Last verified: October 2026
Should someone with dementia go to a memory care unit or a nursing home?
A secured dementia unit in a personal care home or assisted living residence fits someone whose main need is supervision and help with daily activities in a secured setting; a nursing home fits someone with dementia who also needs daily skilled nursing or has medical conditions a personal care home cannot manage.
Many people move from a secured unit to a nursing home as dementia advances and medical needs grow.
How many secured dementia units and nursing homes are there around Pittsburgh?
The seven-county region has 71 DHS-licensed secured dementia units with 2,380 beds and 111 CMS-certified nursing homes with 14,010 beds; nursing homes do not need a separate dementia unit to admit residents with dementia.
See the memory care and nursing home lists.
Who pays for each?
Memory care in a personal care home is private pay apart from narrow exceptions such as the SSI supplement, because Medicaid does not pay personal care home room and board; a nursing home is paid by Medical Assistance for residents who qualify financially and medically.
Families who expect savings to run out should ask early whether a memory care home keeps residents who later qualify for Medical Assistance; usually it cannot be paid that way.
What should you ask either setting about dementia care?
Ask both how they handle evening agitation, falls and refusal of care, how staff are trained for dementia, how they communicate with families, and which behaviors would lead to a discharge.
For a secured unit, ask to see the preadmission screening form; for a nursing home, check the CMS staffing rating and recent health-inspection deficiencies.
How does Medicare treat dementia care in each setting?
Medicare pays for neither setting's long-term room and board: it covers doctor visits, hospital care, hospice and a short skilled nursing stay after a qualifying hospital admission, but not ongoing supervision in a secured unit or long-term custodial nursing care.
A person with dementia who enters a nursing home for rehab under Medicare and then stays on becomes a long-term resident paid privately or by Medical Assistance. Plan for that transition rather than assuming Medicare continues.
Secured dementia unit vs. nursing home
| Secured dementia unit | Nursing home | |
|---|---|---|
| Main need met | supervision and daily help | daily skilled nursing |
| Entry | dementia diagnosis plus screening | nursing-facility level of care |
| Payment | mostly private | Medicare short-term; Medicaid long-term if eligible |
| Rating | none; DHS inspections | CMS Five-Star |
