I think there is a place in Memory Care for both approaches. My daughter worked as an RN in memory care in both skilled nursing and assisted living in the same place my Mom, uncle and several family friends resided. I was there a lot.

In assisted living, memory care residents paricipated in activities in both their unit and the full facility depending on their wishes and capacity (which could change from day to day). I often assisted with baking, snack time and dancing during activities.

By the time most people reached skilled care, the time for reality was usually long past, and for many taking them out of their comfort zone led to upset later. Many of her residents there loved taking care of their dolls or stuffed animals, endlessly dusting the furniture or picking up dishes, or walking the circular hallways. It was a way to be occupied instead of many fidgety repetitive motions or fighting with other residents. Others preferred to watch TV or read magazines.

My niece is in a residential memory care setting, staff and family try to keep her oriented as much as possible. But she says thinking is hard (like about memories) and makes her tired, so we keep visits short. We often dance with her, something she has always loved.

She spends many hours sorting and folding her socks as well as the towels and washcloths. And she walks her preferred paths in the yard for hours each day - rain or shine.

So, it is different for each person and family. And it changes all the time, just like you describe.

Bless you for taking on the almost impossible role of caregiver.

Greed!