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Planning for the costs of Dementia

Planning for the costs of DementiaA recent report from the Alzheimer’s Association states that one in nine Americans age 65 or older currently have Alzheimer’s. With the baby boomer generation aging and people living longer, that number may nearly triple by 2050. Barbara Moss, founder of Elder Law of Nashville offers some advice on how to plan for this potential problem.

Caring for someone with dementia is often more expensive financially and personally as care is needed for a longer period of time. The cost of care in a facility can be out of reach for many families, thus caregivers are often family members who risk their own financial security and health to care for a loved one. However, there are important steps families can take to alleviate some of these burdens.

The Financial Cost of Care
As the disease progresses, so does the level of care and costs required. Options range from in-home care (starting at $46,332 per year) to adult daycare (starting at $17,676 per year) to assisted living facilities ($43,536 per year) to nursing homes ($82,128 per year for a semi-private room).

Care for a person with dementia can last years, and there are few outside resources to help pay.
Health insurance does not cover assisted living or nursing home facilities, or help with activities of daily living, including eating, bathing and dressing.

Medicare covers some in-home health care and a limited number of days of skilled nursing home care, but not long-term care.

Medicaid, which does cover long-term care, was designed for the indigent; the person’s assets must be spent down to almost nothing to qualify.

VA benefits for Aid & Attendance will help pay for some care, including assisted living and nursing home facilities, for veterans and their spouses who qualify.

Unfortunately, most families are not prepared to pay the extraordinary and lengthy costs. As a result, family members will provide the care for as long as possible.

The Emotional and Physical Costs
In addition to the financial costs, caregivers often experience increased levels of stress, anxiety and depression. Caregivers have admitted long-term dementia care can negatively affected their personal health, their relationships with their family and/or spouse, and feelings of inadequacy to provide quality care.

People with dementia may wander, become aggressive and often no longer recognize family members, even those caring for them. Caregivers can become exhausted physically and emotionally, and caring for the patient may simply become too hard for an individual or family on their own.
The financial impact on caregivers is substantial. More than 60% have reported they pay for care with their own savings and retirement funds. These expenses include household expenses, personal items, transportation services, informal caregivers and long-term care facilities.

In addition, absences, reduced hours and chronic tardiness can mean a significant reduction in a caregiver’s pay. About one-third of caregivers provide 30 or more hours of care per week, and leave their job as the result of a long-term care needed.

The Importance of Planning
The best way to overcome these common obstacles is to plan ahead, but unfortunately, most people don’t. The top reasons people fail to plan is they didn’t want to admit care was needed, the timing of the long-term care was unforeseen or unexpected, they didn’t want to talk about it, they thought they had more time, or they hoped the issue would resolve itself.

Waiting too late to plan for the need for long-term care, especially for dementia, can throw a family into confusion on what Mom or Dad would want, what options are available, what resources can help pay for care, and who is best-suited to help provide hands-on care. Having the courage to discuss the possibility of incapacity and/or dementia before it happens can go a long way toward being prepared should that time come.

Watch for early signs of dementia. The Alzheimer’s Association ( has prepared a list of signs and symptoms that can help recognize the beginnings of dementia. Early diagnosis provides the best opportunities for treatment, support and planning for the future.

If your family is currently caring for a person with dementia, here a couple of things the family can begin planning today.

Take good care of the caregiver. Caregivers need support and time off to take care of themselves. Arrange for relief from outside caregivers or other family members.

Join a support group to share frustrations and questions, and learn how other caregivers are coping.
Inquire about flexible schedules for caregivers working outside the home. Depending on how long they expect to be caring for the person, they may be able to work on a flex time schedule or from home. Consider whether other family members can provide compensation for the main caregiver.
In addition, there are a number of legal options to help families protect hard-earned assets from the rising costs of long-term care, and to access funds to help pay for that care. Reach out to your local Elder Law attorney to help create an asset protection plan, help maximize income, retirement savings and long-time care insurance to provide peace of mind to all.

Caring for a loved one with dementia is more demanding and more expensive for a longer time than caring for a loved one without dementia. It requires the entire family to come together to discuss and explore all options so that the burden of providing care is shared by all.

Barbara Moss, founder of Elder Law of Nashville, has practiced law in Nashville for more than 30 years. She focuses her practice on elder law, conservatorships, probate, estate planning, Medicare and Medicaid. Moss was recognized for her contributions to the law profession and the community with numerous honors, including the Athena Award in 2007, induction into the YWCA Academy of the Women of Achievement in 2008, the Molly Todd Cup in 2009 presented by Nashville networking organization CABLE and Nashville Business Journal’s Women of Influence in 2007. She currently serves on the FiftyForward board of directors.

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