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Memory Care Options for Low-Income Seniors

Medically Reviewed by Sabrina Felson, MD on August 12, 2022

Many seniors forget things sometimes. Some seniors with mild memory loss can live by themselves. Others might need help from family and friends. But frequent memory loss can be a sign of dementia and a need for more intensive memory care.

Memory care is a program that creates a safe, structured, and engaging environment for people with dementia. There are several different options for memory care. Some are more expensive than others. Most people pay for memory care out-of-pocket. Luckily, there are several cost-effective programs for low-income seniors.

When to Seek Help

Many seniors with memory loss prefer to live with a loved one. But this means that you have to have the time and training to give them an enriching and safe environment. Over time, they might need more attention than family and friends can give. For example, your loved one might have trouble going to the bathroom on their own. Or they can wander or leave home without you noticing and put themselves in danger.

You need to be aware of your own stress levels as well. People in memory care facilities are trained to take care of dementia. Without this training, you can get frustrated, depressed, and burned out. When these things happen, it might be time to consider other options.

What Are the Types of Memory Care Facilities?

There are different kinds of facilities available to serve people with memory issues. They range from day care centers to nursing homes. You might consider a life plan facility, also called a continuing care community. These facilities offer several different levels of care. In a life plan facility, a senior can switch between care levels as their needs change.

Adult day care

Adult day care centers can be helpful for seniors who want to live at home but need extra enrichment and supervision. These programs can also give caregivers a break.

Day care facilities can be independent or part of senior centers, nursing facilities, hospitals, schools, or houses of worship. There are two types:

  • Adult social day care is recreation-focused. It provides activities like art, music, exercise, and certain health-related services.
  • Adult day health care provides health and social support for seniors with serious medical conditions.

Even if your loved one will be at the center for only a few hours, it’s important to do some research. Some states regulate adult day cares; if you live in a state that does, check whether the center is licensed.

Visit the center before you sign up your loved one. Talk with the staff to see if they seem involved and attentive. If you see a participant or their family member, ask how they like the program. Some states have an adult day care association that also can give feedback on the facility.

To learn more about adult day care centers, contact:

Day care centers usually aren’t covered by Medicare. But assistance may be available through programs like Medicaid, the Older Americans Act, or the Veterans Health Administration.

In some states Medicare’s Program of All-Inclusive Care for the Elderly (PACE) may help cover dementia care for eligible people. BenefitsCheckUp .org and Benefits.gov can help you find other federal and state benefit programs.

Some states offer Home and Community-Based Services Medicaid Waivers, also called 1915(c) waivers. These waivers help cover services that aid independent living, such as home modification and meal delivery.

Assisted living

Assisted living, or supported care, is an option for when it’s no longer possible for someone to live at home. It provides more intensive support while helping your loved one to live as independently as possible. Assisted living facilities usually provide:

  • A small apartment for individual or shared living
  • Meals
  • Housekeeping
  • Medication management
  • Activities and social programs

Some also offer:

  • Personal care assistance (help with dressing, bathing, going to the bathroom, and eating)
  • Homemaker services
  • Transportation
  • Case management
  • Personal emergency response systems

It’s important to find an assisted living facility that specializes in memory care. They offer activities designed to enrich thinking skills, as well as safety measures to prevent wandering.

When choosing an assisted living memory care facility:

  • Visit several times and at least once in the evening. If possible, try to have one unannounced visit.
  • Observe if the facility looks clean and smells good.
  • See if rooms and bathrooms are clearly labeled.
  • Check if the outdoor areas and exit doors are monitored and secured.
  • Notice if other residents seem engaged in activities.
  • Observe how the staff interacts with the residents.
  • Ask about what memory-related training the staff receives.
  • Ask what security prevents wandering.
  • See if food choices look and smell appetizing.

The Alzheimer's Association offers an online directory of senior care services to help you find an assisted living facility.

Memory care assisted living facilities cost an average of $6,935 per month, but costs vary greatly. Medicaid is a federal and state program, and the eligibility requirements, available programs, and benefits depend on the state you live in. Medicaid benefits cover only programs that are listed as “Medicaid-certified.”

An Alzheimer’s diagnosis doesn’t automatically qualify you for long-term care under Medicaid. In some states, you need personal assistance with at least two activities of daily living, like dressing, eating, or using the toilet. Some programs ask for a doctor’s statement that personal care services are needed.

Medicaid doesn’t pay for the room and board portion of assisted living, which generally amounts to about half the program cost. Medicaid might cover things like personal care assistance, homemaker services, emergency response systems, and skilled nursing. Each state has Medicaid programs with different eligibility requirements.

Nursing homes

When people need round-the-clock care and supervision, a nursing home (also called a skilled-nursing facility, long-term care facility, or custodial care) can provide it. Alzheimer’s Special Care Units, or memory care units, are designed for people with dementia. You can find memory care units in assisted living facilities, nursing homes, and other forms of long-term care. In addition to memory-enhancing activities, memory care units often have locked and alarmed exit doors and enclosed outdoor spaces.

When choosing a nursing home, ask about specific policies and procedures related to the care of residents with dementia. How does the nursing home respond if a resident becomes aggressive? Does it use antipsychotic medication? If so, which ones and how often?

Nursing homes cost an average of $10,562 per month, but costs vary by state and level of care. Find out whether the home is Medicare-certified or Medicaid-certified. Medicare- or Medicaid-certified nursing homes must tell you about all their services, charges, and fees in writing. Ask which services are included in your monthly fee and which ones cost extra. You can also check the nursing home’s ratings on Medicare.gov.

Medicare is a federal insurance program for people 65 and older. Medicare doesn’t pay for personal assistance at home, assisted living, or long-term nursing home care. But it will pay for short nursing home stays after a hospitalization. Medicaid may cover the costs of medical care and some types of long-term care for people who have limited income and meet other eligibility requirements. Eligibility requirements and covered services vary from state to state.

What Are Other Ways to Pay for Memory Care?

Some people with disabilities who are younger than 65 are eligible for financial assistance through Social Security Disability Income (SSDI). SSDI offers compassionate allowances, which enable people with dementia and other serious medical conditions to get benefits more quickly. SSDI might be a helpful resource for people with early-onset Alzheimer’s.

If you have a disability and are 65 or older, you might be eligible for Social Security Insurance (SSI). Many states also offer an optional state supplement (OSS) along with the social security benefits that you already receive. This program can help cover some of the room and board costs of assisted living. In most states, the administering agency is either the Department of Human Services (DHS) or the Social Security Administration (SSA). Each state lists local DHS offices on their Medicaid website.

Show Sources

SOURCES:

David LeVine, MD, CMD, geriatrician; chief medical officer, Menorah Life, St. Petersburg, FL.

Eldercare Locator: “Adult Day Care.”

National Adult Day Services Association: “Comparing Long Term Care Services.”

Alzheimers.gov: “Finding Dementia Care and Local Services.”

Alzheimer’s Association: “Wandering,” “Long-term Care.”

AARP: “Memory Care: Specialized Support for People With Alzheimer's or Dementia.”

American Council on Aging: “How Medicaid Can Help Seniors Cover the Cost of Assisted Living.”

National Institute on Aging: “How to Choose a Nursing Home,” “Paying for Care.”

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