Ask the Doctor: September 2022
Q: What’s the difference between memory care and assisted living?
A: Memory care and assisted living facilities provide many of the same services, but there are important distinctions. Assisted living facilities offer “levels of care.” For example, level one may include verbal reminders for bathing and dressing, whereas level two includes hands-on help with the same activities. The more services offered, the greater the monthly fee. In contrast, memory care facilities are typically all-inclusive. However, many assisted living facilities offer levels of care that are suited for residents who have dementia and those who do not. For example, music and art therapy programs can be enjoyable and relaxing for everyone. Medication management and dressing assistance are common options as well. Depending on the degree of dementia symptoms, it’s possible that a person can start off in an assisted living and then transition to a memory care unit, if needed. For people with mild dementia, it can be more inspiring to be with a mixed population.
If a person wanders (typically a later-stage symptom), facilities require placement in a memory care unit. These units provide security so that a person can’t just walk out and get lost. Entrances and exits are locked, doorways may be obscured, require keys or codes to enter, and doorbells typically signal entering and exiting the unit. The layout in memory care units is designed to help minimize confusion and orient residents. Memory care units also include round-the-clock care and supervision. This is useful for people who need a lot of direction throughout the day, frequently lose things, and those with combative and inappropriate behaviors. All residential care facilities have their own evaluation processes that help pinpoint whether their assisted living or memory care offering is best for a particular person. Facilities that offer transitions of care can make moving into memory care less stressful. It also enables residents to maintain continuity of care with staff and healthcare providers.
Q: I took an online quiz for personalized supplements that are supposed be specific to my health needs. Are they worth the cost?
A: The cost of personalized supplements can range from $30 to $100 per month, depending on how many supplements are recommended. Companies typically offer a deep discount on the first month and then make their money on ongoing subscriptions. The supplements typically include those that can be purchased for less in stores (e.g., vitamins, minerals, probiotics, omega-3s, protein powder, collagen and electrolytes). Though companies promote that their supplements will be personalized, how they make that determination varies widely and is questionable. Recommendations may be based on a few quiz questions, such asking about whether you exercise on a regular basis, sleep well, and if you have any digestive issues. DNA tests may be recommended, but research does not show that DNA tests are reliable for creating customized dietary supplements. Some companies offer the support of a dietitian, but most do not. The better option would be to consult with a registered dietitian who can create a custom eating plan and behavior-change strategies that can help you meet your specific goals. Your physician can conduct blood tests to determine vitamin levels and recommend what may be needed.
What these companies are capitalizing on is an emerging field of science called nutrigenomics, which is still evolving. It’s a fascinating field based on genetic testing to assess the interplay between genes, nutrition, and health. The field is exploring how nutrients influence the behavior of a person’s genes and which dietary choices might be best given your genetic makeup. But the field is new and not quite ready for a broad mass market approach. Studies show that foods, not supplements, are the optimal way to obtain needed nutrients. Supplements have their place, but they don’t replace a nutritious diet and they are not without risk. Talk with your doctor or pharmacist before taking supplements, especially if you’re taking any medications.
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