Memory Care – Senior Care

WHY ROUTINE

Most distress on a dementia floor is not caused by the disease. It is caused by surprise — a new face, a moved chair, a meal at the wrong hour.

So we hold the day still. Same caregiver, same seat at the table, same walk after lunch, same voice at bedtime. Families notice it in the second week, usually as fewer phone calls at 3am.

WHERE ARE WE NOW

Three stages, and what changes in each

Families rarely arrive knowing the stage. The assessment places it, and the plan is rewritten as it moves — you are not locked into the level you started at.

Early

Forgetting names, repeating questions, losing objects

Still socially able and largely independent. We keep them in company and in routine: prompted medication, prompted meals, orientation cues in the room, and a labelled wardrobe so dressing stays their own job. Family visits are unrestricted and encouraged daily.

1 : 6 staffing

Middle

Day-night reversal, wandering, agitation at dusk

The stage families find hardest at home. Doors on the floor are secured, the corridor is a continuous loop so walking is safe rather than stopped, and caregivers are trained to redirect instead of correct. Sundowning is managed with light, food and movement before it is managed with medication.

1 : 4 staffing

Advanced

Limited speech, help needed for eating and moving

Care becomes largely physical: assisted feeding with texture-modified food, two-person transfers, two-hourly repositioning to protect skin, and continence care. Comfort leads. If a hospital admission would not improve her day, we say so and treat her here.

1 : 3 staffing

THE FIXED DAY

Every day on the memory floor runs like this

Printed on the wall, followed by every shift, and given to you on the day your mother moves in.

6:30: Waking, curtains, prayer; Same caregiver each morning. Curtains before speech — daylight resets the body clock faster than a greeting does.
7:15: Washing and dressing; Clothes laid out in the order they go on. Residents do whatever they can still do themselves, however slowly.
8:00: Breakfast, assigned seat; The same chair at the same table every day. Vitals and morning medication at the table, not in the room.
9:30: Movement session; Seated exercise or a corridor walk. Physiotherapist present twice a week.
11:00: Hands-on activity; Folding, sorting, gardening, dough, old songs. Chosen from what each resident did for a living or for pleasure.
13:00: Lunch, then rest; Main meal at midday, when appetite and swallowing are strongest. Rest is offered, never enforced.
15:30: Tea and visitors; Visiting hour sits deliberately before dusk, when residents are most themselves.
17:00: Sundowning window; Lights up, television off, a snack, and a walk. Staffing is heaviest here, not at night.
19:00: Dinner, light and early; Then washing, night medication, and the same recorded ghazals in the same order.
21:00: Night rounds begin; Two-hourly checks, motion-sensor floor lighting, door alarms armed. Nobody is locked in a room.

THE SECURED FLOOR

What makes a floor safe for someone who wanders

Beds on the memory floor: 14, single storey
Corridor design: Continuous loop, no dead ends
Exit doors: Alarmed, keypad, staffed
Night checks: Every 2 hours, logged
Floor lighting: Motion sensor, 30 lux
Bathroom contrast: Coloured seat and rails
Wander alerts: Optional wrist tag
Enclosed garden: Yes, unlocked in daylight
Staff dementia training: 40 hours, then annual
Restraint policy: None, chemical or physical
Psychiatrist review: Monthly, or on incident
Family report: Weekly, written

FOR THE FAMILY

The diagnosis arrived for the whole household

Four things we do for you, not for the resident. None of them costs extra.

A monthly sit-down

Thirty minutes with the nurse in charge and, when needed, the psychiatrist. What changed, what we tried, what we are watching. In person or on video for families abroad.

Training for the hard visits

How to answer when she asks for her mother. What to do when she does not recognise you. Why arguing about facts makes the afternoon worse. We teach this, because families are not born knowing it.

A carers group

Second Saturday of each month, facilitated by our clinical psychologist. Open to families of residents and to families still managing at home.

Honest prognosis

We will tell you when a stage has changed, when a hospital trip will not help, and when it is time to talk about comfort rather than treatment. Not comfortable conversations, but better had early.

Dementia care built on a routine that never moves