According to data from the Alzheimer’s Association, approximately 29,000 Hawaiians aged 65 and older are currently living with dementia. By 2025, the number of individuals affected is expected to rise to 35,000, which represents an increase of 20.7%. In 2019, 480 Hawaiian seniors lost their lives to Alzheimer’s and related forms of dementia, making it the state’s sixth-leading cause of death. Each year in the U.S., almost one-third of all deaths in this age group are due to dementia. Nationwide, over 5 million Americans are living with Alzheimer’s, and the CDC projects that the disease will affect 14 million individuals by 2060, which is close to triple the present impact.
Memory care facilities provide those living with Alzheimer’s and dementia with care that is tailored to their unique needs. Memory care can take place in its own facility, or as part of a designated wing of another residential care community. Staff members of memory care units or facilities undergo specialized training in caring for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.
This guide will cover the cost of memory care in Hawaii, financial assistance options for paying for memory care, free memory care resources in the state, and a directory of memory care facilities in Hawaii.
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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.
We added 25% to the assisted living costs reported by the 2021 Genworth Cost of Care Survey to calculate memory care costs.
In Hawaii, the average monthly cost of memory care is $6,719. This is $1,094 more than the United States average of $5,625. In comparison to the coastal states of California ($6,563) and Oregon ($6,306), communities in Hawaii charge slightly more each month. However, seniors in Hawaii pay less on average than those in Washington ($7,500).
There's a big difference between the costs of care in Hawaii, depending on location. In Urban Honolulu, seniors pay an average of $6,719 for memory care, while those in Kahului pay significantly less at $4,781. Across the ocean in San Francisco, CA, seniors pay $7,899, and those in Los Angeles, CA, pay $6,563 each month.
Med-QUEST is the Hawaiin version of Medicaid. It covers residential care and support services for low-income seniors in assisted living communities and other residential facilities. This means that Medicaid in Hawaii covers some of the memory care costs. The exact services covered will depend on the care requirements of the senior and the plan they are approved for. Some of the services covered include personal care, skilled nursing care, housekeeping, nonmedical transportation and medical equipment.
Medicaid eligibility in Hawaii is based on several factors, including age, health and income. Individuals who desire to live in an assisted living facility instead of receiving nursing home care have an annual income cap of $14,820, and married couples are limited to $29,640. Assets are limited to $2,000 per person; however, this excludes properties and vehicles.
|family size||annual income limits||asset limits|
|Two-Person Household (Single Applicant)||$14,820 for applicant||$2,000 for applicant, $137,400 for non-applicant|
|Two-Person Household (Dual Applicants)||$29,640||$4,000|
In addition to meeting the above financial requirements, seniors must also provide the following documentation:
Seniors and their family members have easy access to assistance when applying for Medicaid in Hawaii.
|Department of Human Services Application Counselors||Various locations||The Department of Human Services maintains an online directory of approved Application Counselors. The counselors are employed by local health centers and senior centers and can guide seniors through the application process in person or by phone.|
|Med-QUEST Enrollment Services||800-316-8005||This division assists seniors once they're approved for Medicaid. The enrollment services help seniors apply for the exact plan that best suits their requirements.|
|Med-QUEST Centers||Various locations||Med-Quest Centers are located throughout the state. Agents at the centers can help seniors determine if they're eligible for Medicaid and assist them in the application process. In addition, agents can update seniors and their family members on the status of their applications.|
Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.
That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
In Hawaii, residential care facilities that provide memory care are regulated by the Department of Health, Office of Health Care Assurance (OHCA). There are two types of facilities licensed by the OHCA: Assisted living facilities (ALFs) and adult residential care homes (ARCHs). Type I ARCHs may house up to five residents, while Type II ARCHs may have six or more residents. The state also licenses expanded adult residential care homes, or E-ARCHs, which may provide services similar to those offered in nursing facilities. Hawaii’s state regulations do not include memory care specific licensing requirements for ALFs, ARCHs or E-ARCHs.
The Department of Health inspects all licensed facilities in the state every two years. Unannounced inspections may also take place at any time to ensure compliance with state regulations or in response to filed complaints.
Assisted living facilities must provide certain care services to residents, in addition to room and board, including nursing assessments, health monitoring, medication management and supervision and intervention with behavior problems. The scope of care also includes assistance with daily living activities and personal care services.
Additionally, ALFs must provide or arrange services not related to health care, including:
Adult residential care homes must provide residents with three meals plus snacks each day, with accommodations made for doctor-prescribed diets. Additionally, facilities must offer supervision, assistance with personal care, management and assistance with self-administration of medications, social activities and transportation to medical appointments. Extended adult residential care homes must provide health care related services for residents who meet the criteria of a nursing home level of care. E-ARCH facilities are also required to arrange medical evaluations by a physician for these residents every four months.
ALFs and ARCHs in Hawaii may accept individuals with a wide range of conditions and care needs. State regulations do not limit who may be accepted, beyond prohibiting the admission of individuals who require a nursing facility level of care, but they do define why a resident must be discharged from an ALF. State regulations stipulate that each ALF and ARCH must develop its own admittance guidelines, based on the facility’s capacity and staff training and experience, and ARCHs must also establish discharge policies. The following table offers examples of conditions and situations that may determine admission to an ALF or ARCH, the expanded admissions allowed in E-ARCHs and the discharge guidelines for ALFs, per state regulations.
Residents Who May Be Admitted to ALFs and ARCHs
Seniors and adults with:
Residents Who May Be Admitted to E-ARCHs
Seniors and adults who meet the criteria for a nursing facility level of care, as certified by an RN or physician
Residents Who May NOT Be Retained in ALFs
ALFs may provide assistance to residents with self-administration of medications, and an RN may delegate direct care staff to deliver this assistance. A resident’s medications may be stored in their private quarters, but in shared units, stored medications must be kept under lock and key. A physician or RN must review the medications of all residents every 90 days.
ARCHs may provide assistance to residents who wish to self-administer medications and are capable of doing so. Medications taken by injection must be administered by an RN or delegated to direct care staff if a resident cannot self-administer the injection.
ALFs and ARCHs must conduct a comprehensive initial assessment on each resident admitted to determine their care needs. Facilities must then develop a written care plan for the individual that reflects their assessed needs and choices. The plan should detail the care services to be provided, who will deliver the services, when they will be provided and how often, as well as the expected outcome. Each resident’s care plan must be updated periodically and in response to changes in the individual’s condition.
Facility requirements differ for ALFs and ARCHs. ALFs must provide residents with apartment-style units that include a private bath equipped with a sink, toilet and shower. The unit must have a kitchen or kitchenette equipped with a refrigerator, sink and cooking appliance, which may be disconnected or removed according to the resident’s needs. A unit must be 200 square feet in size, excluding the bathroom.
In ARCHs, rooms may be shared by up to four occupants. The facility must provide one toilet for every eight residents, a sink for every 10 residents and a shower or bathtub for use by up to 14 residents.
Assisted living facilities are required to employ an administrator who is responsible for day-to-day operations. Although state regulations do not stipulate a minimum staff-to-resident ratio, sufficient direct care staff must be on duty to meet the needs of residents, 24 hours a day. Licensed nursing staff must be on hand seven days a week to manage and monitor residents’ care. All staff must be trained in first aid and CPR, and a registered nurse must be employed to train and supervise staff and conduct resident assessments. All staff members are required to complete orientation training and at least six hours of in-service training annually.
Type II adult residential care homes must employ an administrator to oversee staff, residents and day-to-day facility operations and employ an RN to complete resident assessments. E-ARCHs must have a social worker or RN available to train and supervise direct care staff. The state does not mandate a minimum staff-to-resident ratio, but facilities must have sufficient staff on duty around the clock to meet residents’ needs and at least one caregiver on duty during each shift. All staff of ARCHs and E-ARCHs must complete six hours of annual training on specific topics.
Hawaii’s Medicaid program, Med-Quest, offers coverage for memory care services received in ALF, ARCH and E-ARCH facilities through its Quest Integration program. This managed care program is an entitlement of Med-Quest, so individuals who meet the residency, functional and financial criteria are eligible for assistance. The program covers the cost of provided services, but not room and board.
Individuals who have concerns about the treatment or quality of care received by a resident in an ALF, ARCH or E-ARCH facility in Hawaii can contact the Long-Term Care Ombudsman by calling 1-808-586-7268. Alternatively, concerns about elder neglect or abuse in a licensed care facility may be reported by emailing firstname.lastname@example.org.
Hawaii is home to several resources that provide support and guidance for seniors with dementia-related disorders and their caregivers.
|Alzheimer's Association Aloha||800-272-3900||The Alzheimer's Association Aloha advocates on behalf of seniors and their caregivers across Hawaii's islands. It runs support groups and educational workshops. In addition, it links seniors to memory screening centers and treatment options.|
|Dementia Friends Hawaiiemail@example.com||Dementia Friends Hawaii is an initiative dedicated to changing how people think about dementia. It provides information sessions to educate seniors and the public about the different aspects of memory loss.|
|Hawaii Alzheimer's Disease Initiative||808-956-5001||This is a federally sponsored program run by the University of Hawaii Center on Aging. It provides cognitive health assessments that help seniors and their family members understand the senior's needs and treatment options. In addition, it provides training programs for people working with seniors with memory loss disorders.|
|Memory Cafe||808-447-7448||Brightstar Care of Honolulu hosts a regular memory cafe for seniors with memory loss disorders and their caregivers. Seniors can partake in activities and socialize with others in a dementia-friendly environment.|
|Area Agencies on Aging||808-586-4400||The Area Agencies on Aging runs local offices throughout the state. Each office provides a central space where seniors and their family members can find out about local support groups, services and long-term care options.|
Note: The following information was compiled and most recently updated on 2/7/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.
|Am I allowed to visit my loved one in person?||Yes (Conditions Apply)|
|Is my loved one required to quarantine after I visit him or her?||No|
|Am I required to wear a mask if I visit my loved one in person?||Yes|
|Are visitors screened for elevated temperatures?||Yes|
|Are residents allowed to leave the facility at-will?||Yes|
|Are residents of senior living facilities who leave required to quarantine when they get back?||No (Conditions Apply)|
|Are staff members and contractors checked for elevated temperatures?||Yes|
|Are staff members and contractors tested for COVID-19?||Yes|
|Do staff members have to regularly screen residents for COVID-19 symptoms?||Yes|
|Do staff members have to regularly check residents for elevated temperatures?||Yes|
|Do staff members have to regularly test residents for COVID-19?||Yes (Conditions Apply)|