Covering Care Costs for Dementia-Related Psychosis

When a loved one can no longer live safely at home, finding a memory care facility you can afford is top priority.

by Megan McMorris Health Writer

If your loved one is one of the eight million Americans living with dementia, you know it can be an overwhelming experience—for everyone involved. Along with memory loss, confusion, and difficulty concentrating, 30% of people (and their families) are also contending with something called dementia-related psychosis (DRP), where everyday life is interrupted by the person experiencing hallucinations, illusions, and delusions. Caring for someone with DRP is a huge responsibility that can exact an emotional as well as financial toll. The silver lining is there are more resources than ever for those seeking memory care, the term for a senior living facility that provides support for residents with dementia issues.

“Most people don’t realize how far things have come, and still have an antiquated idea of nursing homes with linoleum hallways,” says Sue Johansen, SVP, Community Network at A Place for Mom, a senior care referral service based in New York City. “They don’t realize the wide spectrum of options and programming variations available today, at varying costs.”

So exactly how much should you expect to pay for care for a loved one with DRP? And is it possible to keep fees in check without skimping on quality? We asked experts in the field for advice on how to approach paying for memory care.

Understand Pricing Models

The final financial tally will depend on the services you need, so that’s the first thing to consider, says Johansen. “The level of care drives the costs,” she explains. Does your mom need medication management? Assistance with bathing? Or maybe she just needs prompting to get to mealtimes. All of these factors will dictate how much you’ll pay each month and what environment best suits your loved one’s needs.

In general, memory care facilities handle fees in one of three ways. Some offer an “a la carte menu,” where you can pick and choose what services you need (so you’re not paying for those that you don’t). Another method aggregates costs into three tiers: low, medium, or high levels of care. Other communities offer an all-inclusive option. In this case, “it’s assumed that the level of care will increase over time, since it’s a progressive disease, but you’ll pay one agreed-upon price for housing, services, and care which remains fixed over time,” says Johansen.

As you consider facilities, remember that your family member will need more care as the years go by. A residence that seems just-manageable now, may prove too pricey in a few years when your loved one requires more intensive help. The goal is to pick a community you can afford now and later.

Cost-Trimming Tips for DRP Care

There are ways to save without sacrifice, if you look in the right places. Here are a few:

Suss out your benefits. Chances are, you can use benefits you don’t even realize that you qualify for. Veterans, for example, are eligible for assistance, says Johansen. “Anyone who has served in the military during a time of war or conflict are eligible for a pension, that can offer roughly $2,500 in assistance to a resident, and $2,000 a month to the spouse,” Johansen says. “It’s not talked about much, so some people are surprised that they qualify, but it’s for anyone who needs assistance in their daily living.”

Check your state’s plan. If you qualify for state Medicaid, you can get assistance with part or even all of a community care cost or in-home care. You may also qualify for direct financial help by acting as your relative’s caregiver. (Check your state’s Medicaid program and eligibility requirements.) “For example, here in California, we have a respite care program, where they’ll send someone out to watch your loved one at home while you take care of business,” says Michael Plopper, M.D., a geriatric psychiatrist with Sharp Mesa Vista Hospital in San Diego, CA.

Lean on local resources. Check into your local Alzheimer’s Foundation, which may have resources like support groups and care consultations. “Every community has their own offerings, and they can be helpful not only to reduce costs but to provide better care,” says Dr. Plopper. (Find your local chapter.)

Reassess your priorities. Going into the process, you may have firm ideas on must-haves, and a private room is at the top of most people’s lists. By being flexible about your priorities, such as opting for shared space instead, you might find surprising ways to cut costs that actually benefit your loved one. “A private living area is important to most caregivers, but for those with cognitive issues, being around others is actually better,” says Johansen. “If you look at some of the best memory care communities across the country, they tend to run things in a communal way because they know it’s beneficial to keep people socialized.”

Ask for a deal. It may feel awkward to ask for a special rate when it comes to dementia care, but if you don’t ask you might miss out, says Johansen. “Family members are so involved in the caretaking aspect that they don’t realize there are discounts available, and you’d be surprised at the deals you can get,” she says. “A month free per year, a locked-in rate, waived fees, these are all things you should be asking. You won’t know if they’re available if you don’t.”

Above all, know that there are plenty of communities where your loved one will live comfortably and within your budget, and resources designed to help you navigate the unknowns of memory care. “We usually meet people at one of the worst moments of their life, when they’re overwhelmed, so it’s a great feeling when you can show them they have options,” says Johansen.

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Megan McMorris