Commonly referred to as “memory care,” the official term for an assisted living home for people with dementia in Arkansas is “assisted living facility” with an “Alzheimer’s Special Care Unit” (ASCU). These residences offer room and board with special services specifically for people with Alzheimer’s disease or a related illness like vascular dementia. There are approximately 25 of these residences in Arkansas.
Staff at these communities must be able to assist residents with all activities of daily living (ADLs) at any time, day or night. Also required by regulations:
• Social and recreational activities
• Transportation to appointments
• Housekeeping services
• Three meals per day
• Assistance with medication
Arkansas has Level 2 ASCUs which offer the same services but have registered nurses on staff to provide more specialized healthcare. Alzheimer’s special care units are available in both levels in Arkansas; Level 2 would be a better choice for people in later stages of dementia who have other medical issues as well.
Assisted living in Arkansas is regulated by the Department of Human Services, Office of Long-Term Care.
In 2020, the average cost of memory care per month in Arkansas is $3,780, which breaks down to about $45,360 annually.
Arkansas is one of the least expensive states in the country for assisted living and memory care, but residents may still be able to find a lower-cost alternative nearby: Missouri costs even less (Missouri memory care averages about $3,450 per month and $41,400 annually), so someone living in Rogers, Fayetteville, Harrison, or another northern Missouri town may be able to find a better price across the state border. People who live in the upper and lower deltas may be interested in searching for assisted living options across the river in Mississippi, where the average cost of memory care (about $4,220 per month) is higher than Arkansas’s but still below-average compared to other states.
Arkansas’s most expensive city for memory care is also its biggest: the capital Little Rock, for about $5,700 per month and $68,400 annually. The least expensive is Pine Bluff, for about $3,160 per month and $37,920 annually.
|Arkansas Memory Care / Assisted Living Costs (updated Sep. 2020)|
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Assisted living communities must perform an “initial evaluation” of every resident before admittance. This is undefined in regulations, but likely means an assessment of personal and health requirements, at the residence itself or in the offices of a residence-approved medical professional, in order to plan for every potential need. The cost of this assessment should not be extra; it’s part of moving in. Your loved one should have a less-formal screening to begin this process, to get a general idea of whether the community is a good fit, and then the assessment is part of entering a contractual agreement to live there.
A person could move into memory care, also called “Alzheimer’s care units,” on somewhat short notice. A diagnosis of Alzheimer’s disease or related illness is not necessarily required, as long as the evaluation has determined that your loved one has needs that can be met by the staff at the residence.
Assisted living with memory care residences may not admit someone with the following conditions:
• Needs 24-hour nursing services
• Is bedridden
• Needs help moving from room to room beyond what the residence can provide
• Is dangerous to self or others
• Requires help with medication administration (except in Level 2 residences)
Any Alzheimer’s Special Care Unit must provide a prepared statement to anyone considering living there that explains the process for assessment, forms of care, treatments and related services that are suitable for people with dementia, as well as a breakdown of all costs. You’ll want to file this document in case there disputes later over care or prices.
Every apartment or living unit must be at least 150 square feet for one person and 230 square feet for two people (excluding closets and bathrooms). The maximum number of people in a living unit is two, and they must consent to being roommates. Every living unit needs a toilet, sink, and shower or bathtub.
There are rules about the physical design of Alzheimer’s care units (memory care). For people with dementia, a residence should be built with extra supervision and security to make sure wandering is not a problem. Also, hallways run circular because dead ends can be upsetting for someone who has dementia. Outdoor spaces have also been shown to help with symptoms.
All staff in an Alzheimer’s special care unit must receive eight hours of training per month in the first five months of hiring, on these subjects:
– Facility policies
– Causes, philosophy, and treatment of dementia
– Stages of Alzheimer’s disease
– Managing behavior
– Wandering control
– Medication management
– Communication techniques
– Prevention of staff burnout
– Activities programming
– Individual-centered care
– Making assessments
– Creating individual support plans
Additionally, at least two hours of inservice training is required every three months.
There is no staff-to-resident ratio in Level 1 residences, except to say staff must be adequate to meet the needs of every resident at all times. Level 2 residences must have a staffing ratio of one person on-duty for every 15 residents during daytime hours (7 a.m. to 8 p.m.) and one staffer for every 25 residents during the nighttime hours. There may never be fewer than two people on duty at a time.
Unlike other states, Arkansas does not have regulations saying a person needs 30 days notice to be evicted from assisted living. This means it’s possible your loved one could be evicted unexpectedly, so you’ll want to take steps when moving in to make sure the eviction policy is understood clearly. It is not against regulations to evict someone for not paying bills on time, for instance. Click here for more.
Very broadly, a person whose behavior becomes dangerous (to self or others) cannot continue living in assisted living. Someone may also be told to move out if they have personal or health needs that cannot be met there. Because dementia is progressive, meaning it gets worse, it is possible that a home could be a good fit in the earlier stages of the disease, and then no longer be appropriate in the middle and later stages.
The Arkansas Medicaid Living Choices Assisted Living Waiver (ALW) helps Medicaid recipients cover the costs of care in assisted living and is meant to help someone stay in assisted living when their needs become more acute, rather than moving into a more expensive nursing home. Services, like housekeeping and meals and help with activities of daily living, are paid for by the program, while room and board is not covered. Applicants must be Medicaid-eligible, including monthly income under $2,349 in 2020. Take a Medicaid eligibility test here. More information is available in a downloadable pamphlet here.
Offered through Arkansas Medicaid, Personal Care covers the costs of assistance with activities of daily living from professional caregivers, including in memory care so long as the memory care community is enrolled to receive these benefits from the state. Recipients (and their caregivers) are supposed to self-direct care through this program, deciding which services they’ll receive based on the funds provided. Recipients must be Medicaid-eligible. To apply, contact your local Department of Human Services office.
The Arkansas Independent Choices (IC) program provides a monthly cash allowance to spend on care. The funds are meant to help someone with a debilitating medical condition (like dementia) avoid moving into more expensive full-time nursing care. Benefits are intended to cover help with ADLs and medical devices, like remote monitoring, that make someone healthier or safer. More information, including contact information to apply, is available on the ARChoices Medicaid website. Program enrollees must be Medicaid eligible, see Arkansas 2020 Medicaid eligibility guidelines.
Veterans are statistically more likely to develop dementia. Relevant in all states including Arkansas 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.
There are two veterans’ homes in Arkansas, which are residential care facilities that provide long-term care for veterans. These are located in Fayetteville and North Little Rock. (Arkansans who live in the northern part of the state might note that there are seven VA homes in Missouri, so it might be a good idea to go out-of-state if you can’t find a bed where you live.)
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 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.