Care guide
In-home dementia care vs. memory care — how to choose.
For most families, the hardest question is not what care their loved one needs, but where that care should happen. This guide walks through the two most common paths — and how to know when it’s time to move from one to the other.
In-home dementia care
Care delivered in the person's own home — by family, a trained attendant, a visiting nurse, or some combination. Familiar surroundings, familiar routines, family close by.
- Best for early to mid-stage cognitive decline
- Preserves routine, identity and community ties
- Cost scales with hours of paid support
- Family carries most of the coordination load
Memory care facility
A residential community designed for people living with dementia — secure environments, trained staff, structured programming, 24/7 supervision.
- Best for advanced stages or high safety risk
- 24/7 trained supervision and clinical oversight
- Higher, more predictable monthly cost
- Family shifts from primary carer to advocate
The comparison
Side by side, honestly.
| What matters | In-home care | Memory care |
|---|---|---|
| Familiarity | Highest — own home, own bed, own routine. | New environment; adjustment period is real. |
| Safety at night | Depends on family or paid attendant. | Secured units and awake overnight staff. |
| Clinical oversight | Ad-hoc visits; family coordinates specialists. | On-site nursing; scheduled physician review. |
| Social engagement | Rich if community is close; isolating if not. | Structured programming built into the day. |
| Family impact | Heavy caregiver burden; measurable on CARE-Q. | Family shifts to visits and advocacy. |
| Cost pattern | Variable — a few hours a day to 24/7 shifts. | Fixed monthly fee; typically higher overall. |
The signal to move
When home care stops being enough.
Most families don’t move too early — they move too late, after a crisis. These are the patterns clinicians watch for weeks before a fall or a hospital admission forces the decision.
Night-time wandering or exit-seeking, more than twice a week.
Repeated falls, or a fall with an injury.
Aggression or agitation the family cannot safely de-escalate.
Caregiver PHQ-9 score consistently ≥ 10 for a month.
Medications missed or double-dosed despite reminders.
The primary caregiver’s own health starting to fail.
Where ORMAI fits
A shared record, wherever care happens.
ORMAI is built for the in-home years — remote AMTS screening, longitudinal PHQ-9 for the caregiver, and a safety-bounded companion for the hard nights. When a family does move to memory care, the same longitudinal record travels with them: the facility’s clinicians walk in already knowing how the last 90 days went.