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How old and you and your husband? How long has he had dementia? What is his current level of functioning? For example, what activities does he need help with -- dressing, baths, eating, etc? What is his memory like? These questions are not just being nosey, but will help us get a better picture of the situation.

I imagine by "lose everything" you are referring to applying for Medicaid, and the spenddown process. You don't exactly lose everything, but I would say that Medicaid is hard on married couples, where one will stay in the community and the other be in long term care. Still, it may be the best option. Don't rule it out until you have explored all your options.

Depending on his level of functioning and your relationship, it may be preferrable to care for him at home as long as you can, regardless of the financial considerations. But even to do that you may be better off on Medicaid, to get help for in-home care.

I suggest you talk to a social worker from Social Services in your county, who can explain options and programs available. And then, especially if you are considering Medicaid, talk to an attorney who specializes in elder law, to protect what assets you can.

Dementia is progressive. For many people the time will come when in-home care is just not feasible, especially for a single individual such as a spouse. When dementia is part of the picture, it is always a good idea to face the "what if" a nursing home is required in the future.

I have been caring for my husband with dementia for 9 years, at home. I hope I can continue to do that until he dies, but I haven't promised that because I will always want the best care for him, and someday I might not be able to provide it.

In the beginning the social worker advised me to see an elder law attorney, and to apply for medicaid and a program called elderly waiver. I did. We have a pretty high monthly spenddown (kind of a co-pay or deductible), but things like drugs, equipment, hospitalizations, therapists, a day program and now a personal care attendant, are covered. I applied thinking he might soon need a nursing home, but he surprised us all and has remained stable. But Medicaid turned out to be a very useful program even for in-home care.

To find out the specific help you can get, call your Social Services department.

Good luck!
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