Byline: Melanie Claborne, Founder Thousand Springs Senior Living

Reviewed by the Thousand Springs Leadership Team.

How Do Families Compare Memory Care Communities? 10 Questions Beyond Amenities

After a few tours, memory care communities start to look alike. Each one has a nice lobby, a full activity calendar, and a friendly guide. Tours tend to focus on private rooms and dining areas. Those details matter. But they don’t show you how a caregiver will respond when your mom is confused and upset at 3 a.m.

So how do families compare memory care communities in a way that shows the real differences? This article gives you 10 questions to ask beyond amenities. It also covers a simple way to compare answers and what Missouri families should know.

The short answer: how do families compare memory care communities?

The most meaningful differences between memory care communities often involve staffing, care practices,  communication, and resident engagement, rather than amenities alone. Ask every community the same questions, and write down the answers. Then visit again at a different time of day. A second visit often shows you more than a planned tour.

What families often notice during memory care tours

Families who have toured several memory care communities often come away with the same takeaways:

• Attractive buildings do not always reflect the quality of care being provided.
• Staffing, communication, and resident engagement often tell a family more than amenities.
• Communities should be prepared to explain how they support changing care needs.
• Asking consistent questions makes comparisons easier.
• Daily life often reveals more about the quality of care than a scheduled tour.

A tour is planned ahead, so it shows a community at its best. The questions below help you learn what a normal day looks like for residents.

10 questions families should ask beyond amenities

Ask every community these 10 questions, and write down each answer. Clear, specific answers are easier to compare than general promises.

1. What specialized dementia training do caregivers receive?

Dementia care takes special skills, such as calming a frightened person or helping someone who can’t follow spoken directions. Missouri’s assisted living rules cover communities that care for residents with Alzheimer’s disease or a related dementia. In those communities, caregivers who give hands-on care must get at least three hours of dementia training when they start.1 The training covers talking with residents, responding to behavior, supporting independence, keeping a safe routine, and working with families.1 Dementia training must also continue over time.1

Ask who teaches the training and how many hours caregivers complete beyond the state minimum. Ask whether night caregivers get the same dementia care support training as day caregivers.

2. How often are care plans reviewed?

A care plan is the written guide that tells caregivers what your parent needs and likes. Dementia symptoms change, so a plan that fit in the spring may not fit by fall. Missouri rules require assisted living communities to assess each resident within five days of move-in. After that, they must reassess at least every six months and after any major change in health.1 Each resident’s service plan must be reviewed with the resident or their legal representative at least once a year.1

Ask how often the community actually reviews care plans and whether you’ll be invited. Ask how quickly a plan is updated after a fall, an illness, or a new behavior.

3. What happens when care needs change?

Care needs usually grow as dementia progresses. A community may fit your parent well today and not in two years. Missouri rules say an assisted living community may not admit or keep a resident whose needs it can’t meet. In that case, the resident must be referred to outside help or discharged.1 The Family Caregiver Alliance suggests asking whether residents can move to a higher level of care in the same place. It also suggests asking who decides when more care is needed.2

Ask which changes would lead the community to suggest a move, and how much notice you would get. If your parent may someday need hospice care, ask whether it can be provided without another move.

4. How does the community prevent and respond to wandering?

Wandering is common in dementia. The Alzheimer’s Association reports that six in 10 people living with dementia will wander at least once, and many wander more than once.3 Wandering can happen at any stage of the disease.3 A person who wanders may walk outside, get lost, and be unable to ask for help.

Ask what supervision, monitoring, and safety measures the community uses, day and night. Ask how caregivers respond when a resident tries to leave. Missouri rules require assisted living communities to watch over residents 24 hours a day.1 Ask how that works at night, when fewer caregivers may be on duty.

5. How does the community communicate with families?

Good family communication means you hear about changes before they become bigger problems. Missouri rules cover serious illness, injury, and major changes in health. In those cases, caregivers must take action and quickly try to reach the resident’s listed family contact or legal representative.1 Routine updates vary much more from one community to the next.

Ask who your main contact will be and how quickly you’ll hear about a fall or a change in appetite. The Family Caregiver Alliance also suggests asking whether the community has a family council or support group.2

6. What does daily engagement actually look like?

An activity calendar lists what is planned. It doesn’t show how many residents take part. The Family Caregiver Alliance suggests watching activities to see whether they would interest your loved one and whether people attend.2 Missouri rules also require activities that fit each resident’s needs, interests, background, and culture.1

During your visit, notice what residents are doing between activities. Are caregivers talking with residents, or rushing from task to task? Ask how activities change for someone who can no longer join a group. Our article on wellness programs for seniors explains what a good program includes.

7. How does the care team respond to behavior changes?

Dementia can cause worry, anger, suspicion, pacing, and trouble sleeping. The National Institute on Aging notes that the disease, not the person, causes these changes.4 NIA also lists other causes of upsetting behavior. These include pain, hunger, thirst, poor sleep, new medicines, and a noisy room.4

Ask the care team what they do when a resident becomes upset or refuses care. A strong answer includes looking for a cause, such as pain or hunger, first. Ask how the team tracks behavior changes and when it calls a doctor. NIA advises getting a doctor’s help right away for sudden behavior changes, especially after an infection or a new medicine.4

8. What happens during a medical emergency?

A memory care community is not a hospital, so you need to know what happens when something goes wrong. Missouri requires each assisted living community to have a written plan to protect residents during fires, tornadoes, and severe weather.1

Ask who responds first when a resident falls or becomes ill, and whether a nurse is available. Ask which hospital the community uses. A trip to a strange place can add to confusion for someone with dementia. Ask whether a familiar person will stay with your parent until you arrive.

9. How long do caregivers typically stay?

Caregivers who stay for years learn how your parent communicates and what calms them. When caregivers change often, residents must get used to new faces again and again. The National Institute on Aging suggests asking how many caregivers there are per resident. It also suggests asking how long key leaders have worked there and how often key team members leave.5

Ask whether residents see the same caregivers most days and how shifts are covered when someone is out. Missouri rules set minimum staffing levels for assisted living. The rules also say that meeting the minimum may not meet every resident’s needs.1

10. How does the community measure quality of life?

Safety matters, but so does whether your parent enjoys the day. Missouri describes assisted living as a home-like model of care that respects each resident’s choices, privacy, and independence.1 The Family Caregiver Alliance suggests watching whether residents seem happy, respected, and well cared for.2

Ask how the community learns a new resident’s life story, routines, and favorite foods. Ask how caregivers can tell whether a resident is content when that person can no longer explain their feelings. Then look for signs yourself, such as residents who are dressed, eating well, and spending time with others.

Amenities vs quality of care: where should families look?

Amenities can make daily life more pleasant, and they are worth a look. Quality indicators show how residents are cared for each day. The table below pairs common amenities with signs of good care.

Amenities	Quality indicators	What to ask or look for
Attractive décor	Consistent staffing	How long caregivers have worked there, and whether residents see the same caregivers most days
Large activity calendar	Resident participation	How many residents are taking part during your visit
Restaurant-style dining	Nutrition support	How caregivers help residents who eat slowly, forget to eat, or need help at meals
Fitness space	Personalized care plans	How often plans are reviewed, and whether families take part
Outdoor amenities	Safe outdoor access and supervision	How residents get outside, and who is with them when they do

 

A community with fewer amenities but strong answers in the right-hand columns may give better daily care than one with an impressive building.

How can families compare communities objectively?

These six steps keep your memory care community comparison fair, so first impressions don’t decide for you.

1. Identify your loved one’s care needs. List what your parent needs help with now, such as bathing, eating, or finding their way. Our guides to signs a senior may need more support and assisted living vs memory care can help you decide which level of care fits.
2. Create a comparison worksheet. Put the 10 questions in the left column and each community’s name across the top. Fill in the answers during or right after each visit.
3. Ask the same questions at every community. Matching questions make the answers easier to compare.
4. Observe resident engagement. Watch what residents are doing. The National Institute on Aging suggests stopping by at mealtime. It also suggests a second visit without calling ahead, on a different day or at a different time.5
5. Review staffing and communication practices. Ask about caregiver tenure, shift coverage, and how families receive updates.
6. Compare notes after each visit. Write down your impressions the same day. If other family members toured with you, compare notes while the visit is fresh.

Memory care community evaluation checklist

Bring this checklist to every tour. Check off each item once the community has answered it clearly.

• Staff training explained
• Care plan process reviewed
• Family communication discussed
• Resident engagement observed
• Safety systems explained
• Staffing stability reviewed
• Emergency procedures discussed
• Future care needs addressed

What should Missouri families know before choosing memory care?

Missouri’s Alzheimer’s Special Care Disclosure Act applies to any community that offers an Alzheimer’s special care unit or program. The community must tell the state, in writing, how that care is different.6 The form must explain the program’s goals and who can move in or be asked to leave. It must also explain how care plans are made and updated, and how the care team is trained.6 The community must give a copy to the resident and their next of kin or guardian at move-in.6

You don’t have to wait until move-in to read it. Ask each community for its form while you compare options, and read the forms side by side.

Missouri law also requires dementia training for employees who care for people with Alzheimer’s disease or related dementias. The law covers residential care settings, which can include assisted living. The training must be part of new employee training and continue over time.7 State rules also require assisted living communities to reassess residents at least every six months and review service plans at least once a year.1

For assisted living, Missouri’s minimum is one team member for every 15 residents during the day. At night, the minimum is one for every 25 residents.1 These are only minimums. Ask each community for its actual caregiver-to-resident ratio on every shift.

Local resources for St. Charles County families

Aging Ahead serves older adults in St. Louis, St. Charles, Franklin, and Jefferson counties. It can help with aging information and local resources.8 Missouri’s Long-Term Care Ombudsman Program is a statewide network of trained volunteers. They help people who live in long-term care communities with problems and concerns. You can reach the program at (800) 309-3282.9

If you’re comparing communities in Wentzville, O’Fallon, Lake Saint Louis, or nearby towns, add these questions to your list:

• How far is the community from the family members who will visit most often?
• Which hospital does the community use, and how long does it take to get there?
• Can you speak with families of current residents who live in the area?

Distance matters. The Family Caregiver Alliance notes that the closer your loved one lives, the more often you’ll be able to visit.2

What should caregivers keep in mind while comparing?

Avoiding decision fatigue

Touring several communities in a short time is tiring, and the details start to blur. Limit tours to one or two a day, and take notes at each visit. Narrowing your list before you tour also saves time and energy.

Comparing communities fairly

A community you visit on a quiet morning may seem calmer than one you visit during a busy lunch. Try to see each community at a similar time of day, and plan a second visit at a different time. Use the same worksheet at every stop.

Balancing emotions and practical needs

It is painful to realize that a parent needs more care than your family can give at home. You may feel drawn to the community that feels warmest, even if another gave clearer answers about safety. Write down both your feelings and the facts. The community you choose should feel right and give clear answers about training, care plans, and supervision.

Planning for future care needs

Dementia changes over time, so think about what your parent may need in two or three years. The Family Caregiver Alliance suggests asking whether a community will still be right as care needs grow.2 A community that offers assisted living, memory care, and hospice care in one place may let your parent stay in a familiar home as needs change.

Planning a memory care tour in Wentzville?

Thousand Springs Senior Living is being built at 740 Peine Road in Wentzville as a boutique community with 16 private suites. Our memory care services will focus on consistent caregivers, steady routines, and a secure, comforting setting. Assisted living and hospice care will be offered under the same roof. Your loved one will also enjoy landscaped gardens, an on-site salon and spa, and chef-prepared meals. Learn what makes a boutique memory care community different.

Bring your worksheet to a hard-hat tour and ask us the same 10 questions you ask everywhere else. If your parent’s needs would be better met somewhere else, we’ll tell you that, too. We’re here to answer your questions, without pressure or rush. Speak with our team to schedule a visit.

Frequently asked questions

What is the most important thing to look for in a memory care community?

The most important thing to look for is how well caregivers are trained to care for people living with dementia. Training shapes how caregivers communicate, respond to behavior changes, and keep residents safe. Consistent caregivers and clear care plans also matter.

How many memory care communities should families tour?

There is no single number of communities ever family should tour, but most families benefit from visiting more than one before making a decision. Visiting multiple communities makes it easier to compare staffing, care practices, resident engagement, and communication. The National Institute on Aging also recommends visiting several communities and making a return visit before choosing one.

Are smaller communities better than larger communities?

Smaller communities are a better fit for some people living with dementia, but not for everyone. The Family Caregiver Alliance notes that the right size depends on care needs and how social a person is.2 Some people do best in a quiet, calm setting, and others enjoy a busier one.2 A smaller community may suit someone who gets confused in busy, noisy places.

How important is dementia-specific staff training?

Dementia-specific training is very important because it shapes how caregivers talk with residents and respond to behavior changes. Missouri requires at least three hours of dementia training for hands-on caregivers in assisted living communities that serve residents with dementia.1 Ask each community how its training goes beyond that minimum.

What questions should families ask during a tour?

The most important questions focus on caregiver training, care plans, changing needs, wandering, family updates, daily activities, behavior support, emergencies, caregiver turnover, and quality of life. The 10 questions in this article cover each topic. The checklist helps you track the answers.

How can families compare communities objectively?

Families can compare communities objectively by asking every community the same questions and recording the answers on one worksheet. Visit each community at a similar time of day, return at a different time, and write down your notes the same day.

What signs indicate high-quality memory care?

Signs of high-quality memory care include caregivers who know residents by name and residents who are active instead of sitting alone for hours. Clear answers about training, care plans, and safety are good signs, too. So are long-serving caregivers and regular family updates.

How often should care plans be updated?

In Missouri, assisted living communities must reassess residents at least every six months and review each service plan at least once a year.1 If your parent’s symptoms are changing quickly, ask whether the community reviews the plan more often.

A note on this article

This article is general information for families comparing memory care options. It is not medical or legal advice, and state rules change over time. For guidance about your loved one’s needs, please talk with their physician. For current licensing requirements, contact the Missouri Department of Health and Senior Services. All requirements reflect the sources cited below as of the publication date.

About Thousand Springs Senior Living

Thousand Springs Senior Living is a boutique assisted living and memory care community being built at 740 Peine Road in Wentzville, Missouri. The community will offer 16 private suites, landscaped gardens, an on-site salon and spa, chef-prepared meals, and care around the clock. Thousand Springs serves families throughout Wentzville, Lake Saint Louis, O’Fallon, Dardenne Prairie, St. Peters, and the greater St. Charles County area.

Sources

[1] Legal Information Institute, Cornell Law School.
“19 CSR 30-86.047, Administrative, Personnel, and Resident Care Requirements for Assisted Living Facilities.”
https://www.law.cornell.edu/regulations/missouri/19-CSR-30-86-047
https://www.law.cornell.edu
Accessed September 2026.

[2] Family Caregiver Alliance.
“Residential Care Options: Choosing the Right Place.”
https://www.caregiver.org/resource/residential-care-options-choosing-right-place/
https://www.caregiver.org
Accessed September 2026.

[3] Alzheimer’s Association.
“Wandering.”
https://www.alz.org/help-support/caregiving/stages-behaviors/wandering
https://www.alz.org
Accessed September 2026.

[4] National Institute on Aging.
“Alzheimer’s Caregiving: Managing Personality and Behavior Changes.”
https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/alzheimers-caregiving-managing-personality-and
https://www.nia.nih.gov
Accessed September 2026.

[5] National Institute on Aging.
“How To Choose a Nursing Home or Other Long-Term Care Facility.”
https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/how-choose-nursing-home-or-other-long-term-care-facility
https://www.nia.nih.gov
Accessed September 2026.

[6] Missouri Revisor of Statutes.
“RSMo 198.510, Alzheimer’s Special Care Disclosure Act, disclosure required.”
https://www.revisor.mo.gov/main/PageSelect.aspx?section=198.510&bid=10551
https://revisor.mo.gov
Accessed September 2026.

[7] Missouri Revisor of Statutes.
“RSMo 192.2000, dementia-specific training requirements established.”
https://revisor.mo.gov/main/OneSection.aspx?section=192.2000
https://revisor.mo.gov
Accessed September 2026.

[8] Aging Ahead.
“Contact Us.”
https://www.agingahead.org/about-us/contact-us/
https://www.agingahead.org
Accessed September 2026.

[9] Missouri Department of Health and Senior Services.
“Long-Term Care Ombudsman Program.”
https://health.mo.gov/seniors/ombudsman/
https://health.mo.gov
Accessed September 2026.