Medicaid & Hcbs Waivers And Alzheimers Care
Medicaid is a state and federally funded health insurance program for low-income families and the elderly. Each state administers their Medicaid programs separately. Therefore, each state offers different benefits with regards to caring for individuals with Alzheimers or dementia.
Medicaid Waivers are state programs that allow individuals to receive care outside of nursing homes. Instead of requiring institutionalization, Medicaid Waiver participants can receive care, paid for by Medicaid, in their homes, the homes of relatives, and sometimes in adult foster care homes and assisted or senior living residences. Almost all Medicaid Waivers have both financial eligibility requirements and requirements that the participant have functional limitations. Very few, require a specific diagnosis of Alzheimers or dementia. Instead, they consider ones ability or inability to care for themselves by accessing their ability to perform their activities of daily living. From a functional perspective, mid to late stage Alzheimers patients typically qualify for Medicaid benefits quite easily.
For more information on Medicaid and each states waivers, please use the following links: General Medicaid, Home Care Waivers, Assisted Living Waivers, Adult Day Care Waivers, and Adult Foster Care Waivers.
What Is Memory Care
A memory care community is a residential care facility or unit of a residential care facility that is designed specifically to meet the needs of people who have Alzheimers disease or other dementias. Memory care communities strive to provide residents with a high quality of life while taking additional measures to ensure their safety. There may be security measures in place to ensure that residents do not wander, for example, and some units are locked so that no one may leave or enter.
Memory care facilities may also give you the option of specialized care to help your aging loved one manage their medications and healthcare. These facilities care not just for individuals medical needs, however. They also frequently offer opportunities to socialize or engage in hobbies in ways that work best for people with impaired memories. Some communities may offer pleasurable activities, such as visits from therapy pets, musical entertainment, or the opportunity to spend time in the gardens, that are known to be particularly beneficial for people living with cognitive changes.
How Do I Know When Its Time For Memory Care
Watching a loved one live with dementia, Alzheimers disease, or any other memory impairment is not easy. Out of love and compassion, many families attempt to provide care for their loved one on their own. But, many seniors living with memory impairment do eventually reach a point when they will greatly benefit from professional memory care.
While making the decision to seek memory care is personal for every family, the situations below may indicate that its time to seek professional care for your loved one.
- Getting lost or disoriented while driving or walking on a familiar route
- Losing prescriptions, forgetting to take medication, or taking the improper dose
- Personality changes like increased aggression or withdrawal from loved ones
- Dangerous incidents at home like forgetting to turn off the stove or leaving the door or gate open, making oneself susceptible to crime like burglary
- A noticeable decline in grooming, such as an overgrown, unkempt beard or wearing clothes that appear to be unwashed
- Lack of cooperation with family caregivers
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What Are The Benefits Of Memory Care
Memory care offers seniors with dementia and Alzheimers numerous benefits, including cognitive stimulation, emergency monitoring, and support from specially-trained staff. This can lead to other benefits like a higher quality of life, less use of antipsychotic medications, and improved medical care for other health issues. Some of the most prominent benefits of memory care are explained in more detail below.
- Care Coordination: Your loved ones team will work together, including your aging parent as appropriate, to ensure comprehensive care.
- Staff Knowledge and Competency: The staff can demonstrate training and the necessary skill set to prepare them to work with people who have cognitive impairments.
- Activity Programming Based on Abilities: Activities are available that suit your aging loved ones cognitive ability, memory, attention span, language, reasoning ability, and physical function.
- Behavior Management: The behaviors associated with Alzheimers disease and other dementias are addressed first through non-pharmacological means, such as taking a look at scheduling, environment, and other possible triggers for the behavior.
- Safe and Supportive Physical Environment: The physical environment is managed by the staff to reduce stress and overstimulation, and to keep all residents safe.
How Do I Choose The Right Memory Care Community
Making the decision to seek memory care for a loved one is challenging in itself, and the next step of choosing a memory care community can be incredibly difficult. To help make the process easier, weve broken it down into some key points for you to focus on. In the sections below, we offer some advice on determining when its time for your loved one to start memory care and things to look for when selecting a community.
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First Steps: Getting An Assessment
The first step towards choosing a care home is to get a new needs assessment from social services.
If the assessment suggests a care home would be the best option, the next step is a financial assessment .
The financial assessment will show if the council will pay towards the cost of a care home.
In most cases, the person with dementia will be expected to pay towards the cost.
Social services can also provide a list of care homes that should meet the needs identified during the assessment.
Psych Yourself Up To Be A Dementia Caregiver
In a randomized trial of 119 caregivers, Johns Hopkins MIND at Home researchers found the most upbeat and positive dementia caregivers tended not to hesitate on interventions. Instead, they jumped right in with environmental modifications, communication techniques and other needed interventions. Four months later, the caregivers were fully engaged and seeing positive changes in their loved ones behavior.
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Ethics Approval And Consent To Participate
The study was approved by the Regional Committee for Medical and Health Research Ethics in Southeast Norway using the following procedure: Participants were informed in writing as well as verbally. Competency was evaluated by the nurse in charge in the nursing home, and when competent, the PWD was asked to give his or her informed consent. If not competent, the next of kin was asked to approve or reject participation . In addition, the PWD was informed about the study and asked whether she or he wanted to participate before and/or during each interview . Furthermore, the interview with the PWD was terminated if he or she physically indicated that he or she did not wish to continue, for instance, if the PWD appeared to be nervous or agitated, or walked away. Pseudonyms have been used to preserve anonymity of the participants.
Paying For Alzheimers Care Overview
Alzheimers disease, Lewy Body dementia, Frontotemporal dementia , and other related memory disorders and dementia affect over 5.5 million aging Americans. Depending on the stage of these diseases, individuals can require 24-hour supervision or care. This means each year in the U.S., there are billions of hours spent caring for individuals with these conditions. While the vast majority of that care is provided by friends and family members, what happens when those caregivers are not available? Who pays for Alzheimers care? Fortunately, there are many programs that provide financial assistance, respite care, and other forms of aid to help families and caregivers.
The worldwide cost of dementia care is approximately 1 trillion U.S. dollars. If dementia care were a country, it would be the worlds 17th largest economy.
Helpful Resources
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Using Reverse Mortgages For Alzheimers Care
The decision on whether or not to use ones home, through a reverse mortgage, to help pay for care is not an easy one. In many cases, it does not make good economic sense, but in other situations it does.
Reverse mortgages come due one year after the homeowner moves from their home. Given that most individuals with Alzheimers will eventually require residential care, it becomes a question of how many years until that point. Should one be at the early stage of the condition and wont require residential care for 5 years, a reverse mortgage might make good sense as a funding resource for occasional assistance around the home. However, if one might need to move within 2 years, a reverse mortgage would be considered an expensive source of funds. The exception to this rule is when the individual with Alzheimers has a healthy spouse who will continue to live in the home when the spouse with Alzheimers moves into a care facility. In this situation, a reverse mortgage could be a sound decision.
How Far Have The Alzheimer’s Symptoms And Stages Progressed
Alzheimers disease has three stagespatients at each stage require different levels of care. A person diagnosed with Alzheimers usually lives another four to eight years after diagnosis but could live as long as 20 years. Early-stage Alzheimers patients can live relatively normal lives, although they may notice memory lapses, have difficulty organizing themselves and may struggle in particular with work or social settings. Patients at this stage can usually manage to stay in their own homes and may still have the legal capacity to make decisions about their future care preferences.
The next stage, moderate Alzheimers, can last for several years. Patients during this stage will have obvious symptoms, such as confusion, severe memory lapses, getting lost, and behavioral or personality changes, like delusions, suspicion, moodiness, changes in sleep patterns, and in some cases loss of bladder or bowel control.
Late stage Alzheimers symptoms can make a person unable to function and eventually lose control of movement. They need 24-hour care and supervision. They are unable to communicate, even to share that they are in pain, and are more vulnerable to infections, especially pneumonia.
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Does My Loved One Have A Healthy Structured Routine At Home
People with Alzheimers benefit from a consistent, structured daily routine. They also benefit from a healthy diet, regular physical activity, and mental and social stimulation. Circumstances may make it impossible for you to offer your loved one a daily routine that supports their well-being: for instance, if you work long hours or depend on support from family members who cannot commit to regular hours, the patients routine may be frequently disrupted, which is not ideal.
How Do I Talk To My Loved One About Alzheimers Care
Another big challenge that comes with aging is talking to your loved ones about Alzheimers care. Many people have trouble coming to terms with the disease and therefore are resistant to going to an Alzheimers care facility. The first thing to mention to them is that its very difficult for you to provide them with the care they need for Alzheimers disease without extra medical attention, and that can be very stressful for both of you. Show them how much more comfortable they will be in an Alzheimers care facility, and they may start to realize how much of a difference it will make to be in this type of care. Work with them to find a memory care facility thats comfortable instead of making the decision without them, which can be overwhelming and feel very unfair. If your loved one is particularly resistant, another strategy that works well with Alzheimers patients is to convince them to try a care facility for a short period of time, such as one or two weeks. Theyll likely get used to it very quickly, and if they dont, that might be a sign that they need to be in a different form of care.
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How Can I Find An Alzheimers Care Facility Near Me
There are several ways to find Alzheimers care facilities in your area. The first is to call your current doctor or your insurance provider and see if they can recommend one that they know would be a good fit for you. Another good resource is the Alzheimers care directory available on MemoryCareFacilities.net, which you can sort by location or other important factors. A good way to search for the best facilities is to look for ones that specifically market themselves to Alzheimers patients, instead of just as general assisted living facilities or nursing homes . There are plenty of Alzheimers care facilities around the country, so youre sure to have plenty of choices and should be able to find a great Alzheimers care facility near you. Here’s our list of all Alzheimer’s care homes across the U.S. to get you started:
What Are The Benefits Of Staying In Alzheimers Care Facilities
Dedicated Alzheimers care facilities offer many benefits to seniors suffering from this disease. The biggest benefit is theyre able to stay healthier later in life, because they have access to the latest medications and treatments for Alzheimers. There are many medications that can manage Alzheimers symptoms in early stages of the disease, and there are also many types of therapy that provide a gentle stimulation that can lessen symptoms of the disease. Having regular doctors appointments can also prevent the development of other serious medical conditions, both physical and mental. Aid from nurses with daily tasks also prevents injury and lessens confusion in Alzheimers patients, which helps the seniors stay healthy.
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Can I Care For My Loved One At Home Through All Stages Of Dementia
Home care is often recommended by experts through end of life. However, every family and situation is different, so permanent home care may not always be possible.
Research shows keeping a loved one with dementia at home helps them be happier and live longer however, it is most impactful when introduced early. Its a preventive model to educate the family to be dementia smart and understand the disease progression and triggers down the road, Havrilla explains. But if the family is not able to give their loved one the care they need, rehabilitation facilities, nursing homes and assisted living residences are good alternatives.
Senior Housing Options For Dementia Patients
Finding residential long-term care is relatively straightforward for most seniors. Are Mom and Dad still safe living on their own but craving a little more stimulation in their daily lives? Independent living is the perfect fit. Is Grandma largely independent except for the help she needs with bathing, dressing, and transportation to errands and appointments? Shed likely thrive in assisted living. Does your husband require around-the-clock supervision and skilled nursing care? Then a nursing home is the correct level of care for him.
The different types of senior living seem easy enough to understand at first glance, but deciding where and when to place an aging loved one is far more complicated when they have some form of dementia. One would think that the spectrum of long-term care would match up well with the progressive nature of Alzheimers disease and other types of dementia, but that is not always the case. Several factors go into choosing a long-term care facility for a dementia patient. Even if you get it right, theres no telling how long the perfect fit will last.
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An Overview Of Dementia Care Costs
As of 2018, an estimated 5.7 million Americans live with Alzheimers, dementia, and other memory disorders, and 1 in 10 seniors age 65+ has Alzheimer’s dementia. Depending on how advanced the disease, your loved one may require anything from Post-it note reminders on the walls, to regular in-home care, to 24-hour supervision, to skilled care at a nursing home.
Screenshot via Phrma.org
And therein lies the lions share of dementia care costs: in the actual care. Because while many diseases require expensive drugs, monitoring, tests, and other pricey technology, dementia care most often boils down to sheer time: someone must pay for that 24/7 care, and it doesnt come cheap. In fact, as of 2018, Alzheimers and dementia care in the U.S. will cost an estimated $277 billion more than the entire economyof Finland.
According to a 2015 study, the average cost of dementia care was $287,038, compared to $175,136 and $173,383 . And in 2018, the Alzheimers Association estimates the lifetime cost of Alzheimers and dementia care at a staggering $341,840.
Screenshot via Alz.org
Whats more, the average out-of-pocket healthcare costs for dementia patients in 2015 was $61,522 more than 80 percent higher than the out-of-pocket costs to treat heart disease and cancer. Why? Because common dementia costs, such as hiring caregivers to help patients complete everyday activities is not covered by Medicare.
Dementia Care Levels & Their Associated Costs
Screenshot via NCBI-NIH
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How To Make Moving Day Easier
Moving is very stressful. Moving the person with Alzheimers to an assisted living facility, group home, or nursing home is a big change for both the person and the caregiver. You may feel many emotions, from a sense of loss to guilt and sadness. You also may feel relieved. It is okay to have all these feelings. A social worker may be able to help you plan for and adjust to moving day. It’s important to have support during this difficult step.
Here are some things that may help:
- Know that the day can be very stressful.
- Talk to a social worker about your feelings about moving the person into a new place. Find out how to help the person with Alzheimers adjust.
- Get to know the staff before the person moves into a facility
- Talk with the staff about ways to make the change to the assisted living facility or nursing home go better.
- Don’t argue with the person with Alzheimers about why he or she needs to be there.
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