Hawaii Residential Alzheimer’s Care (Memory Care): Rules, Costs & Financial Help

Legal Definition of Assisted Living / Memory Care in Hawaii

An assisted living residence in Hawaii offers apartment-style living for people who cannot live independently, including those with dementia. Regulations require these communities have:

– Staff on duty 24 hours per day
– Assistance with activities of daily living 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
– Housekeeping
– Nurses who monitor health and perform routine nursing duties
– Transportation to medical and social appointments
– Recreational opportunities
– Social work services
– Maintenance of personal funds for residents

There are no additional requirements for services or staffing at memory care homes that admit people with Alzheimer’s disease or a related dementia.

The Hawaii Department of Health’s Office of Health Care Assurance regulates assisted living and memory care in the state. There are approximately 30 residences with memory care. Hawaii also has 11 board and care homes, which are smaller home-like residences that offer the same types of services as assisted living, including dementia care. For free help finding a home in Hawaii to meet your loved one’s needs and budget, click here.

How Much Does Memory Care Cost in Hawaii?

The average cost of assisted living with memory care in 2024 in Hawaii is $7,036 per month. Costs vary widely across the state, from The Big Island to Kauai. Hawaiian memory care is more expensive than the average for mainland states and above the national average of $5,884.

The most expensive place for care is outside of the larger town and throughout its rural parts. For memory care, they are averaging $7,195 monthly. On Maui, in Kahului, the monthly average for memory care is slightly less expensive, costing $5,009 per month. In the state capital of Honolulu, it costs $7,036 monthly.

It may be possible for Hawaiians to find more affordable memory care if they were to look outside the state. Since the geographical location leads to the disadvantage of not having shared borders in multiple directions, this might not be a viable option for most. The bottom line is that it is possible to find more options and possibly save on memory care if your loved one is willing to travel outside the state.

Hawaii Assisted Living Laws & Regulations

Admissions Process & Requirements

All patients must complete a full assessment before they move into an assisted living community in Hawaii. This details what their needs are and how the facility can best support them. The assessment must be conducted by a medical professional who works for the residence and periodically updated. The cost of this assessment may be included in the base rate or may be a one-time payment often called a community fee that covers the assessment, the creation of a personal care plan, and any other initial details like preparing your loved one’s apartment. These fees generally run $1,500-$2,500. The assessment details the following:

– Ability to be involved in residence functions

– Support needed to help with basic functions while preserving your loved ones dignity, privacy, choice, individuality and independence

– Family members who may help with delivering services

The assessment will reveal which activities of daily living, like eating and bathing, your loved one needs the most help with. The assessment is the key tool in developing an individualized care plan that details how the residence can best support your loved one.

You do not need to have a diagnosis of Alzheimer’s disease or dementia to move into memory care. Dementia is difficult to accurately diagnose because different diseases can seem similar. Finding a home that links symptoms with the right care is crucial. This means the residence is supporting your loved ones symptoms rather than a specific disease.

Facility / Residence

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 also no rules distinguishing the design features in Hawaiian memory care residence from regular assisted living. People with dementia benefit from special architectural features in their home communities. This means things like outdoor spaces that are secure to prevent wandering and circular hallways that don’t come to a dead end. Before entering into a contract with a memory care residence, inspect the facilities with an eye on whether your loved one can be comfortable in the spaces. Freedom of movement without concern for confusion or safety are most important.

Staff & Training

There are no required staff-to-resident ratios in Hawaiian assisted living homes. All staff must be trained in CPR, and a nurse must always be available. Nurses also do the resident assessments and train staff. Administrators must be licensed by the state after completing additional educational and work experience. All staff must undergo training after being hired. Following that, six hours of continuing education is required annually. It covers:

– Philosophy of the facility
– Emergency procedures and disaster plans
– How to best care for patients based on individual needs and service plans
– Appropriate activities for groups and individuals

Evictions

Residents must receive at least 14 days notice before being discharged from Hawaiian memory care. The reasons your loved one could be evicted are:

– Behavior poses a threat to themselves or others
– There is a documented pattern of breaking residence rules

Someone may also be evicted if their care needs cannot be met at the residence. Because Alzheimer’s disease and dementia are progressive, meaning they get worse over the course of its stages. That means your loved one’s new home should anticipate changes to the type of care needed, making an eviction for this reason less likely. Each individual residence has their own rules as to the eviction process and what would cause it. Questions like: Can someone be evicted for late payment of bills, or for verbal abuse? What is the process of appealing an eviction, and does the residence help find more appropriate housing? The answer to these details are important because unfair evictions are a major problem in assisted living. Before agreeing to a move-in contract, make sure you know all the possible reasons a person can be kicked out, and what the steps are. Get these details in writing, so you’re protected. If your loved one in memory care receives an eviction notice and you need to know next steps, click here.

Financial Assistance for Residential Alzheimer’s Memory Care

Med QUEST Integration Program

Hawaii’s Medicaid Program, Med QUEST, covers services including the costs of care in assisted living residences. This program is designed to help those who need additional support services stay in their homes or communities longer and not have to move into a nursing home. Participants must demonstrate a nursing home level of care, meaning they require assistance with multiple activities of daily living. Hawaii Medicaid eligibility requirements in 2024 also include monthly income under $1,398 and assets less than $2,000 for a single person. There are multiple pathways to receiving benefits so if your loved one doesn’t meet certain requirements they may still be able to work with the state to sign up. Special medical equipment, adult day care, respite care, skilled nursing, transportation, and assisted living expenses (that are not room and board) are among the services covered under this plan. There is no waiting list or cap on enrollment. To apply, visit the state’s MyBenefits webpage here. Alternatively, read Med QUEST eligibility criteria here or take a Medicaid eligibility test.

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 as well as 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 one state Veterans’ Home in Hawaii. Located in Hilo, on the Big Island, Yukio Okutsu Veterans Home provides long-term residential care for veterans. In addition to nursing home care, assisted living and memory care may be provided. Normally, looking at neighboring states for more options of veterans’ homes would be a good idea. Because of its geographical location, there are no close options near the islands. This still might be an option for some because there are no requirements that one must live in the state. More info.

Other Options

1) Elder care 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.