times of day, including a mealtime. If problems come up after a move, the Long-Term Care Ombudsman serves assisted living residents as well as nursing home residents; see residents’ rights and the ombudsman. If someone is in immediate danger, call 911, and report suspected abuse to Adult Protective Services. For free help finding local services, call the Eldercare Locator at 1-800-677-1116.
Frequently Asked Questions
Does Medicare Pay for Memory Care?
No. Medicare says it doesn't pay for long-term care, including custodial care and assisted living, which is the kind of daily help memory care provides. Medicare can still cover a short skilled nursing facility stay after a qualifying hospital stay, plus doctor visits and hospice. See what Medicare covers in a nursing home.
Can a Person With Dementia Live in Regular Assisted Living?
Often, yes, in the earlier stages. NIA notes that many assisted living facilities offer a few levels of care and that some have special programs for people with dementia. State rules set the limits: in Alabama, for example, residents whose cognitive impairment would make them ineligible for regular assisted living can be served only in a separately licensed Specialty Care Assisted Living Facility.
Do Memory Care Units Lock the Doors?
Many use secured exits, but under state rules. Oregon requires electronic locks that release under listed conditions and bans keyed locks on entrance and exit doors. California requires a court order or the resident's signed consent before a facility locks exterior doors or gates. Alabama requires delayed-egress or electrical locks that release automatically on a fire alarm or power loss.
Does Long-Term Care Insurance Cover Memory Care?
It can. The federal LongTermCare.gov pages say these policies pay for personal and custodial care in a variety of settings, including facilities, and NIA says some policies partly cover assisted living. Read the policy for the settings it names and how it defines a qualifying need. Learn more in the long-term care insurance guide.
Who Can I Call About a Problem in a Memory Care Community?
Call the state Long-Term Care Ombudsman, whose staff investigate and resolve complaints for residents of nursing homes, assisted living and board and care homes. You can also file a complaint with the state licensing agency listed on your state page. If someone is in immediate danger, call 911.
Is Memory Care the Same as a Nursing Home?
No. Most memory care is a specialized form of assisted living, regulated by the state. A nursing home is federally certified, must have a registered nurse on duty at least 8 consecutive hours a day, and must give residents with dementia appropriate treatment and services. Some nursing homes also run secured dementia units. Compare them in assisted living vs nursing home.
More on Types of Care
- Assisted Living vs Nursing HomeHow the two settings differ in care, rules and who pays
- Memory Care vs Assisted LivingWhen a person with dementia needs a secured memory care unit
- In-Home CarePersonal care, homemaker help and how Medicaid and VA pay for it
- Home Health vs Home CareThe difference between Medicare home health and paid personal care
- Adult Day CareDaytime programs, health services and coverage
- Respite CareIn-home, adult day and short-stay respite and who pays
This guide explains long-term care in plain language from official sources. It isn't medical, legal or financial advice; a doctor, your state Medicaid agency or an elder law attorney can advise on your situation.
Sources
- NIA: Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care
- NIA: What Are the Signs of Alzheimer's Disease?
- NIA: Coping With Alzheimer's Behaviors: Wandering and Getting Lost
- Medicare.gov: Long-term care coverage
- eCFR: 42 CFR 441.310, limits on HCBS waiver payments (room and board)
- eCFR: 42 CFR 483.40, behavioral health services in nursing homes
- VA: Assisted Living
- VA: Aid and Attendance and Housebound benefits
- VA: Community Living Centers
- ACL: Long-Term Care Ombudsman Program
- Texas HHS: Assisted living Alzheimer's certification
- Washington WAC 388-78A-2383: Memory care certification
- Oregon OAR chapter 411, division 57: Memory care communities