There is no memory care list for Encino. Here is how we build one.

Dementia is not a care level, it is a different problem

Most of what a care home charges for scales with the body: help standing, help bathing, help getting to the table. Dementia does not scale that way. A woman who can dress herself, walk unaided and hold a pleasant conversation for ten minutes can still be the hardest resident in the building, because at four in the afternoon she wants to go home to a house that was sold in 2009 and she will keep asking until somebody opens a door.

So a home that is entirely comfortable with a frail ninety year old may decline that same woman on the strength of one word in the assessment. Exit seeking. Sundowning. Resistive to care. These are the words that decide the placement, not the diagnosis on the neurologist's letter.

Which is why the question is never whether a home does memory care. Every home says yes, and most of them believe it. The question is what they do at three in the morning, who is awake to do it, and what happened the last time.

Why we will not give you a count

We publish the whole state register for this catchment: 336 licensed homes across 12 towns, each with its bed count and its licence number, so you can check any of them yourself. What that page does not have is a memory care column, and we are not going to invent one. Every site that shows you a tidy count of memory care facilities near Encino is counting something it invented, or something a marketing department handed it.

If a community describes itself as memory care, ask which licence it holds, ask for the number, and ask whether it carries any additional state approvals for serving residents with dementia. Then check the number against the state's own record. Whether a particular approval is required in a particular situation is a question for the licensing agency, not for a placement agency and not for a brochure, and any answer you get from us on that would be worth less than the one you get from them.

What we can tell you is which homes have actually taken a resident like your mother, recently, and what happened after.

See the full register, all 336 licensed homes

A locked building, or a house with six people in it

This catchment offers exactly two shapes. 305 homes licensed for six residents or fewer, 31 licensed for 25 or more, and none at all licensed for anything in between. For dementia the choice between those two is the most consequential one you will make, and it does not go the way most families expect.

A six bed house can be the better dementia setting, and often is. There are no corridors to get lost in. The same two faces appear every day. Meals happen in one room and the noise level is a living room, not a dining hall. For someone late in the illness, frightened by movement and volume, that is worth more than any programme. The catch is that it is a house, and houses have doors that open onto streets.

A larger building can offer a secured floor, a keypad, and a courtyard where someone can walk in circles for an hour in complete safety, which for a person who paces is not a small thing. The catch is the size. A community licensed for 436 beds is a lot of building for someone who cannot form a new memory of where her room is.

As a rough rule: mid stage, still strong, still walking, still trying doors, and the secured building usually wins. Late stage, in a chair, distressed by commotion, and the house usually wins. We have watched both go the other way, which is why we go and look rather than apply the rule.

Six questions, asked of every home, every time

• Is the perimeter actually secured, and what does that mean in this building? Walk me to the door you mean and show me.
• Who is awake between eleven at night and seven in the morning, how many of them, and for how many residents?
• Tell me about the last resident who tried to leave. Not your policy. The last one.
• At what point would you tell us she is no longer appropriate for you, and how much notice does the agreement give us?
• What is your approach when a resident becomes agitated, who prescribes for that, and how often is a physician actually in the building?
• If she declines further, can she stay? Do you hold a hospice arrangement, or is another move built into this from the start?

Where Encino families end up, and why

Inside Encino there are 6 homes licensed for six or fewer, 36 beds between them, and one licensed for 85. If none of those six houses has an opening this month, and none of the caregivers on duty is comfortable with a resident who exit seeks, then there is nothing else inside the city line to try. That is not pessimism, it is the size of the list.

So the search moves outward, and it is not far. Tarzana west along Ventura has 20 licensed homes. Sherman Oaks east has 19. North up Balboa or White Oak, Van Nuys has 51 and Northridge has 74. Reseda has 36, Woodland Hills has 34, and further east North Hollywood has 52.

Distance matters more with dementia than with anything else, because visits are the treatment. A daughter who can stop in for twenty minutes on the way home four times a week does more good than one who manages a long Sunday every fortnight. When we build the list we weigh the drive from your house, at the hour you would actually be making it.

Moving her once, not three times

The expensive mistake in memory care is not choosing a home that costs too much. It is choosing one that will hand her back. A second move six months in means a new building, new faces, a new room she cannot find, and a person who was managing is suddenly not. Every clinician we have ever worked with says the same thing about relocation and dementia, and every family who has done it twice says it more bluntly.

So we ask the uncomfortable question at the front. Not can you take her now, but can you keep her when she cannot feed herself, and what does that cost. A home that answers clearly is worth more than a home with a nicer courtyard.

We are not clinicians. We do not diagnose, we do not stage the illness, and we will not be the ones to tell you it is time. Her doctor does that. Our job starts the moment you know, and it is to find the one home out of these hundreds that will still be the right home in two years.