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  • Writer's pictureChristopher Zambakari

Dementia Care Settings: When Smaller is Bigger

Dr. Christopher Zambakari, B.S., MBA, M.I.S., LP.D.

Nathalia Zambakari, Board Certified AGACNP-BC


Under a single home care umbrella, Desert Haven Home Care, Apollo Residential Assisted Living, Oasis of Prescott, and Villa Fiore Assisted Living feature unparalleled care, service and advocacy in the compassionate treatment of senior citizens in need of medical attention. Offered in a familial setting, the facilities are teamed by professionals passionate about their work and fully engaged in the welfare of residents. Each facility proudly provides patient-centric supervisory, assisted and directed care, short-term respite stays and memory care support for Alzheimer’s and dementia patients.

This following exploration of the role of advocacy in senior healthcare is one of a series of regular informational blogs relative to the field of service, care and the treatment of our elderly.


“Of all ruins, that of a noble mind is the most deplorable.”

Arthur Conan Doyle, The Complete Sherlock Holmes

Dementia is a progressive neurological disorder that affects an individual’s ability to think, remember and recognize objects and people. It is a complex and challenging condition, and the care and management of dementia patients requires specialized and constant, compassionate attention. For this reason, many families choose to place their loved ones suffering from the debilitating disease in long-term residential assisted living homes that specialize in such critical care. While large care homes may offer a variety of services and amenities, smaller residential settings can provide a number of unique advantages for dementia patients.

A care home is a home away from home that still looks and feels like home, rather than an institutional setting. Called by various names across the country, they are known as residential care homes, residential care facilities for the elderly, adult family homes, board-and-care homes, and personal care homes. Whatever the moniker, they offer a common promise: focused, individualized care for seniors in a home-like setting.

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Making the decision to place a loved one in a long-term setting away from home because of their declining health, signs of dementia or their inability to care for themselves, is a difficult and stressful one. Often tipping the scale in the decision to make such a move is the security and peace-of-mind that comes with the placement of a loved one in a setting where care in a smaller facility is the polestar. The transition from the loved one’s residence to a home-like setting is often times a smoother proposition and easier on the patient. In many cases, it comes down to care, service and advocacy. The three should be at the foundation of any residential care setting – patient-centered care, best-class service and passionate advocacy.

Residential care homes offer unique benefits, thanks to their small size and care models. Among the primary advantages of a smaller long-term residential setting for dementia patients is the enhanced level of personal care. Smaller residential settings typically serve fewer residents, which allows care staff the ability to provide more individualized, customized attention to residents. This personalized focus can be beneficial for these patients, who often have difficulty with communication and may need more help with the activities of daily living (ADLs). In a smaller home setting, staff can more easily monitor the patient’s activity and assess real-time needs, allowing them to intervene more quickly if a patient is exhibiting signs of distress or confusion. This also helps guard against the chance of a health change or illness slipping through the cracks.

At the foundation of any residence care setting should be patient-centered care, best-class service and passionate advocacy.

The smaller size of these residential settings also lends itself to more structured routines and activities that can help dementia patients stay engaged and maintain their independence. Such routines provide a sense of familiarity and stability, help reduce anxiety and confusion, and address feelings of loneliness or isolation, while improving cognition. Furthermore, these settings can be tailored to the needs and preferences of the individual, allowing for greater flexibility and customization in care.

Smaller residential settings also offer a more home-like atmosphere, providing residents with a sense of reassurance and support. The more intimate, familial setting can be comforting to dementia patients. The familiarity of the environment can help reduce feelings of disorientation, as well as provide a sense of security. In addition, the smaller setting allows for more intimate social interaction between residents and staff, which can help reduce feelings of isolation and loneliness. This is especially important for dementia patients, who may be prone to feelings of anxiety and depression.

Greater flexibility in care is often a trademark of long-term residential care. In a more intimate setting, the staff is better able to tailor daily routines and service options to meet the needs of each patient. This can allow for more freedom of choice in activities and leisure pursuits, as well as providing more opportunities for meaningful engagement with staff and the environment. Conversely, the resident with dementia may seek more alone time or activities with fewer participants, which, in a more intimate, familial setting is not only accommodated but is built into care tailored to special interests and needs.

Another consideration in the choice of a long-term assisted living or memory care setting is cost of care. It is difficult to generalize, but, overall, the costs are similar when larger facilities are compared with the smaller residential settings. Costs vary, however – often greatly – from one ZIP code to another, from area to area, from state to state. Genworth, a national life insurance company, estimates the average monthly cost of 24/7 care facilities, large or small, is $4,300 for a private, one-bedroom setting.

Greater flexibility in care is often a trademark of long-term residential care.

The final step in the decision to transition a lived one into a 24/7 care facility is your own endorsement of the location. Tour the residential settings that rise to the top of your list of those deserving of your choice, those qualified to care for your loved one. Visit at different times, interact with staff and residents when possible. Check for cleanliness and the suitability of accommodations. Keep an eye out for safety hazards (stairways, exit signs, lighting, security, etc.), and make note of the surroundings (furniture, outdoor areas, grounds, etc.).

In summary, smaller residential settings such as assisted living facilities and care homes offer a variety of advantages over larger, institutionalized settings for dementia patients. The environment is more familial, the care more individualized. Just as every patient has different needs, care homes – large and small – vary in offerings and benefits. What sets one apart from the other is delivery of care and the quality of care. As noted earlier, care, service and advocacy should be the determining factors in the decision to move a loved one to long-term care.

Patient-centered care. Best-class service. Passionate advocacy on behalf of its residents. Each must be at the foundation of the care your loved one deserves.


About the Authors

Dr. Christopher Zambakari, B.S., MBA, M.I.S., LP.D.

Christopher Zambakari is the owner and operator of four Arizona-based assisted living care homes – Desert Haven Home Care in Phoenix, Apollo Residential Assisted Living in Glendale, Oasis of Prescott and Villa Fiore Assisted Living in Prescott Valley. He provides direction and oversight to a team of licensed medical and caregiving professionals to ensure the highest levels of customized care, service and advocacy at each of his facilities.

Nathalia Zambakari, Board Certified AGACNP-BC

Nathalia is a board-certified Acute Care Nurse Practitioner and a licensed medical professional responsible for short-term care patients suffering from severe conditions. As part of the care team, Nathalia reviews the medical records of incoming residents, helping to manage patient regimens and performing caregiver education to ensure the best care, service and advocacy for her residents-in-care.


The material presented on this blog does not constitute medical advice. We encourage you to consult your primary care physician (PCP). The statements in this blog are not intended to diagnose, treat, cure or prevent any disease. Always consult your personal physician for specific medical advice. If you or your loved one is considering the benefits of quality assisted living, please contact us at 602-670-9326, or email us at

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