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Alabama Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: September 11, 2020

 

Memory care in Alabama provides room and board and personal care for people with Alzheimer’s disease or other dementia. In state regulations, memory care is officially called “specialty care assisted living facilities for residents with dementia or Alzheimer’s symptoms.” These homes may also be called a “Dementia Care Facility” or an “Alzheimer’s Care Facility,” and fall under three categories:

– Family: two or three residents. This is often called “adult foster care.”
– Group: between three and 16 residents. These are often called “board and care homes.”
– Congregate: 17 or more residents. These are often called “assisted living.”

Every resident in Alabama specialty care receives general supervision and health services. Importantly, these communities do not provide medical care, though assistance with activities of daily living like eating and grooming may also be provided. A detailed screening is required before admittance, to assess someone’s physical and mental states. The screening must also determine whether the home can fulfill that person’s needs. People with chronic health conditions requiring medical or full-time nursing care may not be admitted into specialty care homes.

There are almost 100 memory care residences in Alabama, regulated by the Department of Public Health’s Bureau of Health Provider Standards. These residences would be equipped to handle the needs of people with Alzheimer’s, frontotemporal, vascular, Lewy body, and other forms of dementia. There are more than 100 board and care homes, many (but not all) offering memory care.

  Did You Know? In Alabama, free assistance is available to help families locate a memory care home to meet their needs and budgets. Get help here.

 

How Much Does Memory Care Cost in Alabama?

The average cost of memory care per month in Alabama is $3,890, which breaks down to about $46,680 annually. The state’s most expensive place for memory care is the Auburn area, where memory care costs about $4,940 per month and $59,280 annually. The least expensive city for memory care is Gadsden, for about $2,980 per month and $35,760 per year.

Alabama has some of the least expensive assisted living in the nation. These costs are less than in Florida, Mississippi, and Tennessee, on average, but are slightly more than Georgia. Residents in Auburn and other cities in eastern Alabama may, in fact, be able to find more affordable memory-care options on the other side of the nearby border with Georgia.

Other Alabama cities’ costs include:

Alabama Memory Care / Assisted Living Costs (updated Sep. 2020)
Region / City Monthly Cost Annual Cost
Statewide $3,890 $46,680
Birmingham $4,360 $52,320
Huntsville $4,650 $55,800
Montgomery $3,740 $44,880
Mobile $3,820 $45,840
Tuscaloosa $3,490 $41,880

For help finding a living option to meet your family’s needs and budgets, click here.

 

Alabama Assisted Living Laws & Regulations

Admissions Requirements & Process

Someone can move into assisted living with memory care in Alabama on short notice, but every resident must have a medical examination within 30 days of admittance, and an individual plan of care must be developed. Paying for this screening is probably the responsibility of the person moving in, but Medicare recipients will have some of the costs covered. Medicare offers an annual free “wellness visit” (also called a “cognitive assessment”) that screens for dementia symptoms. This is a good way to begin the process of getting the information necessary to move into memory care.

The process requires two assessments on specific forms: a Physical Self Maintenance Scale, and a Behavior Screening Form. Every specialty care assisted living home must have a minimum score for residents on their Physical Self Maintenance Scale. Further screening is also required to move into specialty care, including:

– Clinical history
– Mental status examination including an aphasia screening (to assess communication ability)
– Geriatric depression screen
– Physical functioning screen
– Behavior screen

Essentially, a person must go through a process similar to receiving a diagnosis of dementia before moving into Alabama memory care. (For more on diagnosing Alzheimer’s disease and related dementias, click here.)

 Regulations in Alabama require every resident (or resident’s caregiver) to receive a financial agreement prior to admission that includes a list of regular charges and any possible additional charges. File this document as defense against unexpected costs.

Residents with the following issues may not live in Alabama specialty care:

– Requires restraints for confinement
– Chronic health conditions requiring extensive nursing care
– Requires daily professional observation
– Requires care beyond assistance with activities of daily living
Someone who needs skilled nursing care for less than 90 days may be allowed to stay in specialty care if certain obligations are met.

 Covid-19-related Admittance Rules
During the pandemic, assisted living homes may choose not to admit residents. If they do, these rules apply:
– New residents need doctor’s written assurance that the person is free from contagious disease.
– Family members may not help with move-in, because visitors are not allowed during the pandemic.

 

Facility / Residence

Private living units or bedrooms must be at least 80 square feet for one person and 130 square feet for two people. Two is the maximum allowed in one unit in specialty care. There must be a toilet and sink for every six residents and one shower for every eight residents. Alarm systems and fire detection including sprinklers and smoke alarms must be up to building codes.

Alabama does not have specific rules about the design itself. For instance, no dementia-friendly circular hallways (that don’t come to a dead end) or outdoor spaces are required by regulations. You’ll want to inspect the buildings yourself to make sure they’re good for your loved one.

 Covid-19 Updates for Facilities / Residences
During the Covid-19 pandemic, social distance must be maintained during activities and meals. Staff is required to keep people at least four to six feet apart at all times. Sitting side-by-side at tables is not allowed, and dining areas must have fewer than 25 people at a time.

 

Staff & Training

At least two employees must be on-duty at all times in specialty care assisted living homes. Every specialty care home must have a medical director who is a physician licensed to practice medicine in Alabama, and who is responsible for implementation of care policies and coordination of medical care in the residence. Additionally, every residence needs to employ a registered nurse and a unit coordinator who manages daily routine operations. All staff who have contact with patients must receive appropriate training, including the Dementia Education and Training Series on dealing with issues related to Alzheimer’s and other dementias, and at least six hours of continuing education annually. During the Covid-19 pandemic, all employees must be screened for signs and symptoms of the virus at the beginning of their shifts.

 Did You Know? Alabama is projected to go over 100,000 cases of Alzheimer’s disease by the year 2025. And even though it ranks near the middle of American states in terms of percentage of residents with dementia, the state had the most Alzheimer’s-related deaths in the nation, per-capita, in 2018.

 

Eviction Rules

Very broadly, a person can be evicted if their medical condition, including the level of cognitive impairment, cannot be managed within the community. For example, someone who suffers a medical emergency and needs full-time nursing care would need to be discharged to an appropriate residence. If someone’s mental state got so bad that they needed to be physically restrained for the safety of others, this would be another reason for eviction.

Regulations do not say that residents can be evicted for nonpayment. The reasons a person can be evicted must be spelled out in the agreement signed at move-in, so check this document to know whether failing to pay on time is a possible reason for being asked to leave. If your loved one goes on Medicaid, which does not offer help with paying for memory care in Alabama (see below), this may also affect eligibility for living in memory care. Again, check your move-in agreement or ask management.

Regulations do not say a residence must help you find a new, more appropriate home for your loved one if eviction becomes necessary. For tips on evictions, including what to do if you receive an eviction notice, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

In Alabama, unlike other states, there are no Medicaid programs that help pay for costs in assisted living. However, Medicaid will pay for nursing home care for residents with dementia that require that level of care. The American Council on Aging provides a free, fast and non-binding Medicaid eligibility test on their website.

 

Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Relevant in all states including Alabama is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is an amount of money added to veterans’ and survivors’ basic pensions. Applicants must be at least 65 years old (or disabled) and require assistance with activities of daily living (ADLs) like eating, bathing, and mobility. The cash assistance from these pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from one’s income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2020) maximum amount a veteran can receive through A&A is $27,194 per year, and surviving spouses can receive as much as $14,761. Learn more here.

 As few as one out of every seven veterans who are eligible for Aid & Attendance money have applied to receive it. If you’re eligible, apply as soon as possible, because it takes an average of nine months to be approved.

There are also four veterans’ homes in Alabama, which are residential care facilities that provide long-term care for veterans. They are in Alexander City, Minette (in the southern part of the state), Huntsville, and Pell City. Florida has twice as many VA homes, and Tennessee and Mississippi also have more VA homes than Alabama, so veterans looking to move into one of these residences might consider going outside their state.

In addition to nursing home care, assisted living and memory care may be provided. Payment is made directly from the VA to the facility. State veterans’ homes are typically reserved for veterans whose need for care stems at least 70 percent from their military service. Because there is often a waiting list, contact a home before visiting to see if your loved one is eligible to live there.

 

Other Options

Other ways to help pay for memory care include tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that may include some assisted living costs.

A reverse mortgage may be a good option for a married person moving into memory care, if their spouse continues to live in the home. Should the spouse move from their home, the reverse mortgage would become due.

Elder care loans are for families to cover initial costs of moving into memory care, if you need a little help at first but can afford costs after the initial payments. For example, if one is waiting for a VA pension to be approved or waiting to sell a home.