Do they realize 'why" they are in an Assisted living home? I just started to work in an Assisted Living Home and I see the "shell" a beautiful person. It makes me want to cry when I think of what they have lost -The "pieces" of their lives. Yet at the same time they seem "content" to be as they are.
In some ways his awareness of his disease made life easier for him and certainly for me. In other ways that is a bitter knowledge. My sister said, "If I ever go gaga I hope I just get there and I don't have to go through a journey where I know about it."
If something had happened to me and my husband had to go into a memory care place he would know why he was there. I think that Carol is right that it depends on the particular kind of dementia and the stage they are at. You probably can't generalize about the people you see. Getting to know them as individuals will answer your questions.
However, in most cases when the people are in a memory unit they have passed into a stage where their own reality is the only one they know.
Again, depending on the stage they are in, they may become very frustrated when they forget something they want to remember. It's also common for them to be frightened because paranoia is often part of the disease. For these reasons they may not always be content.
However they may have times of serenity if they are getting proper, individual care. Especially in the later stages of Alzheimer's, you'll see many people totally in their own world. However, I'd never want to take the chance that they don't know what's happening around them. That's why it's important to not speak negatively when they are within hearing distance.
Treating them with dignity and respect is important, and you sound like a person who will do that. It's wonderful of you to care so much.
Take care,
Carol