Frequently Asked Questions

What is Sundowing or Sundown Syndrome?

According to The Mayo Clinic:

The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning can also lead to pacing or wandering.

Sundowning isn't a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease. The exact cause of this behavior is unknown.


Factors that may aggravate late-day confusion include:

  • Fatigue

  • Low lighting

  • Increased shadows

  • Disruption of the body's "internal clock"

  • Difficulty separating reality from dreams

  • Presence of an infection such as urinary tract infection

Tips for reducing sundowning:

  • Try to maintain a predictable routine for bedtime, waking, meals and activities.

  • Plan for activities and exposure to light during the day to encourage nighttime sleepiness.

  • Limit daytime napping.

  • Limit caffeine and sugar to morning hours.

  • Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.

  • In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting.

  • In a strange or unfamiliar setting, bring familiar items — such as photographs — to create a more relaxed, familiar setting.

  • Play familiar gentle music in the evening or relaxing sounds of nature, such as the sound of waves.

  • Talk with your loved one's doctor if you suspect that an underlying condition, such as a urinary tract infection or sleep apnea, might be worsening sundowning behavior, especially if sundowning develops quickly.

When is it time to move from Apartment-Style Assisted Living?

We have found that when residents are having frequent falls, missed meals, missed medication or unusually long wait times when needing assistance with care that it is time to consider a move from Assisted Living. Facilities such as Heart to Home provide an alternative setting to large "apartment" style assisted living environments. Our unique residential senior care homes are designed as an alternative setting. We provide frequent supervision and pro-active nursing which prevents many medical situations from becoming major medical "incidents". Also, our high staff to resident care ratio ensures residents receive personalized 1:1 care through the end of life.

Where is Heart to Home located?

Heart to Home residential senior care and memory care homes are located in Mendota Heights, Minnesota. Our central location is convenient to many hospitals, the Minneapolis Airport and both downtown Minneapolis and downtown Saint Paul. Our homes are located in "regular" residential neighborhoods but are licensed by the Minnesota Department of Health as a Residential Assisted Living and Memory Care Facility.

How to I get on the wait list for Heart to Home?

The best way to get on the wait list at Heart to Home is to contact us (651) 485-8738. Josh, one of the owners, will provide you with a tour and detailed answers to all of your questions about Residential Senior Care Homes. After this initial meeting we will schedule a no cost registered nursing assessment to meet your loved one and place them on our waiting list.

Does Heart to Home accept Elderly Waiver?

Heart to Home accepts private pay and long term car insurance. In some cases we can also accept Elderly Waiver through Dakota County after an initial spend down period. In most cases we require a minimum of 3 years of private pay before being eligible for Elderly Waiver.

What types of care does Heart to Home not provide?

At Heart to Home Residential Senior Care Homes we are not licensed to provide: tube feeding, IV's or bariatric care (our equipment is not rated for people over 250 lbs). Furthermore we are not licensed to provide care for adults younger than 65 years old. If your loved one requires any of these types of care we can refer you to an appropriate provider.

What is the typical schedule or day like at Heart to Home?

Below is a sample of our daily activities and house schedule:

  • Breakfast (Made to Order)
  • Morning Devotions
  • News and Coffee
  • Assigned Activity with Staff (examples: arts/crafts, music, hair, nail salon)
  • Exercise Class
  • Lunch
  • Afternoon Siesta / Nap / Quiet Time
  • Evening happy hour / snack
  • Exercise Class
  • Dinner
  • Assigned Activity with Staff 
  • Bedtime
Where are your residential senior care homes located?

All of our residential senior care and memory care homes are located in regular residential neighborhoods. State law allows settings such as ours to be located in R-1 Residential Zoned neighborhoods without requiring a special permit from the city.

Our homes are all located in Mendota Heights, Minnesota. Most of the residents that live at our residential assisted living facility were originally from Mendota Heights, Lilydale, Sunfish Lake,  Eagan, West Saint Paul, Saint Paul, Minneapolis, South Saint Paul, Woodbury, Apple Valley, Burnsville, Bloomington, Richfield and other Twin Cities Metro locations.

Our conveniently located homes are close to major freeways including 494, 35E and Highway 110 / Highway 62. Our convenient location allows our residents and their families easy access to the Minneapolis / Saint Paul Airport, local hospitals (Regions Hospital, Saint John's Hospital, Fairview Health System, Healtheast, United Hospital) and both down town areas.

How long can you get hospice care?

According to Medicare guidelines:

Hospice care is for people with a life expectancy of 6 months or less (if the illness runs its normal course). If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor recertifies that you’re terminally ill.

  • You can get hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods.
  • You have the right to change your hospice provider once during each benefit period.
  • At the start of the first 90-day benefit period, your hospice doctor and your regular doctor (if you have one) must certify that you’re terminally ill (with a life expectancy of 6 months or less). At the start of each benefit period after the first 90-day period, the hospice medical director or other hospice doctor must recertify that you’re terminally ill, so you can continue to get hospice care.

At Heart to Home we continue to provide care for our residents above and beyond what is normally covered under the Medicare hospice benefit. In fact we often times have residents who come and go off of hospice care during their stay at Heart to Home. Our approach to caring for each person remains the same during their stay at Heart to Home; person-centered care. Since Heart to Home is not a Medicare certified hospice agency we arrange for on-site hospice care through local hospice agencies such as Our Lady of Peace Hospice a local non-profit organization. The hospice agencies work directly with Heart to Home's nursing staff to provide appropriate 24 hour care in the comfort of our homes.

Is your pricing really all-inclusive?

Yes, there are NO a-la-carte services. As your care needs change your price remains the same - our care promise.