Assisted living homes for people with Alzheimer’s disease, or a related dementia, are called “Endorsed Memory Care Communities” (MCC). These communities offer more specialized care than assisted living and residential care facilities, in a special unit away from other residents who do not have dementia. Among the state’s requirements for an MCC are:
– Person-directed care
– Resident protection
– Staff training specifically for dementia
– Physical design and environmental requirements appropriate for residents with dementia
For more on these, see Laws & Regulations below. All assisted living and residential care homes in Oregon, including MCCs, must assist residents with activities of daily living like eating and grooming, and meet whatever health and social needs residents require to thrive. Other minimum requirements:
– Three meals daily, plus snacks
– Social and recreational activities daily
– Help with medications
– Household services (like laundry)
The Oregon Department of Human Services oversees assisted living communities in the state.
The average cost of memory care per month in Oregon is $5,903, which breaks down to about $194 per day and $70,836 annually. Assisted living homes in Oregon are required to disclose all costs, including potential additional fees beyond basic room and board, so be sure to file this information. There should be no surprises in billing. Assisted living, without the additional services required for memory care, costs Oregonians about $4,511 per month and $54,132 annually.
The state’s most expensive place for memory care is Grants Pass, where memory care costs about $6,701 per month and $80,412 annually. The cheapest places for assisted living are outside the major cities, in rural areas, where memory care costs average about $4,826 per month and $57,912 annually. In Portland, by far Oregon’s largest city, memory care costs about $6,541 per month and $78,492 annually.
Assisted living homes in Oregon (including those with MCCs) are required to provide a disclosure form to anyone who asks. The disclosure must include the following:
– Policies including possession of firearms and ammunition
– Payment details including basic rental rate and what that includes, cost of all additional services, billing method, due dates, deposit, and which fees are non-refundable
– Method for evaluating resident’s needs
– Policies for changes to costs
– Refund conditions
– Description of the total scope of services (what staff can provide)
– Philosophy on healthcare and help with activities of daily living
– Statement of residents’ rights and responsibilities
– Medication policies including administration and pharmacy choice
– Details including actions and circumstances that will result in a move-out notice
– Staffing plan
– Notice that the Department of Human Services may examine residents’ records when evaluating the residence
There are also four requirements particularly for people moving into memory care:
– Philosophy of care and services for people with dementia
– Admission, discharge, and transfer criteria
– Training topics and amount, and names of trainers for staff
– Number of direct-care staff assigned to the MCC unit during every shift
An evaluation of a resident’s needs must be made before move-in, and then quarterly (four times a year) thereafter. The evaluation must include:
– Resident’s specific routines and preferences
– Physical health condition
– Communication ability
– Ability to perform activities of daily living
– Ability to perform instrumental activities of daily living
– Skin condition
– Nutrition needs
– Medical treatments required
– Nursing needs
– Risk indicators
Someone with the following issues may not be admitted into (or may be evicted from) memory care in Oregon:
– Care needs exceeding the residence’s abilities
– Behavior that interferes with the rights, health, and/or safety of others
– Complex or unstable medical condition that the home cannot properly address
– Unable to evacuate during an emergency
– Poses a danger to self or others
– Commits a crime
– Fails to pay
Regulations in Oregon differentiate between assisted living facility and residential care facilities, both of which may have a separate wing for memory care. Assisted living facilities provide apartment-style living, with a kitchen and bathroom, and these units must be at least 160 square feet (220 square feet if newly constructed). Residential care facilities have bedrooms built around a centrally located bathroom, and the bedrooms must be at least 80 square feet excluding closets and bathrooms. The most people who can live in one room is two. All buildings must have an automatic sprinkler system, smoke detectors, and automatic and manual fire alarms. One unannounced fire drill must occur every two months.
There is no staff-to-resident ratio requirement in Oregon memory care, other than to say staff must be adequate to meet the needs of every resident at all times. Every residence must establish a system (defined in writing) to decide how many caregivers and staff are working at a time. The state’s Department of Human Services may decide to require a staffing ratio at particular residences if they find cause, including if there are complaints or a problem is found during inspection.
An administrator must be on-site 40 hours per week, and is responsible for making sure staffing is adequate for the health needs of the residents. Administrators must be at least 21 years old and have relevant experience and education. Administrators must also attend a state-approved training program for at least 40 hours before beginning the job. All administrators must have 20 hours of additional training annually, and administrators in memory care must have 10 additional hours of dementia-specific training.
All regular staffers must complete orientation before they can start work, including education on residents’ rights, community-based care, abuse and reporting requirements, standard precautions for infection control, and fire safety and evacuation procedures.
Specific dementia-care training must include:
– Education on the dementia disease process, including how it progresses and behavioral symptoms
– Techniques for understanding and managing symptoms
– Strategies for encouraging socialization and providing meaningful activities
– Addressing pain
– Providing proper nutrition
– Preventing wandering
Also called the K Option, the 1915(k) state plan, or the Community First Choice (CFC) option, this program is meant to provide financial help to people who may need nursing-home level care but wish to remain in their house or assisted living community (including in memory care). Benefits include money to cover medical devices and assistive technology, help with ADLs and IADLs, and behavioral support. To be eligible, your loved one must qualify for Oregon’s Medicaid program. For more information, visit the state’s website. Apply through your local Seniors and People with Physical Disabilities office.
The Aged and Physically Disabled (APD) waiver also provides financial help for people who may need nursing-home-level care but want to live in their own home or assisted living community (including memory care). The benefits are slightly different from the K Plan above, and recipients can be enrolled in both programs. Benefits of APD include money to move out of a nursing home into assisted living, case management, and welfare assistance. Applicants must be eligible for Oregon Medicaid. To apply, contact your local Aging and Disability Resource Center.
Veterans are statistically more likely to develop dementia. Relevant in all states including Oregon 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 Oregon, 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.