Memory care for your loved one with dementia can be provided by two types of non-nursing home residences in Michigan: homes for the aged and adult foster care. A main difference between them is that homes for the aged have a minimum age limit of 55. Both types of homes provide supervision and personal care. Regulations state that adult foster care is for people who are aged, mentally ill, and developmentally or physically disabled. They are required to offer more care services like medication administration, social activities, and assistance with activities of daily living. These services may also be provided in homes for the aged but are not mandated.
Facilities offering memory care (also called Alzheimer’s care or dementia care) must have the following information available in writing for any potential resident or caregiver:
– A philosophy and mission statement regarding the needs of residents with dementia
– The admission and eviction processes for residents with dementia
– Explanation of how a resident is assessed and how the assessment is used to create and implement an individualized care plan
– Staff training and education practices
– Dementia friendly housing, environmental and design features
– The frequency and types of activities for residents
– Explanation of any potential fees (See below for more on costs.)
Assisted living in Michigan is regulated by the Department of Licensing and Regulatory Affairs. There are approximately 380 memory care communities in the state. There are also more than 1,000 board and care homes. These offer the same services as assisted living, including memory care, but in a smaller home-like setting with fewer than 12 residents. Free assistance is available to help families find a memory care that meets your loved one’s needs and budget. Click here for more information.
The average cost of memory care per month in Michigan is $5,565. Statewide there is a large difference in the care price for your loved one.
The most expensive place for memory care in Michigan is in the southern part of the state in Ann Arbor costing $7,951 monthly. The least expensive is in Battle Creek, for $4,453 per month. In Detroit, Michigan’s most populated city, and less than an hour from Ann Arbor, memory care costs about $5,525 per month. In Grand Rapids, memory care runs about $6,321 monthly.
Michigan is in the top 10 states for the least expensive assisted living costs. Memory care there is less expensive on average than neighbors in Ohio ($6,043 per month), Indiana ($5,605), and Wisconsin ($6,003). It is still possible that residents of Michigan might find more affordable memory care outside the state because costs can vary. Other notable Michigan cities and their costs are:
Michigan Memory Care / Assisted Living Costs (updated Feb. 2024) | ||
Region / City | Daily Cost | Monthly Cost |
Statewide | $183 | $5,565 |
Detroit | $181 | $5,525 |
Grand Rapids | $207 | $6,321 |
Ann Arbor | $261 | $7,951 |
Lansing | $186 | $5,645 |
Flint | $188 | $5,724 |
Saginaw | $181 | $5,525 |
To live in a home for the aged, a written statement from a resident’s doctor about specific health care needs is required. Adult foster care guidelines are even stricter, requiring a written assessment that includes the determination that the residence can offer adequate care and that the person appears compatible with others who live there. When considering memory care for your loved one in Michigan, begin the process as soon as possible by speaking with a primary care doctor about what appointments and documents are required. The cost of these visits, before the residence assessment, will probably need to be covered by your loved one, but help with the costs might be available (see Financial Assistance below).
An individual assessment and service plan is required for every resident upon moving into either type of facility. The assessment is conducted by a health professional working for the memory care community. The cost of the assessment is usually covered by an assessment fee or a one-time community fee paid during the move-in process. The fee also covers other up-front costs like painting and deep cleaning and generally runs between $1,500 and $2,500.
Care plans that are formed to your loved one’s unique needs for physical and mental health, and must be updated by qualified residence staff annually or whenever there is a significant change in a resident’s health. Anyone who needs continuous nursing care cannot move into either type of facility, because the residences can not admit someone it cannot adequately care for.
A diagnosis of Alzheimer’s, or related dementia is not required for admittance into memory care in Michigan. Dementia is difficult to diagnose as symptoms change over time, and it’s important to find a community that serves people as individuals with unique symptoms rather than any specific disease.
Homes for the aged must have bedrooms that are at least 100 square feet. Rooms with multiple residents must have at least 80 square feet per person. A maximum of four people are allowed in one bedroom. There must be one bathroom for every eight people, and a bath or shower facility for every 15.
Adult foster care must have bedrooms that are at least 65 square feet. The maximum allowed per bedroom is two. There must be one bathroom and shower or tub for every 10 residents.
Memory care residences in either type of facility must be constructed with design features appropriate for people with dementia. Friendly features aid patients who may be prone to wandering or becoming very confused. An explanation of these design features must be included as part of written information given to all residents and their caregivers.
Regulations in Michigan say there must be an adequate number of staff who are awake and able to serve residents at all times. There is no staffing ratio in homes for the aged, but in adult foster care they must have at least one staffer for every 12 residents. All employees must have clean background checks, including fingerprinting to check for a criminal record.
In homes for the aged:
– Administrators must be at least 18 and have relevant education, training, and/or experience.
– For training, management is required to establish training programs based on the home’s program statement and residents’ service plans.
– Training must also address employee issues like reporting requirements, first aid and medication administration, residents’ rights, and infectious disease containment.
In adult foster care:
– Administrators must have a high school diploma or GED and at least one year of experience working with the population identified in the home’s program statement and admission policy.
– Administrators must also be trained in nutrition, first aid, CPR, the Adult Foster Care Act, fire safety, financial and administrative management, residents rights, and how to contain and prevent communicable disease.
– Staff must be trained in reporting requirements, first aid, CPR, personal care, supervision, protection, residents’ rights, safety and fire prevention, prevention and containment of communicable diseases.
Additionally, all staffers who work with people who have dementia must be trained to meet the specific needs of each resident.
An assisted living home in Michigan is required to give a resident 30 days notice before discharge or eviction. Unlike other states, Michigan regulations do not require the home to help find your loved one a new residence. A person may be asked to leave assisted living, including memory care, because:
– A medical condition that cannot be treated at the residence
– Represents a danger to self and others
– Destruction of property
– Non-payment
Unfair evictions are a problem in all facilities. For information on what steps to take if you receive a notice of eviction from assisted living, click here.
This Home and Community-Based Services Waiver, available through Medicaid, is meant to give extra assistance to seniors and disabled people who require nursing-home-level care but want to stay in their home, that of a loved one, adult foster care home, or in assisted living. Benefits can also aid those who want to transition from a nursing home into memory care. Participants must meet Michigan Medicaid eligibility guidelines, including a monthly income of less than $2,829 and countable assets of less than $2,000 in 2024.
Services for people accepted into the program are determined on a case-by-case basis but can include personal care within an assisted living residence. In addition to assistance with activities of daily living, benefits can include home modifications, meal delivery service, respite care, adult day care, and skilled nursing. Eligible people with Alzheimer’s or related dementia must apply for MI Choice as soon as possible because there’s a waiting list that typically takes between six months and a year before one receives entry into the program. The MI Choice Wavier Agency runs the program. To find the office in your area, including more program information, click here.
The MI Health Link is another Home and Community-Based Services Waiver that is part of the statewide Medicaid program. This waiver is meant to assist those via extra long-term care support services to stay in their community and not need to prematurely transition into a nursing home. MI Health Link is available to individuals who are eligible for both Medicare and Medicaid, combining coverages from both into one streamlined long-term care plan. Among the requirements for MI Health Link are the need for a nursing home level of care and strict financial guidelines. In 2024, they include a monthly income of less than $2,829 and countable assets that are less than $2,000. Benefits are based on an individual’s need and can include assistance with activities of daily living, transportation, adult day care, meal service, respite care, skilled nursing, home modifications, and light housework. More information is available on the program’s website here. To apply, one must be currently enrolled in Medicare and Medicaid, and qualified participants are notified by the Michigan ENROLLS. Subsequently one can also contact Michigan ENROLLS at (800) 975-7630 for further details or to apply. Michigan Medicaid eligibility requirement can be found here or take a non-binding Medicaid eligibility test here.
The Home Help Program is a benefit of Michigan state Medicaid. This program is designed to assist qualified individuals with extra care services to live independently. This includes those living in their own homes or that of a loved one and does accept applicants in adult foster care homes or assisted living facilities. Benefits are primarily based on assistance with activities of daily living but also extend to medication management, case management, meal prep, and light housework. To qualify for the program one must demonstrate a medical and financial need. A minimum of assistance with one activity of daily living is required monthly income less than $1,255 in 2024, and countable assets less than $2,000. More information is available here. To apply, contact your local Health & Human Services Office. Michigan´s Medicaid eligibility requirements can be found here or a Medicaid eligibility test can be found here.
Community Transition Services (CTS) is a program that is a unique benefit of Michigan’s statewide Medicaid program. This program aids individuals who are residing in a nursing transition back into their community. This can include their own home, that of a loved one, an assisted living facility, or an adult foster care home. There are strict eligibility guidelines that include a medical need, monthly income cap, and countable asset limits. Benefits are based on a participant’s need and can include security deposit assistance, assistance with household essentials, home modifications, and assistance with activities of daily living (while waiting for entry into a long-term care program). More information can be found on the program’s website by clicking here. Michigan’s Medicaid eligibility guidelines can be found here or a fast, non-binding Medicaid eligibility test can be found here.
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 are also two veterans’ homes in Michigan, which are residential care facilities that provide long-term care for veterans. They are the Grand Rapids Home for Veterans and the D.J. Jacobetti Home for Veterans, in the Upper Peninsula. In addition to nursing home care, assisted living and memory care are provided. There are 70 beds in the Grand Rapids VA memory care unit and 26 beds in the D.J. Jacobetti memory care unit. In addition to nursing home care, assisted living and memory care may be provided. Neighboring states have more veterans’ homes, so a loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, South Carolina has five veterans homes statewide and several are located relatively close to their shared border. Additionally, Tennessee has four facilities and Virginia has two more homes. More info.
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.