Alzheimer’s Care Guide: Symptoms, Stages, Prevention, and Treatment
There are more than 5.7 million Americans living with Alzheimer’s. This number is expected to reach 14 million by 2050.
The complications from this disease make Alzheimer’s the sixth leading cause of death in the United States, so it’s important to educate yourself on the symptoms, signs, stages, prevention, and treatment.
Difference Between Alzheimer’s and Dementia
Dementia is a syndrome and used to describe symptoms that include memory loss, difficulty problem solving, and struggling with thoughts and language. Alzheimer’s is a disease and is a type of dementia.
In fact, there are over 100 types of dementia. Some forms of dementia can be temporary, reversed, or cured, however, Alzheimer’s disease cannot.
Alzheimer’s Symptoms and Stages
Alzheimer’s can cause changes in the brain long before any symptoms or signs start to show. Understanding the symptoms can help you detect Alzheimer’s early on and increase your chance of benefiting from treatment.
The risk of developing Alzheimer’s will vary per individual, but the following are the largest risk factors.
Age: Alzheimer’s is not a normal part of aging, however, your risk increases with age. Most people with Alzheimer’s are diagnosed after the age of 65. After 65, your risk doubles every five years.
Family History: If your parent or sibling was diagnosed with Alzheimer’s, you are more likely to develop the disease. This risk increases with the number of diagnosed family members.
Other Risks: There is a strong connection between our hearts and our brain. If you have heart disease, are overweight, or lack regular exercise, you’re at a higher risk of developing Alzheimer’s.
What Are the Very First Signs of Alzheimer’s?
Alzheimer’s is a slow progressing brain disease. If you notice any of the following warning signs, contact your doctor:
Forgetting recently learned information (dates, appointments, events, etc.)
Trouble following a recipe
Difficulty driving to a familiar location
Losing track of dates, seasons, and times
Trouble judging distances
Struggling with vocabulary
Misplacing things around the home
Paying less attention to hygiene needs
Avoiding social activities
What Are the 7 Stages of Alzheimer’s?
There are three general stages of Alzheimer’s – mild (early stage), moderate (middle stage), and severe (late stage). However, these stages can be broken down into seven more specific stages.
Keep in mind that the seven stages can overlap, and placing someone into a specific stage can be difficult.
Stage 1 – No Impairment: Alzheimer’s is not detectable in this stage. There are no signs of memory problems or other symptoms.
Stage 2 – Very Mild Decline: Minor memory problems may begin to surface. You would still perform well on memory tests, and Alzheimer’s will be difficult to detect.
Stage 3 – Mild Decline: At this stage, you or family members may start to notice small symptoms. Memory tests may be affected and doctors can detect impaired function. Someone in this stage may be unable to find the right words in conversation or remember new names.
Stage 4 – Moderate Decline: This stage is much more clear-cut. Someone in this stage may have difficulty with basic math problems, have short-term memory loss, be unable to manage bills, and may forget details of the past.
Stage 5 – Moderately Severe Decline: Those in this stage may begin to require assistance in day-to-day life. They may be unable to get dressed appropriately, be unable to recall details like their phone number, and demonstrate significant confusion.
Stage 6 – Severe Decline: People in this stage need constant supervision and may require professional care. They may be unaware of their environment, unable to recognize faces, and unable to remember most of their personal history. Loss of bladder control, personality changes, and wandering are also common in this stage.
Stage 7 – Very Severe Decline: This is the final stage of Alzheimer’s. People at this stage are unable to communicate and respond to their environment. Their speech may be limited to less than six words and they are unable to sit up independently.
How Quickly Does Alzheimer’s Progress?
The rate that Alzheimer’s symptoms progress can vary, but the average person lives four to eight years after diagnosis. However, early detection and a healthy lifestyle can help someone with Alzheimer’s live 20+ years after diagnosis.
There is no single test that can diagnose someone with Alzheimer’s. Doctors use a combination of medical history, physical exams, neurological exams, mental status tests, and brain imaging when diagnosing.
Neurological exams address reflexes, coordination, eye movement, speech, and sensation. Mental status tests give an overall sense if a person is able to understand dates, times, locations, and simple instructions or calculations.
The Main Cause of Alzheimer’s
Although scientists don’t fully understand all the causes of Alzheimer’s, research suggests that this progressive disease is related to aging, genetics, and underlying health conditions.
Environmental and lifestyle factors may also contribute. Often the disease could be a combination of these factors.
Complex factors like age, genetics, environment, lifestyle, and existing medical conditions play a role in developing Alzheimer’s. However, while you can’t change your genes or your age, there are plenty of steps you can take to help prevent Alzheimer’s.
Can Alzheimer’s Be Prevented?
There is strong evidence that shows changing your lifestyle promotes a healthy heart and lowers your risk of Alzheimer’s.
Prevention tips include:
Healthy Heart: There are several connections between our heart and brain. Studies have shown that about 80% of people with Alzheimer’s also have some form of heart disease. Manage your blood pressure, diabetes, and cholesterol levels to lower the risk of developing any heart conditions.
Exercise and Diet: Regular exercise and a healthy diet directly benefit your brain cells. Exercise increases blood flow and oxygen to the brain and a healthy diet limits your intake of sugars and saturated fats.
Social Activities: Staying social helps build and maintain strong connections. This can keep you mentally active. Researchers believe these connections can lower your risk of Alzheimer’s by increasing mental stimulation and reinforcing connections between nerve cells and your brain.
Alzheimer’s Disease Treatment
There is no cure for Alzheimer’s and no way to stop its progression. However, there are drug and non-drug options to help treat the symptoms. These include:
Medications for Memory: Cholinesterase inhibitors and memantine are common drugs used to treat memory loss and confusion. A doctor can prescribe these medications, so be sure to contact your health care provider.
Behavior Treatments: Some doctors may prescribe antidepressants, anxiolytics, or antipsychotic medications for people who demonstrate drastic behavior.
Alternative Treatments: Researchers believe that herbal remedies, dietary supplements, and certain foods can enhance memory and prevent Alzheimer’s. Some examples include coconut oil, coral calcium, and omega-3 fatty acids. To see an extended list, click here.
Are you a caregiver? There are several options available to help a loved one diagnosed with Alzheimer’s. These options include:
Minor Assistance: You can help your loved one with simple tasks like removing objects that could cause injury, maintaining smoke alarms and fire extinguishers, and keeping dark areas, like stairwells, well lit.
Home Care: Home health services and adult day centers are two options that can help with more intensive health and well-being tasks, while the patient is still living in the home.
Residential Care: Residential care is common in the later stages of Alzheimer’s. Residential care can include assisted living, nursing homes, and Alzheimer’s special care units. These options can help with tasks like meal preparation, dressing, bathing, and other everyday tasks.
Alzheimer’s, like other forms of dementia, will often require long-term care. The type of care someone will need will change as the disease progresses; so, at some point, outside care will probably be necessary.
Outside care options include nursing home care, assisted living, adult care services, and respite care. Caring for Alzheimer’s patients in a nursing home is necessary when caring for your loved one at home has become overwhelming.
Alzheimer’s and Dementia Care: Tips for Daily Tasks
The Mayo Clinic organizes tips for caring for some with Alzheimer’s into two groups: things to do to reduce frustration and guidelines to follow to ensure a safe environment.
A care plan to reduce frustration could include the following:
Creating a daily routine for the patient.
Allowing the patient to take their time.
Doing tasks that involve the patient.
Offering the patient choices, such as offering finger foods if it’s time to eat but they are not hungry.
Providing instructions that are easy to understand and simple to follow. Establish eye contact to make sure the patient understands what has been said.
Reducing napping time so that the patient remains aware of whether it is day or night.
Reducing distractions when they are eating, such as turning off the television during mealtime to make it easier to focus on eating.
Some safety tips on dealing with Alzheimer’s patients could include the following:
Preventing falls by avoiding things that could trip a patient up, like extension cords, and installing handrails in places like bathrooms.
Putting locks on all cabinets that could contain dangerous equipment or materials, such as guns, power tools, utensils, cleaning detergents, and so on.
Checking water temperature before showers or baths to avoid scalding.
Avoid accidental fires by supervising smoking.
Making sure all carbon monoxide detectors and smoke alarms have charged batteries.
When applying these dementia caregiver tips, the caregiver needs to be patient and flexible and be open to changing routines as the symptoms of the disease progress.
Caring for the Caregiver
Family caregivers, such as a son or daughter caring for an Alzheimer’s parent, must prepare for a series of distressing experiences as they watch their mother or father forget favorite family memories and lose practical self-care skills.
It’s often challenging dealing with an Alzheimer’s parent because of the overwhelming emotions, the fatigue, the isolation, and the financial complications. Still, it’s rewarding to bond with a parent by providing them with care and service and solving their problems.
There are also new relationships with others they meet in a similar situation through support groups.
Getting Help With Caregiving
Initially, family caregivers can reduce stress by sharing their caregiving challenges with their support groups.
However, caregiver stress will increase as the disease progresses. While medications used for Alzheimer’s will control some symptoms, they can only provide a limited amount of memory care support before a patient experiences significant memory loss.
Eventually, it will become necessary to consider outside care options, such as respite care, senior care, or moving the patient to a skilled nursing senior center.
For information or support on what to do when caregiving for an Alzheimer patient becomes difficult, visit the Alzheimer’s Association at www.alz.org.
Coping With the Last Stages of Alzheimer’s
Alzheimer’s disease and related dementias affecting older adults get severe during the last stages of the disease. Patients will need considerable support because they will lose touch with what is going on around them.
It can be difficult to figure out how to talk to someone with Alzheimer’s when they don’t respond to what is happening in their environment, can’t communicate any discomfort or pain, and have difficulty controlling their movements.
Legal and Financial Planning
Legal and financial planning for someone with Alzheimer’s requires a specialized lawyer because any general powers of attorney will not work for asset protection planning. A skilled and experienced lawyer is also necessary if the patient needs a health care power of attorney document.
Role of Medicare and Alzheimer’s
Original Medicare (Parts A and B) cover inpatient hospital care and some doctor’s fees associated with Alzheimer’s. Plus, Medicare will pay up to 100 days of skilled nursing home care in certain circumstances.
Long-term custodial care, like a nursing home, is not covered. Medicare will pay for hospice care in-home or at a hospice facility.
Some people with Alzheimer’s may be eligible for a Medicare Special Needs Plan. SNPs are a different type of Medicare Advantage plan and generally provide coverage for doctor visits, hospital services, and prescription drugs. Some of these plans can coordinate care services to help you better understand your condition and your doctor’s plan.
If you qualify for a Medicare Special Needs Plan, you may also qualify for a Special Enrollment Period. This means you can enroll or change Medicare plans throughout the year!
If you have any questions about Medicare Special Needs Plans or Special Enrollment Periods do not hesitate to contact us. Our licensed agents are contracted with all the major carriers across 38 states and can help you enroll in a plan that fits your needs and budget.
To schedule a no-cost, no-obligation appointment, click here or call us at 833-438-3676.
9 Questions a Caregiver Should Ask Their Parent’s Doctor
Being a caregiver can be fulfilling and joyful, but it can also be a lot of work. You may not know where to find information about your parent’s health condition or treatment plan. Luckily, your parent’s doctor can be a valuable resource who you can –– and should –– rely on for answers. Here are nine questions a caregiver should ask their parent or loved one’s doctor:
1. What can you tell me about my caregiving situation?
Every caregiver’s situation is different. Your loved one may have different medical, nutritional, or assistive needs, and your doctor can tell you the best place to start with meeting your loved one’s healthcare needs.
For example, your parent may need non-emergency medical transportation to their various appointments, and they might need special care. Your parent’s doctor may be able to provide contact information for medical transportation services, or even schedule rides to the office. You might not have considered that your loved one may need an EMT-certified driver, especially with rideshare apps like Uber and Lyft offering rides to doctor’s appointments.
When you ask your parent’s healthcare provider about your unique situation, the physician can discuss the individual needs your parent has. Your loved one’s doctor should feel like a partner in providing the best quality care. Your doctor may even tell you ways to take care of yourself, because it can be easy to forget your own needs when you’re so focused on someone else’s.
2. Can you help me connect with other caregivers in similar situations to me?
It can be easy to feel like you’re on your own as a caregiver. An important question a caregiver should ask is what type of non-medical support they might need. Your parents’ provider may recommend resources such as caregiver support groups and online forums. It’s valuable to connect with other people in similar situations.
When you feel like you have emotional support, you’re able to take better care of your parent. It can be easy to feel frustrated or overwhelmed as a caregiver. A support group can give you ideas to cope, tips for providing better care, and/or just lend an empathetic ear. Your parent’s doctor can give you ideas about how to build a support system.
3. What can I do to build confidence in my caregiving activities and skills?
Your parent’s doctor should talk about your parent’s treatment plan and care needs with you. You should feel confident in your abilities to properly administer medications or help with physical therapy. If you’re unsure of how to do something the doctor recommends, ask them to explain the task further.
Ask if there are any shortcuts, tips, or tricks you need to know about. Find out if you can practice complex tasks so you can help effectively. Some tasks may be dangerous to perform on your own, and you may need to find outside assistance. Find out if you need to look into home health care services or if you can perform the tasks on your own.
4. Can you help me arrange respite care when I need a break?
Providing 24-hour care can be rewarding, but also exhausting. Sometimes you need to take a break. “Respite care” is when your loved one stays at a hospital or other care facility so you can get some much-needed rest. It may give you peace of mind to know that your parent is staying at a facility with qualified professionals.
Your loved one’s healthcare provider can point you in the right direction for finding respite care services.
5. What do I need to know about my parent’s diagnosis?
Every health condition or disease may have different need-to-know information. For example, your doctor may tell you to avoid fatty cuts of beef if your loved one has high cholesterol.
Your parent’s provider should tell you how and when to administer medications, how often you need to make follow-up appointments, and what symptoms to watch out for. The healthcare provider should help you provide the best possible care for your loved one, and that includes knowing the ins and outs of your parent’s health.
6. How will you coordinate with my loved one’s other healthcare providers?
Some diagnoses mean that your parent requires a care team. For example, your loved one might have a gerontologist, a physical therapist, and a neurologist. Ask how the team will coordinate your loved one’s care and keep you in the loop.
For example, some healthcare facilities feature apps to contact care team members if you have questions or need to refill prescriptions. Health facility apps can also include post-appointment notes so you can access any information you need.
7. I found this information on the internet. Is it accurate?
Google has a wealth of information about any disease you can think of. Sources such as WebMD and the Mayo Clinic offer information about symptoms, causes, risk factors, and treatments for a seemingly infinite number of health conditions.
Even though the internet has more information that you could ever need, the information can pose a problem for doctors and patients.
For example, your loved one could fall and bruise their knee. You Google “knee pain,” and read the first web page you see from WebMD. The article you read could have you thinking that your loved one needs a full knee replacement, but all they really need is an ice pack and some over-the-counter pain medications.
Your parent’s doctor will be able to help determine what’s really going on and sort out the facts from the fiction.
8. Should I be concerned about these new symptoms I’m observing?
If your parent has a degenerative health condition or they have new symptoms, ask the doctor if you should be concerned. Your loved one’s healthcare provider will let you know if they need to see your loved one or if you notice something normal. Your parent’s doctor should be available to answer your questions in a timely manner.
9. How will I know when it’s time to look into hospice care?
At some point, your loved one may need to switch from curative (to find a cure) care to palliative (to provide comfort) care. Your parent may be eligible for hospice care if curative care will not work and palliative care is the only option.
Ask your doctor to let you know when it’s time to start palliative care only, and if they know of any resources to find hospice care.
Find Medicare Caregiver Resources
As a caregiver, you’ve got a lot on your plate. Use this list of questions a caregiver should ask their loved one’s doctor can be a valuable source of information if you ask the right questions.
Another valuable resource is your parent’s health insurance plan. If you have durable power of attorney, you can make Medicare decisions for your loved one. A licensed agent with Medicare Plan Finder may be able to help you find a Medicare Supplement or Medicare Advantage plan that suits your healthcare needs and fits your budget. Call 1-844-431-1832 or contact us here to schedule a no-cost, no-obligation appointment today.
How to Get Paid to be a Caregiver for Parents
There are close to 34 million Americans providing care for their parents, and many are not compensated for their time. The value that caregivers provide for “free” is estimated to reach $375 billion annually. That’s double the amount of what is actually spent on homecare services.
Being a caregiver is rewarding, but it comes at a cost. The average caregiver spends 20 hours a week caring for their loved ones and spends an average of $5,500 each year out-of-pocket.
At Medicare Plan Finder, we know how hard you work and how much you deserve financial support, and we want to help you understand how to get paid to be a caregiver for parents.
Can Caregivers Get Paid by Medicare?
Currently, Medicare does not pay caregivers. However, some state Medicaid programs do pay family members to provide care.
Medicaid Caregiver Compensation
Medicaid caregiver pay varies per state, but all states (and the District of Columbia) offer Medicaid waivers that allow qualified individuals to manage their own care. This means your parent can hire and fire their own caregivers. Certain states will permit a family member to be hired to provide the care.
The eligibility, benefits, coverage, and rules will vary depending on which state you live in. Some may pay for family caregivers but exclude spouses or in-laws. Others may only provide compensation if you do not live in the same house as the person in your care.
When you are researching programs in your state, be conscious of program names. Each state will have a different name (Self-Directed Care, In-Home Supportive Services, etc.).
To start the process, your parent(s) must qualify for Medicaid and meet state caregiver qualifications. Contact your state Medicaid office to start the application and learn about eligibility.
Your parent(s) will be assessed for risks, needs, strengths, and capacities that meet the requirements by the Centers for Medicare and Medicaid Services (CMS).
You and your parent(s) will write a service plan that details the type of daily assistance that will be provided. This can include bathing, dressing, meal preparation, feeding, laundry, driving, and other daily tasks. When this plan is set, you will be approved or denied for the state’s Medicaid compensation program.
Getting Paid to Be a Caregiver for Veterans
If your parent is a veteran, they may qualify for the Veteran Directed Home & Community Based Care program. This program is available in 37 states and the District of Columbia. It provides several medical benefits to people who need a high level of nursing facility care, but want to live at home with a caregiver.
The average monthly allowance is $2,500. The veteran will choose the caregiver. This can be a family member, including spouses, siblings, or children/grandchildren.
Another program that can help provide financial compensation is Aid and Attendance (A&A). This program provides benefits to veterans who qualify for a VA pension and have served at least 90 days in active duty and one day during a wartime period.
The program is intended to supplement the pension and help cover the cost of a caregiver. The caregiver can be any family member.
To qualify for A&A, at least one of the following must apply:
Confined to bed due to a disability
Be in a nursing home due to physical or mental limitations
Have limited eyesight (Corrected 5/200 visual acuity or less in both eyes)
Require the aid of another person to assist with daily living activities (bathing, dressing, feeding, etc.)
Long-Term Care Insurance and Caregivers
Long-term care insurance is a policy that helps cover the cost of long-term care. These costs can include assisted living, nursing homes, or in-home care (including caregivers). Plan benefits will vary, but if home care coverage is included in the plan, homecare caregivers may be covered as well.
However, it is important to note that all plans are different, and some plans may exclude these benefits. Additionally, some plans may have restrictions on who qualifies to be a paid caregiver. Some plans may exclude spouses or in-laws, and others may exclude family members altogether.
Other Paid Family Caregiver Options
If your parent does not qualify for any of the above programs, don’t worry! There are other ways to get some type of compensation. The following are round-about ways that explain how to get paid to be a caregiver for parents:
Tax Deductions: It may not be the same as a monthly paycheck, but tax deductions can help you save money each year for certain expenses you incur. You may be able to write off certain expenses like dental costs, medical costs, home modifications, and transportation costs.
Payment From a Family Member: Asking for payment from your parents or another family member may be awkward or uncomfortable. Put all of these feelings aside and discuss needs, wages, schedule, etc. Create a contract that includes the wage and services provided.
Area Agencies on Aging: Each state has a local Area Agency on Aging. You can find your closest office by searching your city in their directory tool. The staff at each location can help you find additional programs that you or your loved one qualify.
Paid Leave: If your parent’s needs are short-term, you may be eligible for a paid leave through your employer. This is not guaranteed, but there is no harm in talking to your HR representative to see what type of paid leave policies are offered by your company. Something as small as a few weeks of pay can still provide a financial cushion and allow you to go back to work in the future.
Remote Work: Paid leave can only help for a short time, and may not be the best solution for you and your family. Talk to your employer and see if telecommuting is an option. Again, each company will vary, but there is no harm in asking. Working full-time and acting as a caregiver can be difficult, so consider your workload when making these decisions and having these conversations.
Caregiver Support and Power of Attorney
There’s no doubting the weight that caring for a loved one can put on your shoulders. If you’re a caregiver, it’s crucial you feel supported so you can continue to help your loved one on a daily basis.
Medicare Plan Finder’s Caregiver Support page provides caregiver information specific to your loved one’s needs. Learn about how you can receive support for yourself while caring for your loved one, stress relief tips, support groups you can join, and Power of Attorney (POA) information.
Being a caregiver does not automatically grant you the ability to make certain medical, legal, or financial decisions on behalf of your parent. To do so, you will need to become their Power of Attorney.
If your parent is mentally competent, they can sign their rights over to you. If they are not, you will need to go before a judge and have their rights granted to you.
Medicare Coverage and Caregivers
As a caregiver, one of your biggest concerns, among understanding how to get paid to be a caregiver for parents, may be making sure your loved one has the best possible health plan for their unique needs and budget. At Medicare Plan Finder, we want to help make that happen!
We specialize in educating seniors on Medicare Advantage, Medicare Supplements, and Part D plans. Our licensed agents are contracted with all of the major carriers so you know your parent is being shown the best plans at the best price. Give us a call at 844-431-1832 or click here to get in contact with an agent.
This post was originally published on May 30, 2019, and updated on October 23, 2019.
A Guide to Medicare Coverage for Dementia
A Guide to Medicare Coverage for Dementia
Dementia is a decline in mental capacity that becomes severe enough to hinder a person’s ability to function. According to the Alzheimer’s Association, one-third of Americans die with some form of dementia.
Medicare Parts A and B (Original Medicare) will cover everything that’s medically necessary for dementia patients, but many other services won’t be covered.
Original Medicare dementia care may be limited, but certain Medicare Advantage plans offer coverage for more services that can include unexpected offerings like meal delivery.
Medicare Coverage for Dementia Patients Clarified
An Original Medicare plan will cover services that your doctor deems medically necessary. Medicare Part A covers inpatient hospital care, and Medicare Part B covers outpatient care and medical expenses such as doctors’ appointment costs.
Original Medicare will pay for the first 100 days of care in a skilled nursing facility (there may be some associated fees), and some Medicare Advantage (Part C) plans may include long-term care coverage as well as skilled nursing care.
Private insurance companies offer Medicare Advantage plans, so they have the freedom to cover benefits Original Medicare doesn’t. Medicare Part D or certain Medicare Part C plans cover prescription drugs such as cholinesterase inhibitors that can temporarily improve symptoms of dementia.
Medicare Supplements (Medigap) plans can help cover the expenses that Original Medicare does not. Unlike Medicare Advantage plans, Medigap plans do not cover medical expenses, but they cover financial items such as Part A and B coinsurance and copayments. Even though Medigap and Medicare Advantage are two different types of plans, you cannot enroll in both at the same time.
Does Medicare Pay for Dementia Testing?
Medicare Part B covers cognitive testing for dementia during annual wellness visits. A doctor may decide to perform the test for patients who are experiencing memory loss.
The test consists of about 30 questions like, “What year is this?” to assess the patient’s memory and awareness. The test can be used as a baseline evaluation for future wellness visits and can be a valuable tool for catching dementia early.
Medicare Testing for Alzheimer’s
Dementia is a symptom that can result from many different diseases. Alzheimer’s disease is just one cause of dementia. The risk of developing Alzheimer’s increases with age and with a family history of Alzheimer’s.
There is a correlation between genes called apolipoprotein E (APOE) and Alzheimer’s, but those genes do not necessarily cause the disease. Medicare will not cover genetic testing for APOE genes.
Dementia as a SEP-Qualifying Condition
Medicare eligibles with dementia also qualify for specific Medicare Advantage plans called Chronic Special Needs Plans (CSNPs). These health insurance plans involve coordination and communication between the patient’s entire medical team to help ensure the patient gets the best possible care.
The best way to sort through the thousands of plans available and find the right CSNP for you is enlisting the help of a qualified professional by contacting us here.
If you’re diagnosed with dementia and already enrolled in Medicare Parts A and B, you will qualify for the Special Enrollment Period (SEP). The SEP allows you to enroll in new Medicare coverage or make changes to your existing CSNP whenever you need to instead of having to wait for certain times of the year.
Eligibility for Medicare Coverage for Dementia
If you meet the eligibility requirements for Medicare Parts A & B, you will also be eligible for the dementia coverage provided by Medicare. You can obtain Medicare coverage for dementia services if you are:
Age 65 or older
Any age and have a disability, or end-stage renal disease (ESRD)
Dementia patients are also eligible for other specific Medicare plans once they are officially diagnosed with the condition, like special needs plans (SNPs) and chronic care management services (CCMR.)
Medicare can also cover home health care that dementia patients often need. In order to receive this coverage, it must be certified as necessary by a doctor. The patient must also be classified as homebound, meaning they have trouble leaving the house without help.
Does Medicare Cover Memory Care?
Memory care is a specific type of long-term care for Alzheimer’s patients or people with dementia. Original Medicare will cover occupational therapy but does not cover assisted living facilities. However, certain Medicare Part C plans may include coverage for Medicare dementia care services such as adult day care or help to get dressed or to bathe.
Medicare dementia coverage is split between its component parts. Part A helps cover the cost of inpatient hospital stays, including the meals, nursing care, and medication that you need while you’re there. Meanwhile, Part B will cover the doctor’s services that you might receive during your stay in the hospital, such as testing or medical equipment.
Even more services can be covered by Part C, also called Medicare Advantage. In addition to everything covered by Parts A & B, these plans can also offer options for long-term and home care for dementia patients.
How Much Does Medicare pay for dementia care?
Each different part of Medicare will pay for its benefits in different ways. For example, Part A will cover the entire cost of your hospital or skilled nursing facility stay for the first 60 days. After this period, you will need to pay 20% coinsurance until day 90, when Part A will stop paying entirely.
Part B, on the other hand, will usually pay for 80% of all services that it covers. Medicare Supplement plans are often purchased to cover the remaining costs, and can also provide additional benefits to the patient.
Does Medicare cover long term care for dementia?
The long-term care insurance offered by Medicare depends on the nature of the service being provided to the patient. In many cases, the long-term care needed by dementia patients is classified as custodial care and won’t be covered by Medicare.
However, if your doctor prescribes a long-term care service as “medically necessary,” Medicare may help cover the costs. These exceptions can include services like hospice care, and part-time nursing care or occupational therapy provided in the home.
Does Medicare Pay for Home Health Care for Dementia Patients?
It is usually difficult to obtain coverage from Medicare for elderly care at home. However, it can completely cover some home health services that are deemed medically necessary by your doctor, including:
Physical and occupational therapies
Part-time skilled nursing care
Medicare social services
Most nursing home care is also classified as custodial care by Medicare, meaning it will not be covered. Medicare will cover custodial home health care for dementia patients only if it’s a part of hospice care.
Medicare Advantage plans, however, can offer many different home health benefits for those who suffer with dementia. Examples include personal care assistance, homemaker services, and meal delivery.
Does Medicare Cover Assisted Living for Dementia?
Original Medicare will not cover any services that are deemed custodial or personal care, including any that aid in typical activities of daily living, such as:
Using the restroom
This rule also applies to assisted living and memory care facilities which provide these services. But depending on your state and the facility of choice, Medicaid may be able to help cover the cost of long-term custodial care provided in assisted living facilities.
Medicare Dementia Hospice Criteria
In order for Medicare to cover hospice care, your doctor must first document that you have less than six months to live. You or your durable power of attorney must sign documents indicating that you agree to accept care for comfort and that you waive other Medicare benefits.
What dementia services does Medicare not cover?
In almost all cases, Medicare will not cover any non-medical care services, such as:
Assisted-living or long-term care
Custodial services provided in a facility or in the home
There are exceptions to these rules, but the service in question must be recommended as medically necessary by your doctor. Medicare Advantage plans may offer coverage for these and other personal care services not covered by Medicare.
How to Cover the Gaps with Medicare and Dementia
Paying for dementia care can be daunting, even for Medicare beneficiaries. Both Parts A & B have deductibles you have to meet, and Part B only pays for 80% of its covered services. At the end of the day, a patient and their family may be left wondering how to pay for Alzheimer’s care.
The answer may come in the form of Medicare Part C, also called Advantage plans, which can pay for many of the custodial care costs not covered by Original Medicare. Another option may be a Medicare SNP, or special needs plan, which are geared toward patients with certain chronic conditions such as dementia.
Early Signs and Symptoms of Dementia
Dementia can have a variety of symptoms depending on the cause, as well as if the patient is in the early stages or late stages of the disease. However, some common signs symptoms include:
Loss of memory
Difficulty finding the right words during conversation
Getting lost while driving to and from familiar places
Difficulty with logical reasoning or solving problems
Difficulty with completing complex tasks
Difficulty with planning and organizing day-to-day activities
Difficulty with muscular coordination and motor functions
Being confused or disoriented
Changes in personality
Inappropriate or irrational behavior
How to Find Memory Care
Medicare.gov has a tool to find nursing homes that accept Medicare for medical services. To get started, click here. Not all of these facilities have dedicated memory care teams, so you’ll need to contact them to verify their services.
Once you’re on the nursing home finder tool page, enter your zip code as shown below in red. We used 37209, which is our corporate headquarters’ zip code in Nashville, Tennessee. Then click “Search,” shown in yellow.
Then you’ll reach a list of nursing homes in your area. The nursing home finder tool lets you sort facilities by star rating, which is based on a scale of one to five.
Basically, the higher the rating, the better the care the facility provides. For demonstration purposes, we only chose to see homes that have a five-star rating (shown below in red) and that take Medicare insurance (in green.)
You may have to contact more than one facility to find the right one for you. Ask about costs and how they help patients with dementia. If one seems like it may be a good fit, ask to tour the home to really get a feel for it.
Resources for Families
Family members of dementia patients have access to a wide variety of resources to help them cope. The first step for helping your loved ones is to educate yourself about the disease and to learn how you can be the most supportive.
You should also look into support groups for your family so they can find like-minded people who are having similar experiences. Dementia should not be dealt with alone.
If you are a caregiver for a parent with dementia, you should consider important things such as who will have the power of attorney and make financial decisions for the patient at the end of his or her life. If you haven’t enrolled in a life or a final expense insurance policy, you should consider doing so now.
We Can Help You Find Medicare Coverage for Dementia
Dementia is difficult for everyone involved. If you or a loved one has dementia, we can help you navigate Medicare dementia care and find a Chronic Special Needs Plan that’s right for you. Set up a no-obligation appointment with a licensed agent by calling 833-438-3676 or contacting us here today.
Medicare Power of Attorney 101
If you are a caregiver for your parent or loved one, you may not realize that you’re unable to make medical and financial decisions on their behalf until it’s too late.
You don’t want to get caught in a tough situation and feel powerless. Fortunately, a power of attorney can help, but it’s crucial you understand the different types of POAs and common misconceptions.
Types of Power of Attorney
A lot of people don’t understand that a power of attorney is one of the most powerful legal documents you can obtain.
It allows the “principal” (the person granting the power) to select an “agent” (the person receiving the power) to be in charge of a wide range of certain medical and financial matters. Depending on the type of POA granted, you may be given the ability to:
Collect Social Security benefits on the principal’s behalf
Use the principal’s money to pay various bills
File the principal’s taxes
Make financial decisions on their behalf
Buy, sell, or manage the principal’s property
Give gifts or donations on behalf of the principal
Make decisions regarding the principal’s health
Your loved one can appoint several people to be a POA. However, multiple agents can make the decision-making process sloppy. The best bet is to designate people in the areas they have experience in or where they feel comfortable holding responsibility.
Help your parent or loved one make the best decision by educating them on the different types of POA:
Non-Durable: This type of POA is set for a specific amount of time and is generally used for one particular transaction. Once the transaction is over, the POA ceases.
Durable: A durable POA can be used to manage all of the principal’s affairs. Durable POAs are effective immediately and only expire when the principal passes away.
Special or Limited: This type of POA is typically used on a limited basis for one-time financial decisions, like a sale of a particular property. This is most commonly used when the principal cannot complete the transaction due to other commitments or illnesses. The POA has no other power apart from the one-time financial transaction.
Medical: A medical POA has authority on all healthcare decisions if the principal becomes incapacitated. This generally takes effect upon approval of a presiding physician. It’s important to note that you would not be able to make any health decisions if they have the mental and physical capacity to make decisions on their own.
Springing: This type of POA will become effective in the future, only if a specific event occurs. This event can include incapacitation or a triggering event, like leaving the country. This POA can be durable or non-durable and can encompass any affair. This allows the principal to create a POA that is specific to their needs.
What is a Medicare Power of Attorney?
Technically, a Medicare Power of Attorney should be appropriately referred to as a Durable Power of Attorney as it is the only POA that allows you to make health decisions alongside your parent before they become incapacitated.
Medical POA only grants you power after your parent becomes incapacitated. However, a Durable POA gives the power to help your parents make decisions regarding Medicare Advantage, Medicare Supplements, Part D plans, and more. If you are looking to become a “Medicare Power of Attorney,” you will need to explore the Durable Power of Attorney instead.
It’s crucial that you understand that a power of attorney document doesn’t make you the sole decision maker. You and your parent would have the same legal weight in the decision-making process. Plus, your parent can revoke the POA at any time.
Does Medicare Recognize Power of Attorney?
Yes! When it comes to Medicare, you need legal authorization anytime you are acting on behalf of your parent. This means, unless you have the appropriate POA, Medicare will not allow you to make any decisions or even discuss their healthcare plans. However, a Durable Power of Attorney gives you equal power when making your parent’s healthcare decisions.
This means unless you have Durable Power of Attorney, Medicare will not allow your parent to make an appointment with a licensed agent to enroll, change, or switch their plan with your presence or consent.
How to Get Power of Attorney for Elderly Parents
When creating a power of attorney, your parent must be mentally competent at the time of signing. As a general rule, you should start these conversations as soon as possible. Once your parent selects an agent and type of POA, they will need to fill out the proper forms and have it authorized by a notary.
There are several POA documents available online, however, it is recommended that you avoid downloading any forms and that you work directly with an elder law attorney or courthouse.
Once the documents are finalized, you and your parent should make several copies and store them in a safe and secure location.
Power of Attorney Medicare Enrollment
Once you have durable POA, fill out this CMS medical release form provided by CMS and attach your Power of Attorney document. The form will allow you to view your parent’s medical information.
Your durable POA document will allow you to meet with an agent and make decisions on your parent’s behalf including enrolling in a Medicare plan.
Elder Law Attorney Finder
An elder law attorney is a lawyer who focuses on the needs of seniors. Elder law is a broad field that includes Medicare law and power of attorney. If you need a lawyer to help with POA, the National Academy of Elder Law Attorneys (NAELA) is a great place to start. To use NAELA’s attorney finder tool, click here.
That will lead you to NAELA’s homepage. Click “Find a Lawyer.”
Enter your zip code in the search bar as shown below in red. For our purposes, we’re using 37209, which is the zip code for our corporate headquarters in Nashville, TN. Then click “Search,” shown in yellow.
That will lead you to a list of elder law attorneys in your area with contact info. You may have to call more than one to find a good fit.
Power of Attorney for Elderly Parent With Dementia
If your loved one is starting to develop Alzheimer’s or dementia, you should try to have the conversation about a POA immediately. In order for your parent to sign a POA, they need to be mentally competent and understand what they are signing.
If the Alzheimer’s or dementia worsens, your parent may be unable to sign and you cannot be granted a POA. If this happens, you can explore becoming a conservator. Conservators act similarly to a POA. You will still be able to make certain medical and financial decisions, but there will be a costly court procedure.
How to Get Power of Attorney for Parent in Hospital
If your parent is sick in the hospital, they can still sign a power of attorney form. You will just need to bring the document to the hospital. A notary will also need to meet you at the hospital if your parent is unable to leave.
Some facilities have on-staff notaries. Once the document is signed, the process is the same as if they weren’t in the hospital. There should be several copies made and stored in a safe place.
Common POA Misconceptions
Misconception: POAs extend after the principal’s death. Truth: All POAs expire when the principal passes away.
Misconception: If a principal signs a POA, they forfeit their independence and rights to make their own decisions. Truth: The scope of POAs can be as broad or as narrow as the principal wants. Many times, principals can require a physician statement to attest if they are incapable of making their own decisions.
Misconception: POAs are the same in every state. Truth: POAs can vary across different states. Be sure to research the type of POA and state guidelines before signing.
Misconception: POAs can be found online. Truth: You can find POA documents online, but your best bet is to work directly with a lawyer or courthouse to guarantee authenticity.
Misconception: POAs take away your parent’s decision making power. Truth: A POA document does not remove your parent’s ability to make decisions on their own, it just authorizes someone else to act under the limitations that they have set.
Medicare POA and How to Get Coverage for Your Loved One
If you are a Medicare power of attorney for your parent, you hold some responsibility in ensuring they have the best health coverage for their unique needs and budget.
At Medicare Plan Finder, we make sure both you and your parent are educated in plan options including Medicare Advantage, Medicare Supplements, and Part D plans. If you are interested in arranging a no-cost, no-obligation appointment for you and your parent, click here or give us a call at 833-438-3676.
This post was originally published on May 31, 2019, and updated on August 16, 2019.
Elder Care Legal Advice: What Caregivers Need to Know
While most of caregiving is handling everyday tasks such as bathing and eating, a lot of legal issues surround elder care. Elder law is the body of rules created to protect the elderly. It covers areas such as legal guardianship and protection against elderly abuse and neglect.
You may have to fight for your loved one or for yourself. Many caregivers also take on estate administration and power of attorney issues along with medical care decisions. It can seem daunting, but we’re here to answer your questions and provide support.
Unfortunately, some people take advantage of the elderly in their vulnerable state and they fall victim to abuse at the hands of nurses, strangers, and even family members. Elderly abuse comes in different forms including physical abuse, financial abuse, emotional abuse and neglect. It can be easy to overlook the signs of elderly abuse, but it is important to pay attention to your loved ones to catch these things early on.
Signs of Elderly Abuse
Nursing home staff or other caregivers may seriously mistreat your loved one. Here’s what to look out for:
Signs of injury such as bruises, welts, or scars, especially if they’re on only one side of the body
Pill bottles that have more or less remaining product than they should
Nursing homes refusing to let you see your loved one alone
Money or other items missing from the senior’s home
Malnourishment not resulting from an illness
Lack of grooming or poor hygiene
Untreated bed sores
Dirt, bugs, soiled bedding or other indications of unsanitary living conditions
Leaving the senior out in the elements with unsuitable clothes
Substandard living conditions such as faulty wiring or lack of heat or running water
Huge cash withdrawals from the senior’s bank accounts
Multiple bills for the same medical service or device
Evidence of subpar care when bills are fully paid
Problems with the care facility staff: poor training, poor pay, or understaffing
Leaving the elder behind in public
As a caregiver, you must be an advocate, even if you can’t fix the problem yourself. If the person under your care is abused in any way, seek elder care legal advice from an attorney who focuses on elder law to find the best course of action.
Federal Anti-Abuse Programs
If you don’t know where to look for professional elder care legal advice, start with these federal resources:
The National Center on Elder Abuse (NCEA) is dedicated to preventing elder abuse and raising public awareness. The NCEA website provides information about a variety of important topics such as elder rights and how to report elder abuse.
You should start planning for mental incapacity as soon as your loved one is diagnosed with a chronic disease such as Alzheimer’s. You may want to enlist in the help of an elder law attorney who can give you in-depth elder care legal advice. Your lawyer will help you with estate planning and determining who will make financial and medical decisions.
Both power of attorney and legal guardianship are tools that allow caregivers to make important decisions on behalf of the seniors under their care. The difference is that guardianship requires a court decision, while a senior can choose a power of attorney when he or she is of sound mind.
In many cases, the best course of action is for your loved one to appoint a power of attorney early on so that you can step in to make important decisions as soon as you need to.
There are three different types of power of attorney. The differences between each boil down to when legal decision-making power starts and stops:
Conventional power of attorney: Starts when the senior signs the power of attorney document and stops when the senior becomes incapacitated.
Springing power of attorney: Starts when the senior becomes incapacitated.
Durable power of attorney: Starts when the senior signs the document and continues until the end of his or her life.
Caregivers and seniors benefit most from the caregiver having a durable power of attorney to make healthcare decisions.
Medicare and Power of Attorney
If the person under your care is 65 or older, is diagnosed with ALS or ESRD, or receives SSDI for at least 25 months, he or she will qualify for Medicare. You’ll need to have legal authority in order to help enroll your loved one in a Medicare plan.
The Medicare beneficiary under your care can decide the scope of your responsibilities as a caregiver. Depending on where you live, a power of attorney may give you an all-encompassing authority to make financial decisions such as selling real estate or making donations to charity, or it can be limited to healthcare decisions.
Medicare has protections in place that limit access to medical information to people other than the beneficiary. It’s useful to have the person under your care fill out a form authorizing Medicare to release medical information to you. You might need to prove that you have durable power of attorney to access the healthcare information.
At some point, many seniors won’t be able to take care of themselves or make important decisions on their own. You can become a legal guardian for the elder by going through these legal proceedings:
File a petition with the court in your state.
Tell the elderly person along with his or her family about the petition for guardianship.
Comply with a court investigation to determine whether guardianship is necessary.
Engage in a hearing during which the judge looks at investigation results and listens to the senior in order to make a decision regarding the petition.
Legal Protection You Have As a Caregiver
The Family Medical Leave Act (FMLA) allows eligible employees up to 12 weeks of unpaid leave to care for immediate family members who have serious illnesses. FMLA requires that you return to the same or equivalent position upon your return, and your employer must continue to provide the same group health insurance during your leave. You don’t have to take the leave all at once.
If your employer refuses to grant qualifying leave, you should show them a printed copy of the law. If that doesn’t work, ask an employment lawyer to draft a letter. If your employer still refuses to grant leave even after the letter, you can sue for FMLA violations.
You can also sue if your employer retaliates and fires you or drastically changes your working conditions. Talk to your employment lawyer or your state’s Department of Labor to find out if your situation warrants a lawsuit.
You are not alone as a caregiver. Organizations such as Caregiver Action Network (CAN) provide a wealth of support to caregivers all over the US. Caregivers will find a community of like-minded people who are having a similar experience. CAN aims to make caregivers’ lives easier by providing resources such as where to find elder care legal advice and education specific to their seniors’ conditions.
How We Help Caregivers
Medicare Plan Finder can help you or a loved one find the right health insurance plan. Our mission is to serve the seniors you care about the most. Having power of attorney can be a lot of work, especially when you have to think about your own family and career. We can guide you through finding a Medicare plan for your loved one if you have power of attorney. Call us at 833-438-3676 or submit this form today.
This post was originally published on May 13, 2019, and was updated on June 28, 2019.
11 Crucial Tips for Taking Care of Elderly Parents at Home
Taking care of an elderly parent at home may be the most important thing you ever do, but it can be easy to get bogged down with the day-to-day struggles you may encounter.
You can help minimize your physical and financial stress that can come with caring for aging parents with some planning and resources. Follow these 11 tips to set yourself up for caregiving success.
1. Monitor Medications
One vital part of caregiving is making sure your parent receives his or her medications on time. Many pharmacies have apps that allow you to set up automatic refills for qualifying prescriptions, and you can even have prescriptions mailed directly to you.
It’s important to find a health insurance plan that will help pay for all of your parent’s medical needs. Medicare is a fantastic resource for paying medical expenses, but Original Medicare may not cover all of the services your loved one needs, such as prescription drugs.
You may have to look into private insurance policies called Medicare Supplements or Medicare Advantage plans to cover additional services and ensure that your parent’s insurance meets his or her needs.
If you need help paying for your parent’s medications, Medicare Part D or certain Medicare Advantage plans offer prescription drug coverage. There may be many plan options out there for you, and asking a qualified professional for help finding the right one may make the difference in your loved one receiving the right care.
2. Find Assistive Devices to Help Make Life Easier
As your parent ages, he or she may have difficulty performing actions such as bathing, standing up, or walking, and you may consider using assistive devices or Durable Medical Equipment (DME) to help make life easier. Assistive devices for the elderly range in supportive functions from fall prevention and mobility (canes, walkers, wheelchairs) to helping button shirts or clean.
Medicare Part B will help cover DME if your doctor prescribes the devices. You may owe deductibles or coinsurance. Some items such as wheelchair ramps and handrails may not be considered DME, but some Medicare Advantage plans cover those home modifications.
3. Hire Outside Help if Necessary
At some point, your parent may require more help than you can provide. You may have to enlist the help of skilled nurses or other healthcare professionals to perform the required level of care. If you don’t know where to start looking, your parent’s doctor may recommend a home healthcare service, or Medicare has a registry where you can find agencies in your area.
Some parents will need long-term care, and Medicare will not cover those services. You can, however, purchase long-term care insurance to help pay for expenses such as a full-time nurse.
4. Make Sure Your Loved one Stays Active
An active lifestyle that includes regular exercise may help prevent chronic diseases. Resistance training combined with cardiovascular exercise can help manage symptoms of osteoporosis, diabetes and chronic hypertension. Go on walks with your parent, go to the pool or look for fitness classes geared toward seniors such as Silver & Fit® or SilverSneakers® in your area. Certain Medicare Advantage plans cover fitness classes.
5. Find Proper Nutrition for Your Loved One
Ensuring that your parent eats properly can be time-consuming. You may be responsible for grocery shopping, meal preparation, and making sure your loved one eats at the right times throughout the day. Not only that, but your parent’s doctor or dietitian may recommend that your parent eats a certain number of calories or that your parent’s diet focuses on lean protein sources, fruits, and vegetables.
You can cut down on the time it takes for meal preparation by preparing meals for a few days in advance and putting them in single-serving containers. Look for recipes with simple cooking methods such as using a slow cooker or one-pan meals.
Some Medicare Advantage plans even cover meal delivery, which would dramatically cut down on the time you spend worrying about your parent’s nutrition.
6. Create a Schedule
Creating a schedule and sticking to it is extremely important when taking care of elderly parents at home. You’ve got a lot to do for yourself and your loved one, and if you don’t establish a routine for house cleaning, running errands, or bathing, then those things may not get done.
Take some time every week and make a list of everything you and your parent need to accomplish. Create a calendar that includes all of the events for the week because seeing doctor’s appointments, meal delivery times, etc. will help you coordinate everything your parent needs and also let you schedule some time for yourself.
7. Take Time to Care for Yourself, Too
It can be easy to forget about self-care when you’re so involved with your loved one, but taking some time for yourself is extremely important.
Find some time to relax. Take bubble baths, meditate, or do anything else that makes you happy. The important thing is that you feel refreshed and recharged when you go back to your parent.
Be active. Exercise is not only beneficial for your physical health, but also your mental health. The vast majority of people who exercise regularly report lower stress levels than sedentary individuals. Consider doing yoga, jogging, cycling or joining the gym where your parent takes fitness classes.
8. Find a Support System
Self-care may look like finding a support group or therapist so you can talk about how you feel. Your job as a caregiver may be overwhelming if you feel like you’re alone. If you can openly talk about what’s going on and get information on how to cope, you can provide better care because you’ll have better emotional health.
Sometimes you may just need a break, but you’re unable to leave your loved one alone.
Ask other family members to step in when you need some time off or it could be time to consider finding respite care services, which allow you to rest. Respite care may mean that your parent stays in a hospital temporarily or goes to adult day care.
You have rights as a caregiver. The Family Medical Leave Act (FMLA) allows employees who meet certain requirements to take up to 12 weeks per year off to care for qualifying immediate family members.
If your employer has 50 or more employees, you must be allowed to return to your original position or its equivalent when you return to work.
If your employer fires you or demotes you, or refuses to grant leave, you may have a case against your employer for FMLA violations and workplace discrimination.
Talk to an employment lawyer or to your to the Department of Labor if you think your rights have been violated.
10. Obtain Power of Attorney to Make Important Decisions
In order for Medicare to allow you make decisions for your parent, you must first have the right kind of power of attorney (POA). There are many different types of POA, but a Durable Power of Attorney is the only kind Medicare will accept, and it’s the most beneficial for taking care of elderly parents at home. A Durable Power of Attorney will allow you to make medical decisions for your parent before he or she becomes incapacitated.
11. Find Government Assistance for Caregivers of Elderly Parents
Taking care of elderly parents at home can be a full-time job. You may be able to find government assistance for caregivers of elderly parents and receive payment for your hard work. Medicare will not pay for you to provide caregiver services, however, Medicaid will in some states.
It may feel like you’re all alone, but there are some federal resources that can help ease your stress. The National Family Caregiver Support Program (NFCSP) provides a wealth of resources to caregivers information on where to find support groups, educational materials for specific conditions and contact information for advocacy organizations. You’ll be a better caregiver if you use the government resources available to you.
We Can Help You and Your Loved One Find Coverage for Home Care Services
The right insurance plan can help cover the cost of at-home care services. If you have power of attorney, a highly-trained licensed agent with Medicare Plan Finder may be able to help you find a plan that fits your budget and lifestyle needs. Call 844-431-1832 or contact us here to learn more.
Home Care Services vs. Senior Assisted Living
Nearly half of everyone over the age of 65 needs some form of assistance in their daily routine. That’s approximately 18 million seniors! When choosing between home care services and senior assisted living, it’s important to consider the costs, qualifications, and available services before making a final decision.
Home care services allow you to get the assistance you need in the comfort of your own home and is great for anyone who is chronically ill, disabled, recovering from surgery, or needing basic assistance. Senior assisted living is an affordable way to get 24/7 care that includes interaction with other residents and eliminates the need of hiring, scheduling, or managing caregivers. This is great for those who have difficulty moving around and require more medical supervision. Both home care and assisted living focus on providing care, but the specifics of what is provided differ.
What Services Does Home Care Provide?
The three major types of home care services are:
Personal Care and Companionship
Personal care and companionship can provide assistance with self-care including bathing, grooming, and dressing. They also help with fall prevention by assisting with movement around the home. Meal preparation, cooking, light housekeeping, laundry, and other errands are included. Plus, this type of care allows you or a loved one to have companionship which can help with isolation issues, especially in the winter. Personal care and companionship can be long or short-term and is great for those who need basic help around the home.
Private Duty Nursing
Private duty nursing can help with basic medical services inside the home. This includes monitoring vital signs and administering medications. Ventilator, tracheostomy, gastrostomy, catheter, and feeding tube care may also be included. Private duty nursing care is typically long-term and is ideal for those who have a chronic illness, injury, or disability.
Home Health Care
Home health care includes several short-term nursing services. This includes physical therapy, occupational therapy, speech-language pathology, medical social work, and other home health aide services. Home health care is often short-term and is recommended by a physician. Home health care can help patients recover from an injury, illness, or hospital stay.
What is Assisted Living for Seniors and Medicare Eligibles?
Senior assisted living provides 24/7 care, meals, housekeeping, laundry, transportation, recreational activities, and wellness programs. Plus, facilities may offer on-site pharmacies, physical therapy, and even salon services.
Another large benefit of assisted living is social activities and entertainment. Many facilities have common areas including libraries, cafes, and game rooms. Plus, there are several social activities offered like gardening groups, book clubs, and movie nights.
Senior assisted living can help you or a loved one rest easy knowing that all care is personalized to meet any and all health needs. Emergency first aid, medication management, pharmaceutical services, and maintenance of medical records is often provided to residents. Some facilities have a staff physician who provides routine checkups.
Senior Assisted Living and Home Care Services Costs
It’s important to look at the price tag when making a decision. Home care and assisted living offer different services and their prices reflect that.
What Does Home Care Cost?
The cost of home care services is unique to each situation. According to NPR, the average costs for home care services are:
Personal Care and Companionship: $70/day or $18,200/ year
Private Duty Nursing: $19/hour or $19,760/year
Home Health Care: $21/hour or $21,840/year
There are several companies that provide home care services, but the prices will vary. Plus, there are several other costs that are not included. Keep these in mind when looking at your budget. These costs include groceries, personal hygiene items, household items, transportation, rent or mortgage, utilities, and maintenance.
What is the Average Cost of Senior Assisted Living?
The type of residence, size of the apartment, services included, and location of the community are all factors that can increase the overall cost of senior assisted living. Costs can range from $2,200 to $6,000 per month depending on the cost of living for each state. However, keep in mind these are all-inclusive costs and eliminate the cost of rent, utilities, maintenance, meals, and personal care if you or a loved one lived at home.
Senior Assisted Living and Home Care Services Qualifications
Assisted living and home care each have a specific set of qualifications. Before finalizing on a plan option it’s crucial to know if you qualify.
How Do You Qualify for Home Care?
Within the three types of home care, personal care and companionship is the only type that doesn’t require a prescription. Plus, if Medicare or Medicaid is covering some of the costs, there are different qualifications. To qualify you must meet the “homebound” criteria as established by the Centers for Medicare and Medicaid and require skilled care on a part-time basis in order to improve or maintain your health issue. If you meet these requirements, Medicare will cover your costs, but only if you receive your care from a Medicare-approved home health agency.
Who Qualifies for Assisted Living Facilities?
Qualification for senior assisted living is largely dependent on the level of care a resident needs. You or a loved one may qualify if assistance with daily living facilities like personal care, hygiene assistance, mobility, meals, and medication management is needed.
Those who require daily nursing services from extensive medical needs may not qualify. The application process is the same regardless if you or a loved one lives in a private residence, rehabilitation center, nursing facility, or a hospital. The typical application process includes facility admission paperwork, medical history, physical, and tuberculosis (TB) test or chest x-ray.
Role of Medicare and Medicaid
Medicare only covers the third type of home care services: home health care. The only cost you may have is 20% of the Medicare-approved amount for durable medical equipment. Medicare typically does not cover the costs of senior assisted living. However, Medicare may cover qualified healthcare costs while living in the facility. This includes doctor visits, lab tests, certain preventive services, physical therapy, and medical supplies.
Medicaid may cover some of the costs of home care services, but the coverage will vary by state. In some cases, Medicaid can be used to pay for some assisted living costs through a Medicaid waiver, but there is often a waiting list.
Making a Decision
Home care services and senior assisted living are two options that could greatly impact you or a loved one’s quality of life. There is an abundance of information available which can make finzaling a decision difficult. Are you a caregiver and looking to help a loved one? Our Ultimate Aging Parents Checklist can help you prepare for what is often a tough decision and discussion.
Medicare and Medicaid may only cover a small amount of the total costs. However, Medicare Advantage plans may provide additional coverage beyond Original Medicare and include benefits like hearing, dental, or vision coverage.
At Medicare Plan Finder, our goal is to make sure you have the coverage and benefits that enable you to live the healthiest lifestyle possible. Plus, we make sure you are informed on important information like the Medicaid look-back period and how Medicare and Medicaid work together. Our licensed agents can help answer any questions you may have about Medicare Advantage, prescription drug coverage, and Medicare supplements. If you’re interested in arranging a no-cost, no-obligation appointment, call us today at 833-438-3676 or fill out this form.