An assisted living residence in Hawaii offers apartment-style living with services that help residents be as independent as possible. Regulations require these communities have the following:
– Staff on duty 24 hours per day
– Assistance with activities of daily living (ADLs) like eating and bathing
– Three meals daily, including modified meals (approved by a dietician) for people with special dietary needs
– Laundry services
– Activities that encourage socialization
– Nurses who monitor health and perform routine nursing tasks
– Transportation to medical and social appointments
– Recreational opportunities
– Social work services
– Maintenance of personal funds for residents
Unlike in other states, there are not additional requirements for services or staffing at homes that admit people with Alzheimer’s disease or a related dementia. (These homes are often called “memory care.”) The Hawaii Department of Health’s Office of Health Care Assurance regulates assisted living in the state.
The average cost of assisted living with memory care in Hawaii is $5,743 per month, which breaks down to about $188 per day and $68,916 annually. If you are considering moving into any assisted living home in Hawaii, ask for a breakdown of costs including base rates and any additional fees, including for optional services. File this information, in case there are unexpected charges in the future. Assisted living, without the additional services required for memory care, costs Hawaiians about $4,389 per month and $52,668 annually.
The state’s largest city, urban Honolulu, is also its most expensive place for memory care. The average cost of memory care there is $5,903 per month and $70,836 annually.
A full assessment of residents’ needs is required before they may move into assisted living homes in Hawaii. There is no standard form for this assessment, but it must be periodically updated and include the following:
– Ability to be involved in residence functions
– Support necessary to preserve dignity, privacy, choice, individuality and independence
– Family members who may help with delivering services
A residence may not admit someone whose needs cannot be met there. If someone needs to be evicted because of dangerous behavior or because their needs can’t be met, then 14 days notice is required.
Every bedroom must be at least 220 square feet and include a bathroom with a sink, shower, and toilet, and a kitchen with a refrigerator, sink, and cooking space. There are no rules about how many residents may live in a single room.
There are no required staff-to-resident ratios in Hawaiian assisted living homes. All staff must be trained in CPR, and a nurse must be available seven days per week. Nurses must also make resident assessments and train staff. Administrators must be licensed by the state after acquiring adequate educational and work experience. All staff must have an orientation upon hiring that covers philosophy, organization, practice, and general goals in assisted living. Six hours of in-service training is also required annually.
Hawaii’s Medicaid Program Med QUEST covers services including the costs of care in assisted living residences. Eligibility requirements include monthly income under $1,224, but Hawaii has multiple pathways to receiving benefits and if someone doesn’t meet certain requirements they may still be able to work with the state to sign up. Special medical equipment, transportation, and assisted living expenses (that are not room and board) are among the services covered under this plan. For more information, click here. To apply, visit the state’s MyBenefits webpage here. Alternatively, read Med QUEST eligibility criteria here or take a Medicaid eligibility test.
Veterans are statistically more likely to develop dementia. Relevant in all states including Hawaii is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is 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 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 $14,761. Learn more here.
There is also a State Veterans Home in Hilo (Yukio Okutsu) that provides long-term residential 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 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 claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that might 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, the reverse mortgage would become due.
Elder care loans are for families to cover 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.