Assisted living homes for people with Alzheimer’s disease, or a related dementia, are called “Endorsed Memory Care Communities” (MCC) in Oregon regulations. 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 (ADLs) like eating and grooming, and meet whatever health and social needs residents require to thrive. Other minimum requirements:
– Three nutritious meals daily, plus snacks, from menus made with input from residents
– 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. There are 250 MCCs in the state. There are also 75 board and care homes, which offer the same services as assisted living (sometimes including memory care) in a smaller more house-like setting, usually for fewer than 12 people. For free help finding memory care to meet your family’s needs and budget, click here.
The average cost of memory care per month in Oregon is $5,488, which is about $65,856 annually. Oregon is one of the more expensive states for memory care; the national average for monthly costs is roughly $5,000.
The state’s most expensive place for memory care is Eugene, where memory care costs about $6,421 per month and $77,052 annually. The most affordable place is Grants Pass, for average costs of about $4,699 per month and $56,388 annually. In the Portland area, including Hillsboro and Gresham, memory care costs about $5,704 per month and $68,448 annually. Other notable Oregon cities and memory care costs:
|Oregon Memory Care / Assisted Living Costs (updated Feb. 2021)|
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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 residents’ 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 an eviction
– 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
– Staff training topics and amount, and names of trainers
– 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 (ADLs)
– Ability to perform instrumental activities of daily living (IADLs)
– Skin condition
– Nutrition needs
– Medical treatments required
– Nursing needs
– Risk indicators
The residence is responsible for these evaluations, which are used to make a personalized service plan that details how exactly a person will be cared for. A medical professional working for the home performs the assessment. If the cost of assessing isn’t included in the base rate, then there may be a one-time move-in fee, called a “community fee,” that covers up-front expenses including the assessment and also things like deep cleaning and painting a new resident’s room. Community fees usually run between $1,500 and $2,500.
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
There is not a rule requiring that a person be diagnosed with dementia in order to move into memory care in Oregon. Many people with Alzheimer’s, or a related disease like frontotemporal, vascular, and Lewy body dementia, are never officially diagnosed because symptoms can vary widely and the process involves expensive tests like PET brain scans.
Regulations in Oregon differentiate between assisted living 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. No more than two people may live in one room.
Oregon regulations say the physical design of a building must be beneficial for people with dementia (the exact wording is “maximize functional abilities” and “accommodate behavior related to dementia”). This means clear sight lines and a layout that’s easy to navigate, soft paint colors, bright lighting, and secure outdoor spaces. Hallways that run circular to avoid dead ends have been shown to allow for wandering without a person becoming agitated. Special locks or security are also necessary to prevent a wandering resident from getting outside.
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 behavioral symptoms in early, middle, and late stages
– Techniques for understanding and managing symptoms
– Strategies for encouraging socialization and providing meaningful activities
– Addressing pain
– Providing proper nutrition
– Preventing wandering
A resident must be given 30 days notice before getting evicted, though that requirement might be waived if there is an urgent situation involving health and safety. Before evicting, the memory care community must try to resolve the issue or otherwise demonstrate that the eviction is a last resort.
These are the reasons a resident can be asked to leave:
– Care needs can no longer be met at the memory care community, possibly because of a change in medical condition
– Dangerous behavior
– Cannot evacuate in an emergency
– Drug use or other criminal activity
– Non-payment of bills
Memory care communities in Oregon may have their own further guidelines on what can get a person evicted. It’s very important to ask exactly how and why a person can be evicted before agreeing to a move-in contract, because unfair evictions are a major problem in assisted living. Get the answers in writing. If you’ve received an eviction notice in an Oregon assisted living home and need to know next steps, click here.
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.
Because men and women who see combat have higher rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), 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 income improvement pension that adds money 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 pay for 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 (2021) maximum amount a veteran can receive through A&A is $27,540 per year, and surviving spouses can receive as much as $14,928. Learn more here.
There is also one veterans’ home in Oregon, which is a residential care facility that provides long-term care for veterans. The Oregon Veterans Home is located in The Dalles, along the Columbia River and the state’s northern border. In addition to nursing home care and assisted living, memory care is provided. Payments are 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. Click here for contacts and more information.
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.