Memory care

Memory care is a place to live that is set up for people with Alzheimer's disease and other kinds of dementia. It is often a separate floor or wing inside an assisted living community or a nursing home. You may also hear it called a special care unit (SCU).¹

For many families, memory care comes up in the middle or late stages, when a person needs someone nearby day and night. This page explains what memory care offers, what Virginia requires, what to ask about staff, what it costs, and how to tell when a move may be the right step.

What memory care is

A memory care unit groups people with dementia together in one area of a larger building. Many units are secured so that residents cannot walk out alone. Some are not locked at all, so ask.¹

Good units offer more than a locked door. Look for staff trained in dementia, activities made for people with memory loss, small groups and quiet spaces.¹ Some places put a "memory care" sign on an ordinary unit, so look at what really happens there.¹

Dementia is very common in these settings. A 2018 Alzheimer's Association report said about 4 in 10 people living in assisted living (42%) had Alzheimer's or another dementia. About 6 in 10 nursing home residents (61%) had moderate or severe thinking problems.²

Memory care in assisted living vs a nursing home

Virginia rules for memory care in assisted living

Virginia calls a locked dementia unit in assisted living a "safe, secure environment." The rules also use the term special care unit. Separate rules cover homes where people with serious memory problems live mixed in with other residents.⁴

Who can live in a secured unit

A secured unit is only for a person with serious thinking problems from dementia who cannot spot danger or keep themselves safe.⁵

Before the move, an independent licensed clinical psychologist or an independent doctor with the right specialty must assess the person in writing.⁵ The facility must also get written approval. This comes from the person if they can decide, or else from a guardian, legal representative or close relative, in a set order.⁶ If anyone in that order says no, the facility cannot place or keep the person in the unit.⁶

The facility must review whether the unit still fits 6 months after the move, then once a year. It also reviews it when the person's condition changes.⁷ Family members, the doctor and staff can be part of that review.⁷ It helps to have a power of attorney in place before this point.

What the unit must provide

These are minimums. A good unit often does more. Before you sign, every Virginia assisted living facility must give you a plain-language disclosure statement. It lists services, fees and what extra items cost, and the number and types of staff on each shift.¹³ You can look up licensed facilities and file a complaint on the Virginia Department of Social Services website.¹⁹

Staffing questions to ask

Staff matter more than fancy furniture. The Alzheimer's Association suggests asking:¹

1. Is dementia training required? How many hours, and what topics does it cover?
2. How long have most care workers been on staff? High turnover can mean the person keeps meeting strangers.
3. How many residents does each care worker look after, by day and at night?
4. How do staff handle agitation, refusing care or trying to leave? Ask for a recent example, with no names.
5. Is a registered nurse on site at all times? How often do doctors and nurse practitioners visit?
6. Is personal care, such as bathing and toileting, planned around each person's habits and abilities?

Also ask how staff respond to agitation and aggression and wandering. Ask what the plan is if needs grow, and when they would ask a resident to move out.^1,13

What memory care costs

There is no single national price for memory care. The large CareScout cost survey reports assisted living and nursing home prices, but not memory care on its own.¹⁴ Memory care is often priced as the assisted living rate plus extra fees for dementia care.¹

Source: CareScout (Genworth) Cost of Care Survey 2025.¹⁴

Treat the assisted living number as a starting point. Ask each place for a written list of all charges. Ask how fees go up as care needs grow. Read more on what dementia care costs.

How families pay

What Medicare does not pay. Medicare does not pay for long-term care or room and board in assisted living, memory care or a nursing home.¹⁵ It still covers doctor visits and other medical care. If the person enters hospice, Medicare can cover hospice care in the memory care unit. It still does not pay room and board.¹⁶

When is it time to move?

There is no perfect moment. In the middle stages, many people need someone watching over them around the clock. Late-stage care becomes heavier still.¹ See middle-stage and late-stage dementia.

The Alzheimer's Association suggests a move may make sense when:¹

• The person is no longer safe at home, for example getting lost or leaving the stove on.
• Their health, or yours, is at risk.
• Their care needs are more than you can physically manage.
• You often feel stressed, short-tempered or impatient.
• You are falling behind on work, family or your own health.
• The person would do better with more routine and more people around.

Moving someone you love is hard. It can bring guilt, grief and relief all at once. Choosing good care is a way of caring. See caregiver stress and moving a parent into care.

Common questions

Will a locked unit feel like a prison?

A good unit should feel like a home, with things to do and safe places to walk. Virginia requires daily activities and a chance to go outside every day, weather permitting.^8,12 Visit and watch how residents spend their day.

Can my parent stay if they get worse?

Sometimes. Each Virginia facility must explain its rules for moving a resident to another level of care and for discharge.¹³ Some people later need a nursing home or hospice. Ask before you sign.

Is memory care better than staying home?

It depends on the person, the home and the caregivers. Some people do well at home with in-home care, adult day care and respite. Others are safer and calmer in memory care.

Can family still help after the move?

Yes. Your visits, knowledge of the person's habits and history, and close watch on their care still matter a great deal. Share a short life story with staff so they know who your loved one is.

When to get help now

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.