Dementia and Memory Care at Hillsboro House


An aging population has caused an increasing need for the care of cognitive disorders: memory loss, dementia, Alzheimer’s Disease. And many institutions have responded to that need by creating segregated wards, sometimes behind locked doors, called dementia units or Alzheimer’s units.  By any measure, fifty years of experience caring for people with cognitive and memory impairments  make Hillsboro House specialists in Alzheimer’s and dementia care in New Hampshire; in practice, however, that experience has made Hillsboro House more specialized in individualizing the care of each of our residents.

Approaching Memory Care: The security of being an individual

Most fundamentally, what fifty years of dementia care has taught us is that cognitive decline manifests differently in each of our residents. So while we care for people with all phases of dementia, we do it without segregating these people and we do it without the assumption that any persons’ needs perfectly parallel those of any other resident . Instead, we believe in the individualization of care and the very deliberate tailoring of supportive services. That’s why our caregiver ratios far exceed the average.  It’s why we work hard to attract, train and retain a staff that is deeply familiar with our residents as people rather than patients.  Our staff  has specialized training and advanced licensure in geriatric nursing, pain management, palliative care and interventions unique to the elderly population.  In addition to being enormously stable (the turnover at Hillsboro House is a fraction of the national average), the small staff ensures that our residents interact daily with caregivers who know them individuals with individual preferences and individual routines.

What we have learned, in five decades, is that the needs of our residents change often daily.  That’s why Hillsboro House offers a calm, homelike environment that fosters independence with the creation of productive routines and individualized activity programming.  In fact, Hillsboro House has long been an innovator in dementia and memory care – the idea of creating a home rather than an institution is widely replicated as an innovation in long term care nearly sixty years after Hillsboro House pioneered the idea in New Hampshire.

The Best Dementia Care for the Best Outcomes

At Hillsboro House, we’ve cared for residents affected by dementia and cognitive deficits for many, many years, and we’re committed to offering them an environment of dignity, safety and meaningful interaction.  In support of this commitment, we tend to group elements of the care planning process around two essential domains.

The Highest Possible Quality Medical Care and Physical Well Being

At Hillsboro House, we believe that dementia and memory care is indeed a clinical specialty demanding unique skills and advanced training.  Our doctors, nurses, pharmacists and therapists all contribute to a base of knowledge as deep as it is varied.  As a result, we maintain a focus on:

  • Nutrition and hydration with the recognition that both contribute to cognition, health maintenance and the management and interaction of chronic conditions.

  • Pain Management with the recognition that physical discomfort often manifests as behavioral changes.

  • The maintenance of physical activity with the recognition that independence contributes both to health and the preservation of important elements of control and participation.

  • An environment of physical safety free from unneccessarily restrictive intervention with the recognition the physical, pharmacological and clinical interventions have an often complex and highly differentiated interaction.


Meaningful Interaction

The walls at Hillsboro House are filled with photos of our residents.  After several decades this collection presents something of a history of our community, but it also portrays  a growing portrait of the rich lives of our residents.  Although we often meet our residents only after what in some cases is a century of their lives, we endeavor to sustain a kind of continuity with their experiences, accomplishments and their interests.

This is why we work hard to have our operation as a facility dictated by the people who live here. It’s why we create routines and activities that reflect the interests of our residents, that facilitate meaningful relationships and empower our residents as participants in and contributors to their community.



I do wonderfully now and have all of you to thank. Sandy, Phalla, Maggie and whichever cook makes the carrot cake… thank you.

Jean E., Peterborough, NH

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