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Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.
According to Genworth Financial’s 2019 Cost of Care Survey, the average cost of assisted living in Delaware is $6,035 per month. This is almost $2,000 more than the $4,051 national average and significantly more expensive than the rates paid in neighboring Pennsylvania and Maryland, where the average assisted living costs are $3,913 and $4,300, respectively. The price is even higher in New Jersey, where the average cost is $6,400 per month. Based on a 25% increase over the amount paid for standard assisted living in Delaware, the estimated cost of memory care is $7,544 per month.
Assisted living in Delaware’s capital, Dover, costs $6,180 per month, which is $145 above the state average and $2,129 higher than the national median. This is also substantially more expensive than the rates charged in nearby Baltimore, Maryland, and Philadelphia, Pennsylvania, where assisted living care costs $4,225 and $4,875 per month, respectively. Using the $7,544 estimate made previously, Delaware seniors in need of memory care can expect to pay around $1,500 over the rates charged for basic assisted living.
Delaware Medicaid offers the Diamond State Health Plan – Plus Long Term Care Community Services Program to eligible low-income residents who wish to remain in the community, instead of being placed in a nursing home. The LTCCS managed care program covers medical and personal care services for individuals receiving memory care in assisted living settings, but it does not pay for room and board. A personalized plan of care is developed for each program member, which specifies the services required to meet their needs. Those in need of memory care can receive case management, assisted living care and cognitive services. Depending on their needs, members may qualify for additional benefits, such as community transition assistance; physical, speech and occupational therapy; private duty nursing and transportation services, among others.
Delaware provides eligible residents living in state-licensed assisted living facilities with an Optional State Supplement payment, which may be put toward the cost of memory care services or used for personal expenses. Seniors who qualify for Supplemental Security Income receive the extra funds along with their monthly benefit check from the Social Security Administration. Individuals who do not qualify for SSI but meet the state’s eligibility requirements receive their monthly benefit payment from the Delaware Department of Health and Social Services.
Delaware seniors currently enrolled in Original Medicare Parts A and B may switch to a Medicare Advantage plan to recoup some of the costs they pay for memory care in an assisted living facility. MA plans, or Medicare Part C, are available through Medicare-authorized private insurance companies. The Centers for Medicare and Medicaid Services requires that Part C plans provide the same basic coverage as Parts A and B. Many plans also offer Part D coverage for prescription drugs, as well as a range of extra benefits. Depending on the particular plan, these extras may include dental and vision care, wellness programs, personal emergency response systems, nonmedical transportation and personal care services.
Recent CMS rule changes have enhanced the coverage options available through MA plans, and seniors may now use an assisted living facility as their official address with an MA insurance provider. These updates may allow Delaware seniors to sign up for an MA plan that reimburses certain costs for memory care and other long-term care services, such as the UnitedHealthcare Assisted Living Plan. The exact coverage provided differs between MA plans and providers, so seniors should ensure that a specific plan meets their needs before enrolling.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
Assisted living facilities that provide memory care are licensed by the Delaware Department of Health and Social Services (DHSS), Division of Long Term Care Residents Protection. The division is responsible for monitoring compliance with federal and state regulations governing long-term care facilities, as well as performing annual surveys and unscheduled inspections. DLTCRP staff also respond to incidents and complaints regarding quality of life, quality of care and violations of residents’ rights in assisted living facilities.
An ALF that offers special services, such as memory care, must provide a disclosure document that details the facility’s:
Assisted living facilities in Delaware provide housing, supervision, personalized assistance and health care and supportive services for individuals who need help with activities of daily living. Facilities must ensure that each resident’s care plan is implemented properly and provide all required personal services, arrange access to necessary health care and social services and facilitate or arrange opportunities for leisure activities and social interaction. Residents may receive care from licensed hospice programs and home health care agencies, with prior approval from the ALF’s director.
Licensed assisted living facilities in Delaware may accept adults and elderly individuals with a range of conditions, including Alzheimer’s disease and other forms of dementia. The following table offers an overview of the conditions and circumstances that determine whether an individual may be admitted or continue receiving memory care in an assisted living facility, based on the applicable rules and regulations.
|Residents Who May Be Admitted To and Retained in ALFs:||Seniors and adults who:|
|Residents Who May NOT Be Admitted or Must Be Discharged:||Individuals who:|
Prospective ALF residents must have a medical evaluation and RN assessment completed 30 days before admission, and a reassessment must be conducted within 30 days of move-in. Based on these assessments, a service plan must be developed to meet the individual’s care needs. This plan should detail the services to be provided and address all aspects of their care, including:
The rules regarding ALF staff providing assistance with medication self-administration are contained in the state Board of Nursing regulations. The rules require that within 30 days of a new resident’s admission, an RN must assess their ability to self-administer medication and determine whether they need assistance. An RN must also conduct regular reviews to ensure that medications have been received, are properly labeled and stored and are not causing any adverse side effects. Only aides who have passed an exam may assist residents with self-administering medications.
Delaware assisted living facilities, including those that offer memory care, may offer private rooms, as well as shared rooms for no more than two residents. Private rooms must provide at least 100 square feet of living space, and shared rooms must offer 80 square feet of living space per resident. Facilities may feature private bathrooms accessed from individual resident rooms or shared bathrooms that serve no more than four residents. If in-unit bathrooms do not contain a tub or shower, such facilities must be provided in a readily accessible location. ALFs must provide residents with in-unit kitchen facilities or access to a central kitchen. State regulations stipulate that facilities providing memory care must detail any specialized physical environment and design features in their disclosure documents.
ALFs in Delaware must have a sufficient number of trained staff on duty to provide adequate care for all residents. Staff employed by facilities that offer memory care must be properly trained and hold appropriate certifications and licenses to ensure the needs of residents are met.
Delaware regulations include minimum requirements for ALF management staff, based on the size of the facility.
Newly hired care staff must receive a comprehensive orientation on state-mandated topics, which include residents’ rights, the health and psychosocial needs of residents being served, infection control, first aid and the facility’s fire, life safety and emergency disaster plans. Staff members must also receive at least 12 hours of ongoing training annually.
Delaware Medicaid administers the Diamond State Health Plan – Plus, a managed long-term care entitlement program that covers services in assisted living facilities for eligible state residents, including those who require memory care.
Concerned parties can report witnessed or suspected abuse, exploitation or neglect of an assisted living facility resident by calling the Division of Health Care Quality’s 24-hour, toll-free report line at 877-453-0012. Alternatively, individuals may complete and submit an online complaint form.
|Alzheimer’s Association – Delaware Valley Chapter|
|800-272-3900||The Alzheimer’s Association’s Delaware Valley Chapter provides dementia sufferers and their loved ones with information, support and access to local resources. Assistance is available through the association’s website and its 24-hour, toll-free helpline. The chapter also works in tandem with the national AA organization in its fundraising, advocacy and research efforts.|
|Alzheimer’s Impact Movement – Delaware|
|Join AIM by filling out the online form or sign up to be an advocacy volunteer||AIM is a nonpartisan, nationwide organization that advocates for memory loss-related public policies. Members engage with lawmakers at the state and federal levels, with the goal of increasing government funding for dementia research, care and support.|
|Delaware Prescription Assistance Program|
|Call 844-245-9580 for assistance completing a DPAP application|
|The reinstated DPAP program helps elderly and disabled state residents pay for medically necessary prescriptions, including those used to treat dementia. The program provides up to $3,000 in assistance per year for individuals who have an income at or below 200% of the Federal Poverty Level and only Medicare Part D prescription coverage.|
|Locate a memory cafe in your area|
|Memory Cafes, held on a regular basis in Delaware communities, are gatherings where those with memory loss and their family members can enjoy welcoming atmospheres, dementia-friendly activities and opportunities to socialize and benefit from mutual support.|
|Community Legal Aid Society, Inc. Elder Law Program|
|New Castle County: 302-575-0666|
Kent County: 302-674-3684
Sussex County: 302-856-4112
|The nonprofit Community Legal Aid Society, Inc., administers the Elder Law Program to provide free legal assistance to Delaware residents aged 60 and older. Seniors living with dementia may benefit from the help available on various civil legal matters, such as advanced health care directives, powers of attorney, guardianship, care facility resident rights and Medicaid and Social Security benefit issues.|
|Delaware Aging and Disability Resource Center|
|Use the ADRC service search to find local resources or call 800-223-9074 for assistance||The ADRC gives Delaware residents a single access point to dementia-related resources in their local area. The center’s trained staff provides seniors and their family members with information about available resources, personalized options counseling and program enrollment support.|