In Louisiana, the official term for assisted living for people with Alzheimer’s disease or another dementia (memory care) is “Alzheimer’s Special Care Units” within an “Adult Residential Care Provider.” ARCP services include lodging, housekeeping, meals, and help with activities of daily living (ADLs). These residences must also provide activities that encourage socialization, including taking residents out into the community.
The Alzheimer’s Special Care Units must go further, either segregating or providing a special program for people with dementia. An enclosed outside area is required, so residents can safely go outside. There also may be special locks on doors, to prevent wandering. Special training is required for staff (see below).
The Louisiana Department of Health, Health Standards Division, oversees assisted living in the state.
The average cost of memory care per month in Louisiana is $4,786, which breaks down to about $157 per day and $57,432 annually. Remember that all costs, including additional costs not included in the residence’s base package, must be disclosed to anyone considering moving into memory care. There should never be surprises in billing. Assisted living, without the additional services required for memory care, costs Louisiana residents about $3,658 per month and $43,896 annually.
The state’s most expensive place for memory care is also its biggest city: New Orleans Special Care Units for people with dementia are about $6,182 per month and $74,184 annually.
The cheapest city for memory care is Hammond, for about $3,949 monthly and $47,388 annually. The second-largest city in Louisiana is Baton Rouge, where memory care costs about $4,347 per month and $52,164 annually.
An assessment is required before someone can move into Adult Residential Care in Louisiana, including Alzheimer’s Special Care Units (also called “memory care”). The assessment, or screening, must determine a resident’s mental and physical health status. It also assesses how much help the residence will need to provide for activities of daily living, like eating and dressing, and instrumental activities of daily living, like managing money and cooking.
Assisted living homes must provide the following information to anyone considering living there:
– How to apply and reasons an application might be rejected
– Types of residents the home can serve (what level of care)
– Services offered and allowed
– Responsibilities of residents
– Smoking policy
– Pet policy
– All fees, including additional costs
– Criteria for eviction
Someone with the following issues may not be admitted into assisted living in Louisiana:
– Stage 3 or 4 pressure ulcers
– Nasogastric tubes
– Ventilator dependency
– Continuous IV/TPN therapy
– Vacuum-assisted wound closure
– Requiring physical or chemical restraints
– Anyone who is dangerous to themselves or others
Very basically, no assisted care residence in Louisiana may admit someone whose needs cannot be met there. A resident may, however, coordinate with the residence to receive appropriate third-party care from an outside doctor.
Bedrooms in Louisiana assisted living homes must be at least 100 square feet for a single occupant, and 170 square feet for two occupants. Louisiana has a Level 3 qualification for residences that offer independent apartments equipped with kitchenettes, and these must have a living area that’s at least 190 square feet. (Level 3 homes may not be good for someone with dementia, except in the earliest stages.) There must be at least one bathroom for every four residents. Grab bars and non-stick flooring must be installed in every shower and bath area.
There is no staff-to-resident ratio in Louisiana, but assisted living homes are required to have the following: a director, a designated recreational/activity staff person, and a direct-care staff person. A director must meet qualifications including a college degree and at least three years of experience in a relevant field. Directors are also required to have 12 hours of training annually.
Memory care staff dealing directly with residents must have eight hours of dementia-specific training within 90 days of hiring, and eight more hours annually. This is in addition to the requirements for all assisted-living staff in the state, including 12 hours of annual training on:
– Resident policies and procedures
– Emergency response and evacuation
– Residents’ rights
– Reporting abuse and critical incidents
– Infection control
This Medicaid waiver replaced the Elderly and Disabled Adult Waiver, and is designed to keep people who need nursing-home-level care in their home of choice (which may include memory care) in order to lower costs. Community Choices provides financial assistance to cover healthcare needs including case management, healthcare equipment, therapies, and assistance with ADLs. A person must be eligible for Medicaid to apply. Keep in mind that there is a waiting list, and highest priority is given to applicants who have experienced abuse or neglect. For more information, click here. Read Louisiana Medicaid eligibility requirements or take a Medicaid eligibility pre-screen.
Another Medicaid program for people who need nursing-home-level care but want to avoid the high cost of actually living in a nursing home, LT-PCS provides financial help to cover activities of daily living for adults with disabilities. Eating, bathing, dressing, and help getting to medical appointments are among the services this program covers. Applicants must already be enrolled in Louisiana Medicaid. Unlike the Community Choices Waiver detailed above, LT-PCS does not have a waiting list. To apply, contact your local Area Agency on Aging, or call Louisiana Options in Long Term Care at 1-877-456-1146. Read Louisiana Medicaid eligibility requirements or take a Medicaid eligibility pre-screen.
Permanent Supportive Housing (PSH) in Louisiana is designed to offer low-rent living units providing limited healthcare services to low-income elderly people with mental disabilities, including disabilities developed due to aging. Applicants traditionally have had difficulty living successfully in a community. There may be a significant waiting list for services, and people who are homeless get priority. Download the application here. Contrary to it’s name PSH is probably not a permanent solution for persons with dementia.
Veterans are statistically more likely to develop dementia. Relevant in all states including Louisiana 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 Louisiana, 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.