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 dementia. More specifically, staff must be able to assist residents with all activities of daily living (ADLs) at any time day or night. The home must offer social and recreational activities, transportation to appointments, housekeeping services, three meals per day, and assistance with medication.
Arkansas also has Level 2 ASCUs which offer the same services but have registered nurses on staff to provide more specialized healthcare.
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 $4,148, which breaks down to about $136 per day and $49,776 annually. Arkansas regulations say a current statement of all fees and charges must be provided to all potential residents. File this information as defense against unexpected charges. Assisted living, without the additional services required for memory care, costs Arkansas residents about $3,170 per month and $38,040 annually.
The state’s most expensive city for memory care is also its biggest: Little Rock, for about $6,262 per month and $75,144 annually. The cheapest place is Pine Bluff, for about $3,470 per month and $41,640 annually.
Though there is no standard form, every assisted living facility must perform an “initial evaluation” of every resident before admittance. This is undefined in regulations, but probably means an assessment of personal and health requirements in order to plan for every potential need.
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 explicitly explains the forms of care, treatments, and related services that are suitable for people with dementia, as well as a breakdown of costs.
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.
All staff in an ASCU 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.
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 ALDs, are paid for by the program, while room and board is not covered. Applicants must be Medicaid-eligible, including monthly income under $2,349. 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 also veterans homes in Arkansas, which are residential care facilities that provide long-term care for veterans. 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.
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.