How do you pay for Alzheimer’s memory care?”

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My mom has been diagnosed with dementia and it has been suggested that we move her to assisted living. She will, barring unforeseen circumstances progress to a memory care facility. Many of the ones we have looked at (all of the best ones) don't take medicare. What do we do?

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Medicare rarely covers assisted living or nursing home care. People are expected to pay their own way until they qualify for Medicaid, which is a program for the poor. Your mom's assets will have to be "spent down," meaning that she will pay her own way using all of her assets until she can qualify for Medicaid. Generally, people are then placed in nursing home care - in her case a memory unit.
Because individual states differ (even though Medicaid is a Federal program), you will do best to get local information from your local social services office. Another great resource in your long-term care ombudsman who can be found by typing in the Zip code at These people are very helpful and can guide you.
I will tell you for sure that your mom won't get this care paid for while she has the money to do so herself. If she has a lot of assets (house, cars, investments) you may want to talk with an elder law attorney for planning purposes.
Good luck,
My momhas medicare part b and has dementia. I am looking for a long term facility for her. She needs to socialize with people. he refuses to stay by herself. She was put in the hospital brcause she does not eat. She forgets to feed herself but she will feed her cats I dont know what to do. She recently moved away from me and since then she has gotten worse. I sometimes think it is just separation anxiety. Do you have any ideas?
AllisonBaham, the financial burden on top of everything else is crushing, isn't it? Have you tried applying for Medicaid for your mom?
Not all Assisted Living Facilities accept Medicaid, but some do. Some have a certain number of units built into their budget for accepting Medicaid, and those usually go to people who have been private-pay and then run out of money. Some nursing homes do not accept Medicaid, but most do.

I can believe it is VERY frustrating to hear over and over again that a place does not accept Medicaid. Keep searching ... you'll find one that does! To help narrow down the search try contacting the Alzheimer's Association in your area, and/or your state's Aging Care help line.
Some of the ladies in my home town chose to move to a continuing care community about 45 mins away. They knew most people would not drive that far to visit, but they knew that the ones who really cared would. I think we all want a home which is in our backyard, when in reality, there might be a spot a little further away that was out of our comfort zone.
We placed my mthr about 30 mins from home. I know that seems far, but it works out well for us. The important thing is that they had availability when we needed them. What a blessing.
It is a sad truth, that no financial programs are out there to assist with payment for the elderly with Alzheimer's, dementia, or total care unless they have no assets with the exception of a few thousand dollars. At that time they can apply for Medicaid assistance. Yes you have to pay private pay (money out of the patients pocket) untill they become Broke basically,
Yes she has medicaid but as soon as you say medicaid.Sorry
we do not have a bed for you. Plus she needs memory care? I hope i never get this disease. This is soo sad. She doesn"t own anything.
MusicMom, does Mom have any assets at all? Insurance policies? Stocks, Bonds, property? Anything that could be sold? If she is on Medicaid I suspect that the answer is No -- she would already have spent down her assets. And I suspect that her monthly income is not enough to pay for a care home -- right?

What level of care does she need? What kind of care center are you looking for? Assisted Living? Group home? Memory Care? Nursing Home?

I don't know how it is in Washington, but in Minnesota it is not hard to find good Memory Care or Nursing Home facilities that accept Medicaid from day 1. It is harder to find Assisted Living Facilities that don't expect some private pay before they will accept Medicaid. They do exist, but they are harder to find. I don't have any experience with Group Homes.

Your profile says Mom has dementia. Except in the early stages, many persons with dementia need (or will need) more personal care than ALFs typically are set up to provide. Does your mother wander? Can she dress herself. feed herself, toilet herself? What does she need help with?

You are in a very tough spot. Ask her case worker for help in finding a suitable care center that accepts Medicaid. Also check with your state's Department on Aging.

Have you considered getting paid for your mother's care? If finances are the only obstacle, find out what kind of in-home help your mother is qualified for and see what you would need to do to be able to be her paid aide or caregiver. Again, talk about this with Mom's Medicaid case worker. The money may not be enough to meet your needs, and I realize that there may be other factors that are involved here. But it is worth checking out.

Another thing that Medicaid often pays for (at least in Minnesota) is adult day care. Mom would be picked up, taken to the center, given breakfast and a hot lunch, and returned home in the late afternoon. This arrangement allows some caregivers to work while their parent or spouse is safely looked after. It also provides some stimulation and socializing opportunities to the care receiver.

Explore all the options. If placing Mom is the best option, I sincerely wish you well in finding a good place that accepts Medicaid.
Regarding the "Spend down until you qualify for Medicaid" : Some may think this is an unethical thing to do, or that it's cheating the system, but forcing someone to go broke before allowing them financial assistance is ridiculous. What I recommend is moving your parent's (or loved one's) assets into a trust with you (the caregiver) as the custodian. There's a legitimate reason for doing something like this, anyway, as your loved one's capacity for understanding financial decisions will decrease over time. At that point, they can claim few assets and apply for Medicaid. I did something similar when my father's Alzheimer's progressed and he needed assisted living.
Regarding care for Alzheimer's patients: first contact a hospice care organization. Many people think they only deal with people in final stages of life. This is not true. Upon recommendation of your doctor they will provide many services to aid in care at home such as nurse visits, incontinence supplies, social services, bathing care, some prescriptions. This is not full-time care, it is meant to supplement whatever home care you are doing or hiring for, but it is a big help and the cost is covered by medicare.
I have been told by an elder attorney that if you have too much in assets to qualify for medicaid for your spouse, there are some methods to protect your assets and that one way is to convert your assets (stocks, bonds, etc.) into an annuity. I haven't done this yet as we still have long term care benefits, but they will soon run out. Does anyone have any suggestions to avoid getting wiped out financially by Alzheimer's. Also if you or your spouse is a veteran, there is an organization, which I believe is called Veteran Angels that can provide monthly payments.

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