Delaware Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help
Legal Definition of Assisted Living / Memory Care in Delaware
In Delaware, housing communities that offer room and board with security, supervision, and personal and health care for patients who cannot live independently are called assisted living facilities. Medically stable residents enter into a service agreement with the care facility to receive personalized care. A service plan is created which includes details the activities of daily living a resident needs help with, such as dressing, eating, going to the bathroom, etc. Assisted living in Delaware must also provide activities and opportunities for socialization.
An assisted living home that offers specialized care for people with dementia, also called memory care, must have policies and procedures that go beyond regular care and address the needs of people with Alzheimer’s disease. Extra security is required, and staff at these residences must have additional training, though regulations are not specific about what it needs to be about.
There are approximately 20 memory care communities in Delaware. There are also about four board and care homes, which offer services similar to assisted living in a smaller, more home-like environment. Assisted living and memory care in Delaware are regulated by the Department of Health and Social Services, Division of Long Term Care Residents Protection. Delaware residents can receive free assistance in locating and evaluating memory care homes to ensure they meet one’s needs and budget. You can begin this process by completing this short form, click here.
How Much Does Memory Care Cost in Delaware?
The average cost of assisted living with memory care per month in 2024 in Delaware is $7,831. Delaware is one of the most expensive states in the country for assisted living and memory care. In Dover, memory care costs $7,951 per month.
Families seeking more affordable options may find slightly less expensive memory care in neighboring states. This can be especially true in Maryland and Pennsylvania. In Maryland, the average cost of memory care is $6,400 per month. To the north in New Jersey, memory care costs about $8,507 per month. Additionally, to the north in Pennsylvania, the average cost is about $5,367 per month and $7,434 in Philadelphia. These costs will vary because all assisted living community costs are different. If your loved one is in New Castle, Kent, or Sussex County and has dementia you might look at options out-of-state.
Delaware Assisted Living Laws & Regulations
Residents – Their temperatures are checked and patients are also tested regularly.
Visitors – Can visit loved ones, must wear a mask, and temperature is checked upon entry.
Staff – Have temperatures checked upon entry and are regularly tested.
Admissions Requirements
Within 30 days of moving into a residence, your loved one must have an assessment completed by a registered nurse or another medical professional who works for the residence. This evaluates your loved one’s personal and healthcare needs. The assessment is to be completed on an official form (available here) and includes sections on the individual’s ability to perform activities of daily living, dietary requirements, medical history, and more. Whether you pay extra for this assessment will depend on the residence; there may be a community fee that covers multiple move-in costs including the assessment and other details like getting the living unit cleaned and painted. A medical evaluation by a doctor is also required within the same time frame. This evaluation may be paid for by the residence but, again, it depends on the specific assisted living community’s policy. Anyone considering moving into a Delaware assisted living home is entitled to a document that lists all charges and potential charges, and this document will tell whether assessments and evaluations are covered.
Moving into memory care does not require an official diagnosis of Alzheimer’s, vascular dementia, or any other related disease. The services a residence provides are based on treating your loved one’s symptoms. Assisted living, especially memory care, needs to match your loved one with a staff that can help with specific needs, not necessarily a specific disease.
Memory care homes must provide potential residents with a detailed list of services suitable for people with dementia, including specialized staff training. Be sure to file this document in case of new management or any other change at the residence. Someone with the following issues may not be admitted into assisted living or memory care in Delaware:
– Needs full-time nursing care
– Needs special supervision and regular adjusting of medications
– Is medically unstable
– Is bedridden for more than 14 days
– Has stage III or IV skin ulcers
– Needs a ventilator
– Needs to be isolated due to any disease or condition
– Has an unstable tracheotomy or PEG tube
– Is dangerous to self or others
– Has unmanageable behavior
And while it might be possible for someone to move into memory care in Delaware on short notice, this is not a good idea. Finding the right home takes months of investigating residences and asking questions of staff and others who live there. Ideally, you would begin searching for memory care before a move becomes necessary. The sooner you begin investigating options, the more input the person with dementia can have on the decision.
Facility / Residence
Bedrooms must be at least 100 square feet for one person or 160 square feet for two people, not including closets and bathrooms. Two is the maximum number of people allowed to live together in one room. Rooms must have a kitchen, or there must be a kitchen that’s easily accessible for all residents. One bathroom with a toilet, sink, and shower or bathtub is required for every four residents. A plan for emergency and fire safety must be put into place, and staff must be drilled regularly.
Unlike many other states, Delaware regulations do not require dementia-friendly building layouts, like curving hallways that do not lead to dead ends. Before choosing a home, be sure to inspect it with an eye on whether someone with Alzheimer’s disease can easily navigate corridors. Secure outdoor areas are also beneficial for people with dementia, and Delaware does not have a rule requiring outdoor access for memory-care residents, so look for these as well.
Staff & Training
There are no required staffing ratios in Delaware for assisted living. There must be enough staff to adequately meet the needs of every resident. Likewise, regulations do not specify requirements for staff training, only that training must be adequate to meet all residents’ needs.
Orientation is required for all new staff. At least one awake staff member must be in residence. Every residence must have a nursing director who is also a registered nurse, and all administrators must maintain certification with the state.
Eviction Rules
Regulations in Delaware do not have rules about the process for evicting someone in assisted living. This means that facilities will set their policies. It’s very important to be clear on what exactly it would take for your loved one to be asked to leave. Can you be evicted for nonpayment? Will a change in medical condition mean you need to find another home? These are important questions to ask upfront. Get the policy in writing before agreeing to a move-in contract. Aggressive or inappropriate behavior can get your loved one evicted from assisted living, but only after the residence has documented the behavior for 60 days, and made a reasonable effort to fix the problem. If you receive an eviction notice and need to know the next steps, click here.
Financial Assistance for Residential Alzheimer’s Memory Care
Diamond State Health Plan-Plus (DSHP-Plus)
The Diamond State Health Plan-Plus is a Delaware Medicaid program that provides funds for people who are elderly or low-income to cover the costs of medical care at home, in a nursing home, or assisted living. The sub-program that helps pay for assisted living (including memory care) is called Long Term Care Community Services. It covers personal care and medical services, including assistance with activities of daily living like eating and bathing, but will not cover room and board. To receive support through this program, your loved one must be Medicaid-eligible (see Delaware Medicaid eligibility guidelines by clicking here), including a monthly income of less than $2,358 in 2024. A Medicaid eligibility test for Delaware is available here. Other services covered can include transportation, medical equipment, and physical and occupational therapy. To learn more, download the state’s DSHP-Plus pamphlet. To apply, contact your local Division of Medicaid and Medical Assistance or through the Delaware ASSIST website.
Veterans Affairs (VA)
Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia and different pension types.
VA Pensions
There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:
1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:
– Veterans without spouses or children up to $16,551
– Veterans with dependent spouses or children up to $21,674
– Surviving spouses without dependent children up to $11,102
2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:
– Veterans without spouses or children a maximum of $27,609
– Veterans with dependent spouses or children a maximum of $32,729
– Surviving spouses without dependent children a maximum of $17,743
3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:
– Veterans without spouses or children a maximum of $20,226
– Veterans with dependent spouses or children a maximum of $25,348
– Surviving spouses without dependent children a maximum of $13,568
Veterans Homes
There is also one veterans’ home in Delaware, which is a residential care facility that provides long-term care for veterans. It’s in Milford, in the central part of the state, and accepts residents who need nursing-home-level care. Memory care may be provided. This is a facility that provides long-term residential care for veterans. They also have a special wing that has 30 beds for Alzheimer’s care. In addition to nursing home care, assisted living and memory care are provided. Neighboring states also have veterans’ homes. Your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Pennsylvania has six veterans’ homes statewide. Additionally, New Jersey has three facilities and Maryland has one. More info.
Other Options
1) Eldercare loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.
2) 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 can include assisted living costs.
3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.