“Assisted living residences” in Colorado offer room, board, and meals to three or more adults, as well as providing security, supervision, personal care, and social services. Care and services include things like transportation and help with activities of daily living (ADLs) like grooming or getting dressed. Someone who needs 24-hour nursing care typically may not reside in an assisted living residence, but ALRs may provide memory care for people with Alzheimer’s disease, or related dementia, in the entire residence or in a secured wing.
An ALR with memory care (also called “Alzheimer’s care”) must go further, offering the following:
– A detailed assessment to determine the resident’s personal needs (see below)
– Secured spaces with special locking devices
– Enhanced monitoring to ensure safety indoors and outside
– Specialty services like activities to strengthen memory and encourage socialization
Assisted living in Colorado is regulated by the Department of Public Health and Environment.
The average cost of memory care per month in Colorado is $5,384, which breaks down to about $177 per day and $64,608 annually. Remember to fully research the costs at any memory care home, asking for a complete list of fees and charges including any potential add-ons. Assisted living, without the additional services required for memory care, costs Colorado residents about $4,115 per month and $49,380 annually.
The state’s most expensive place for memory care is Boulder, where it costs about $6,222 per month and $74,664 annually. Memory care is much cheaper in Colorado’s rural areas, outside its cities, at about $4,467 per month and $53,604 annually. In Denver, the state’s biggest city, memory care costs about $5,903 per month and $70,836 annually.
A pre-admission assessment is required for all residents in assisted living and must be updated at least annually. This is because ALRs may not admit someone whose needs cannot be met by the services provided therein. There is not a standard assessment form, but the screening must determine:
– Physical, health, and social needs
– Preferences (cultural, religious, etc.)
– Ability to self-care
The following information must be provided to anyone moving into a Colorado ALR:
– Right to receive CPR (residents may refuse to be resuscitated)
– Minimum staffing levels (see below)
– Policy on whether ALR has staff awake during nighttime hours
– Emergency alert devices and evacuation plan
– Individualized care plan
– Smoking prohibitions
– On-site location of latest inspection report
– Upon request, a copy of most recent licensing rules
Someone who requires regular 24-hour medical or nursing care may not be admitted into an ALR, and neither can a person with a history of conduct that poses a danger to self or other residents.
A single-person living unit or bedroom must be at least 100 square feet, not including bathroom and closet areas, and a two-person unit must be at least 120 square feet. Two people is the maximum allowed in one room, unless the residence was built before 1986. One bathroom with a sink, toilet, and shower must be provided for every six residents. Alarm systems and fire detection including sprinklers and smoke alarms must be up to building codes.
There is no required staff-to-resident ratio in Colorado, except that staffing must be adequate to meet the needs of every resident on-site, and at all times there must be at least one person working who has CPR and first-aid certification. Every employee or volunteer at an ALR must have an orientation to start the job including:
– care and services provided at the specific residence
– residents’ rights
– overview of state regulations
– infection control
– emergency response
– reporting requirements
Administrators must go through a background check and be at least 21 years old, with experience including one year supervising administration of personal care services such as help with activities of daily living like eating and dressing. Forty-five hours of care-related training is required for administrators, and 40 hours of administrator training are also required.
This waiver provides financial assistance for people who may need nursing-home-level care but want to stay in their residence of choice, including ALRs. Services covered do not include room and board, but additional costs of assisted living like laundry, housekeeping, and medical help may be covered. Among the eligibility requirements for Colorado residents is income (for one person) under $2,349 per month in 2020. This program’s full name is the Home and Community-Based Services Waiver for Persons Who Are Elderly, Blind and Disabled (HCBS-EBD). The waiver is available state-wide but may enrollment be capped, so eligibility doesn’t guarantee availability. This means there might be a significant wait time to receive benefits. More information is available on the state’s website here. To apply, contact the Colorado Single Entry Point Agency in your area.
Elderly, low-income Colorado residents may be eligible for financial help with costs including services in assisted living. The Old Age Pension is meant to bridge the gap between a person’s monthly income and a reasonable cost of living. Someone in the program can receive more than $800 per month, depending on income and enrollment in other programs like Social Security. To apply, contact your County Department of Human Services office here.
Someone in the early stages of dementia may be eligible for financial assistance through the Adult Foster Care Program. Adult foster care homes are for people who can live more independently in a family-like environment. This is not appropriate for someone in memory care, but someone with early-stage dementia who is still relatively independent and functional may benefit. Among the costs covered are meals, transportation, and help with activities of daily living. To apply, contact your local County Department of Human Services here.
Veterans are statistically more likely to develop dementia. Relevant in all states including Colorado 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 Colorado, 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.
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.