Why Both Terms Exist
"Memory care" is the national marketing term, popularized by large assisted living companies that built secured wings or buildings for dementia residents.
"Dementia care home" is the Washington-specific term for an adult family home that holds a DSHS dementia specialty designation. Both serve people with Alzheimer's, vascular dementia, Lewy body, frontotemporal, or other cognitive conditions — but the settings are quite different.
What "Memory Care" Means Nationally
A typical memory care community is a secured wing or floor of a larger assisted living facility. Common features: locked exterior doors, magnetic door alarms, structured daily programming run by an activity director, dedicated dining room within the secure area, and a higher monthly rate than the rest of the ALF.
Size ranges widely — some memory care wings have 12 residents, some have 40+. Staff ratios vary by state and by facility.
What "Dementia Care Home" Means in WA
In Washington, an adult family home with a DSHS dementia specialty designation is what families often call a "dementia care home." The home must meet specific state requirements: additional caregiver training hours (typically 16–32+ hours beyond the standard certification), specialized care plans, and environmental safety features for residents with cognitive impairment.
The home itself is still a residential house with up to six residents. The difference is staff training, care plan structure, and home modifications.
Key Differences in Practice
Size and ratio. An AFH dementia home has 6 residents and 1–2 caregivers. A memory care wing might have 20–40 residents and 2–4 caregivers per shift.
Caregiver consistency. AFH residents usually know the same 1–3 caregivers every day. ALF memory care has more staff rotation.
Environment. AFH is home-like — quieter, fewer transitions, smaller sounds. ALF memory care has more activity, more bustle, more programming.
Programming. Memory care communities employ activity directors and offer structured group programs. AFHs run smaller activities organically — cooking, gardening, walks.
When Each Is Right
An AFH dementia care home is often the better fit for residents with anxiety, sensory sensitivity, advanced dementia, who benefit from consistent caregiver relationships, or whose families value Medicaid coverage and a home-like atmosphere.
A memory care wing of an ALF may be the better fit for residents who are still socially engaged, want regular group programming, or who tolerate institutional environments well.
There are excellent and mediocre examples of both. Setting alone doesn't determine quality. Full memory care guide →
Cost Comparison
Memory care wings in Washington ALFs typically run $7,000–$13,000/month. Memory care AFHs typically run $5,500–$9,500/month for similar acuity.
Medicaid (COPES) covers AFH memory care for eligible residents but rarely covers private memory care wings. For families anticipating Medicaid in the future, an AFH dementia home is often the more sustainable choice. Paying for memory care →
Frequently Asked Questions
Q: Are dementia AFHs secured? A: Yes — doors are secured to prevent wandering, but residents have free access to common areas and outdoor spaces.
Q: How do I find the DSHS designation? A: Check the DSHS RCS facility locator — the home's profile shows specialty designations.
Q: Can my parent stay in a dementia AFH late-stage? A: Often yes — many AFHs handle care through end of life with hospice support.
Q: Which has better activities? A: Memory care wings have more structured programming. AFHs offer fewer but more individualized activities.