Honolulu Senior AdvisorWhat is the difference between assisted living and memory care in Hawaii?
In Hawaii, assisted living is a licensed setting under HAR 11-90, while memory care is a description of dementia-focused care that may be provided in a secured part of an assisted living facility or nursing home, or in a care home; the state has no separate memory care license.
Because there is no license category, “memory care” on Oahu means whatever a provider says it means. Ask what is actually different: secured doors, staff ratios at night, dementia training, structured activities and how residents are assessed for the unit.
When does someone need memory care rather than assisted living?
Someone usually needs dementia-focused care rather than standard assisted living when they try to leave and get lost, cannot use a call system or remember to eat, become distressed without constant reassurance, or need cueing for every step of daily care.
Many people with early dementia do well in standard assisted living or a calm care home. The question is safety at night and when no one is watching.
What should we ask an Oahu provider that offers memory care?
Ask how the area is secured, how many staff are awake at night and for how many residents, what dementia training staff complete, how behaviors are handled without sedating medication, and what would make them ask a resident to leave.
- Ask to see the secured area at mealtime, not just on a quiet tour.
- Ask how families are told about falls, weight loss and medication changes.
- Ask for the latest OHCA or CMS inspection report.
- Ask whether Med-QUEST members can live in the memory care area.
Can a small care home handle dementia?
Many Oahu care homes care for residents with dementia well, especially calm residents who benefit from a familiar routine and one main care giver, but a single-family house rarely has secured exits, so persistent wandering is often the point where a home can no longer keep a resident safe.
Read memory care in Hawaii.
At a glance
| Assisted living | Dementia-focused care | |
|---|---|---|
| License | HAR 11-90 assisted living license | No separate license; provided within other licenses |
| Doors | Residents come and go | Secured exits in a dedicated area |
| Days | Residents set their own schedule | Structured activities and cueing |
| Fit | Largely independent residents | People at risk of wandering or confusion |
Sources include Hawaii Administrative Rules chapters 11-100.1, 11-90 and 11-800, HRS 321-481 and 321-1.8, Office of Health Care Assurance rosters and pages, the 2026 HHS poverty guidelines, CMS, CareScout and VA rate tables as cited above; see our editorial standards.
