How to Choose a Memory Care Facility in Missouri

Updated with what current research shows about dementia care regulations across the United States and in Missouri.

Memory care in Missouri refers to residential care settings and programs designed for people living with Alzheimer’s disease and related dementias. These services are usually offered within assisted living facilities, residential care communities, or specialized secured units inside these settings.

Missouri does not have a separate license classification for memory care. Instead, dementia care is regulated under the same rules that govern assisted living and residential care. Research shows that Missouri is one of the states that has dementia care requirements built into its regulations, but the state does not license dementia units separately. Because of this structure, the quality and consistency of memory care can vary, and families need to ask careful questions when choosing a facility.

This guide explains how memory care works in Missouri and what families should look for.

How Missouri Regulates Memory Care

Missouri uses its residential care and assisted living regulations to oversee dementia care. National analyses show that states vary widely in how they regulate dementia care. Some states license memory care units separately. Missouri does not. Missouri falls into the group of states that include dementia-specific requirements within the general assisted living rules.

These requirements may include:

• Pre-admission assessments

• Consumer disclosure about dementia services

• Administrator training

• Staffing expectations

• Physical environment standards for safety

However, the exact details of Missouri’s requirements depend on the state’s administrative code. The research available does not reproduce Missouri’s exact staffing ratios or training hours, so families must ask each facility what dementia-specific standards they follow.

Evidence About State Variation and What It Means for Missouri

Large national studies show:

• Only a minority of states have dedicated dementia unit licensure

• Most states, including Missouri, address dementia care through general assisted living regulations

• Only some states specify staffing ratios for dementia care

• Many states require dementia training for administrators, but fewer mandate detailed training for direct care workers

• A small number of states require pre-admission cognitive assessments specific to dementia

One national study found that states with more specific staffing requirements had lower hospitalization rates for residents with dementia. This means staffing consistency and training matter deeply, especially in states like Missouri where memory care is embedded within assisted living.

What Memory Care in Missouri Typically Includes

Even without a separate dementia license, most memory care units in Missouri offer:

Modified environments
Secured doors, simple layouts, visual cues, circular walking paths, and other dementia-friendly design elements that reduce wandering and confusion.

Specialized dementia training
Staff trained in understanding behaviors, redirection, and safe care approaches.

Structured programming
Activities that match cognitive and functional levels, including music, sensory stimulation, movement, and personalized engagement.

Closer supervision
Higher oversight than standard assisted living, with predictable routines that support memory, comfort, and safety.

Access to Memory Care in Missouri

Availability varies by region. Access can be limited in:

• Rural counties

• Areas with lower socioeconomic resources

• Communities with fewer licensed assisted living or residential care facilities

Medicaid also affects availability. Many memory care units are private pay. Some facilities accept MO HealthNet (Medicaid), but not all allow residents to remain after converting to Medicaid.

Ask every facility:

• If they accept Medicaid

• If you can stay once you convert

• What happens if private funds run out

• Whether they participate in spend-down or waiver programs

Get all financial guarantees in writing.

What Families Should Ask When Evaluating a Memory Care Facility

Because memory care is not separately licensed in Missouri, detailed questions matter.

Training and competence

• How many hours of dementia training staff receive

• How training is updated

• Whether new staff shadow experienced caregivers

• Who teaches the training

Staffing and stability

• Staff-to-resident ratios on each shift

• Overnight staffing

• Staff turnover

• Whether residents have consistent caregivers

Safety and environment

• How wandering is prevented

• Access to secured outdoor areas

• Lighting and noise levels

• How the design supports dementia care

Behavioral support

• How agitation, restlessness, and confusion are managed

• Use of non-medication approaches

• Policies on antipsychotic and sedative use

• Communication with families during behavior changes

Medical oversight

• Nurse availability

• How weight, hydration, and nutrition are monitored

• How medication changes are managed

• Policy for hospital transfers

Daily engagement

• Activity schedules

• Actual engagement observed during visits

• Opportunities for movement and outdoor time

• One-on-one and small group options

Touring a Memory Care Facility

Visit the facility several times.

• Formal tour

• Unannounced visit

• Evening or weekend visit

• Meal observation

Talk to families. Watch staff interactions. Note how residents appear emotionally and socially.

Trust Your Observations

Look for:

• Gentle and respectful interactions

• Predictable routines

• Residents who seem calm and engaged

• Clean and organized spaces

• Staff who know residents by name

If you feel uneasy, take that seriously.