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Money Does Matter

For many families, finances and the cost of dementia care can be one of their greatest worries. Families hope there are sufficient assets to meet the expenses for the next four to 10 years. According to a Care.com Usage and Attitude Family Caregiver survey, in 2014, over 50 percent of families spent more than $5,000 per year to cover out-of-pocket expenses. The same survey reveals that seven percent of survey respondents report having spent more than $50,000 per year to cover the costs of their loved one’s care.



Talking about personal finances is often difficult. To make these initial family discussions go as smoothly as possible, invite an elder-care lawyer, a financial advisor, or a geriatric care manager to guide discussion and offer their expertise. The goals of this and ensuing conversations are to define needs and expenses, and based on this information, develop a realistic financial plan.


Dementia care is more than house utilities and groceries. Home expenses also include rent or mortgage payments, house maintenance, home, and car insurance, as well as assorted federal, state, and local taxes. Dementia care also involves the out-of-pocket deductibles and co-pays associated with the diagnostic procedures and treatments for dementia and any other medical conditions your loved one may have. Do not overlook the expenses of such things like personal care supplies, equipment rental and purchases, adult daycare, and assisted living fees. Sadly, circumstances may be one where your loved one has neither sufficient savings nor income to pay for the services he or she needs.


What happens then? Sometimes families are able and willing to pay the difference--and sometimes not. Long-term care insurance is expensive, must be purchased well before need, and is not long-term in the sense of “forever care.” Often families must resort to state and federally-funded programs.

Medicare, parts A, B, and D, and most private insurance policies pay only for expenses not related to having dementia. However, your loved one may be eligible for dementia coverage under one of several Medicare Special Needs Plans or “SNPs.”


There are other avenues worth exploring – all of which have specific eligibility requirements. Some of these are Medicaid, a program that helps very low-income people get the healthcare they need, and the Program of All-Inclusive Care for the Elderly (PACE) that provides comprehensive medical services to Medicare and Medicaid enrollees.


The United States Veterans Administration (VA) offers a broad range of services to help veterans who have dementia. To take advantage of the various VA programs and services, the veteran must be enrolled in the VA healthcare system. While the veteran does not have to have a service-related injury to receive dementia benefits, the veteran must have an honorable or a general discharge.


Other strategies to supplement your loved one’s income include a Home Equity Conversion Mortgage (reverse mortgage), the conversion of certain kinds of life insurance into long-term care insurance, as well as borrowing against the value of a life insurance policy. Disability insurance is another resource when dementia makes employment no longer possible.


Community not-for-profit organizations offer many helpful services that can range from household repairs and yard maintenance to elder daycare programs and caregiver respite grants. Sliding scale fees are another not-for-profits feature. Therefore, your loved one will have to meet eligibility criteria, to receive a reduced rate.


Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

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