Winston-Salem Senior AdvisorWhat is the difference between assisted living and memory care in North Carolina?
Assisted living is an adult care home or family care home license; memory care is a special care unit, a block of beds on that license that DHSR has approved for residents with Alzheimer's disease or a related dementia, with secured exits, dementia-trained staff and a written disclosure statement.
In the five counties, 23 adult care homes hold special care unit beds (789 in total on DHSR's October 28, 2026 list), and 4 nursing homes hold another 104.
A resident with mild memory loss can live in an ordinary adult care home if staff can keep them safe under the care plan. The special care unit exists for the residents that ordinary setting cannot protect.
When does a parent with dementia need a special care unit?
When the dementia creates risks an open building cannot manage: trying to leave or getting lost, wandering at night, not recognizing danger, or behavior that unsettles other residents and that staff cannot redirect.
Ask the parent's doctor for a frank view and ask the adult care home what it has seen. Many families move a parent twice, first into assisted living and later into a unit, which is hard on someone with dementia. If the diagnosis is clear and the decline steady, choosing a home with its own special care unit can make the second move a walk down the hall rather than a new address.
Does memory care cost more than assisted living around Winston-Salem?
Usually, yes, because units need more staff per resident, but no one publishes a memory care median for North Carolina, so the only real comparison is between written quotes from the homes you are considering.
CareScout's 2025 statewide assisted living median is about $6,200 a month. Ask each unit for its base rate and every add-on, and ask how the rate changes as the dementia progresses. For residents with limited income, Special Assistance pays its Enhanced Rate inside a special care unit, a higher amount than its Basic Rate in ordinary assisted living, if the unit accepts it.
How can we confirm a home really has a memory care unit?
Look it up on DHSR's special care unit list, which our directory reproduces: if a home shows special care unit beds, its dementia unit is licensed; if it shows none, any “memory care” on its website is a description, not a license.
Then ask for the G.S. 131D-8 disclosure statement and compare it with what you see. Some buildings advertise a “memory care neighborhood” that is simply a hallway; others are entire dementia homes where every licensed bed is in the unit. In the five counties, several homes in Clemmons, Kernersville, King and Mocksville fall in that second group.
What should we ask on a Winston-Salem memory care tour?
Ask how many staff are inside the unit on each shift, especially overnight; what training they have had; how residents spend a weekday afternoon; and exactly which changes would lead to a discharge.
Watch whether residents are engaged or parked in front of a television, whether staff speak to residents by name, and whether the outdoor area is actually used. Then compare the visit with the unit's star rating and survey documents on its facility page. Our memory care list covers every licensed unit in the five counties.
What it is, and what it is not
| Choose a special care unit when | Ordinary assisted living may still work when | |
|---|---|---|
| Safety | Exit-seeking or getting lost has started | The parent stays put and recognizes danger |
| Nights | Night wandering or confusion is frequent | Nights are quiet |
| Behavior | Staff cannot redirect agitation | Reminders and cueing are enough |
| Money | Special Assistance's Enhanced Rate would apply | The Basic Rate covers the setting |
Based on N.C.G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS documents, NC Medicaid, CMS, the VA, CareScout and the local agencies named above; see our editorial standards for how each is checked.
